Must have an A1C of 7.0 or less for surgery

Hi.  New to this forum.  I've just been thrown for a loop.  My final appointment before my surgery is next week and I get a letter in the mail from my surgeon stating that I cannot have surgery until my A1C is 7.0 or below.  What????  If my numbers were below 7.0 I wouldn't be opting for this surgery.  I'm currently 8.3 and I've been as high as 11.4 when newly diagnosed 11 years ago.  I am very angry that this wasn't spelled out a year ago.  I wanted lap band, but 3 surgeons refused and the 4th first said yes and then changed his mind.  I know they want all their ducks in a row in order to get paid because my insurance does not preapprove.  They're going to have to do it and bill it and hope they get paid. But I come here and I see people having lap band that weigh 100 lbs more than I do (my weight one of the main reasons they don't want to do lap band)  and I see people having RNY who have A1C's way higher than 7.0.  Maybe it's because my insurance requires a Center of Excellance that I have so many obstacles to overcome?  I don't know.  I guess my question is how long is it going to take for my A1C to drop from 8.3 to 7.0? and does anyone have any suggestions on how I'm going to do this?  I have this tiny window of opportunity to have surgery between summer semester and fall semester of college.  If I don't have it by July 21 I can't have it until Christmas break.  So can I get to 7.0 in a little less than two months? Joanna

To get your A1C down, I would recommend going as low carb as possible with your diet. And test FREQUENTLY - when you get up in the morning (fasting), and then 60, 90, and 120 minutes after everything you eat to see if anything spikes you and, if so, to ensure your levels are coming back down by 2 hours out.

Otherwise, I would switch surgeons! My surgeon (also at a Center of Excellence, so that's not the issue here) never required my A1C to go down before surgery. My last known A1C pre-op was 7.9 (down to 7.2 at 1 month post-op!).

This is the 4th surgeon I've seen and I really don't want to go thru it all again.  Also I live 3 hours from any Center of Excellence and so it's hard to run back and forth.  I'm testing before breakfast, before lunch, before supper, and bedtime.  Sometimes I get up in the middle of the night and test. My youngest child just moved out of the house May 15 so I don't have to worry about feeding anyone but myself.  I haven't had any bread product since that time.  I also cut out milk.  Milk spikes my blood sugar like nothing else!  After upping my Lantus by 4 units last week my sugars are running 110-135.  This is good for me because it's usually 175-195.  But is this good enough? 

You really need to test AFTER you eat, not just before. Who cares what your glucose is before a meal if it spikes to 200 an hour or two after you eat?

I pretty much know what spikes it, milk and bread.  I always have to test before because i take insulin on a sliding scale.  But I will add some after meals testing if it will help me get to where i need to be. 8 or 9 sticks a day  ugh.  Thanks.

I know, I hate having to stick myself multiple times a day. It's hard. But it's hopefully not forever!

I had fruit the other day and tested after an hour - shot me up to 166, so no good. I avoid most fruits (except strawberries - very low on the glycemic index, and I usually have them with some protein, never alone).

Part of having a lower A1c is also for healing. If your blood sugars are higher, then you run the risk of infection and slower healing times. I would recommend a lower carb diet to get your sugars to be consistantly under 150. Good Luck!

I do understand this, but it is really frustrating.  I need the surgery to lower my blood sugar and can't have the surgery unless I lower my blood sugar.  I just want to pull my hair out.  I'm doing a modified South Beach diet at the moment.  I say modified because I have 2 pieces of fruit a day.  I guess I can "X" the fruit if that will help.  Thanks!

I wonder if they also want the A1C lower because you are going for band instead of bypass (recommend by FDA for diabetes) so they have to prove to the insurance company that you can control your diabetes with diet. I am noticing a lot of insurance companies have stricter requirements for getting the band than bypass? Just a thought.

Sorry I forgot to add that I would call and talk to the surgeon ask why? Also point out that you already went from 11.4 to 8.3 so that is showing progress.