Losing 20 pounds will lower your A1c in most cases as a 5% to 10% weight loss reduction can improve your blood sugar control significantly.
For someone weighing 200 lbs, a 10 to 10 pound weight loss is within this range and because weight loss, especially fat around your liver and your pancreas, improves insulin sensitivity, it makes it easier for the body to use insulin to manage your blood sugar levels.
Losing excess weight helps the body respond more effectively to insulin, which can also lower your A1C levels.
And studies also show that a 5% to 10% weight loss can lower your A1C by an average of 0.5% or more.
In addition to your A1C being lower, losing weight can also lower your blood pressure and reduce your risk of cardiovascular disease.
And some people that lose weight also find that they can even manage their blood sugar levels with less medication after they lose a significant amount of their weight.
To achieve weight loss, aim for at least 30 minutes of physical activity and exercise per day, as exercise is also a key part of reducing insulin resistance, with or without weight loss.
And instead of eating foods with a lot of carbs at one meal, spread the foods out throughout the day to help keep your blood sugar levels more stable.
And prioritize protein rich and fiber rich foods into your diet and cut back on foods with added sugars.
The A1C level that metformin should be started is when your A1C level is 7% or higher.
And for people with prediabetes, specifically with A1C levels between 5.7% and 6.4%, metformin is not the standard first line treatment and should only be considered for people at the highest risk.
And in cases of severe hyperglycemia, (A1C>9-10%) with symptoms, insulin is usually the recommended treatment instead.
An A1C level of 7% is the typical starting point for beginning metformin therapy for type 2 diabetes.