An HbA1c of 44 means that you are likely in the prediabetic range, but could be in the diabetic range, and therefore I would suggest being formally tested with a fasting glucose and/or a glucose tolerance test. It sounds like you have made appropriate lifestyle changes, and are not overweight, so there is not much more you can add. It may be that you have one of the unusual types of diabetes(Monogenic or LADA), but you would need further testing for this with your doctor
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