5 ways to Lower Your A1C

The A1C is a blood test that shows how well your diabetes management plan is working. Here's how to reach a healthy A1C number and avoid diabetes complications.

By Mikel Theobald

Medically reviewed by Farrokh Sohrabi, MD

Home blood sugar testing is an important and useful tool for managing your blood sugar on a day-to-day basis — but it only provides a snapshot of what’s happening in the moment, not long-term information, says Gregory Dodell, MD, an endocrinologist in private practice in New York City. That’s why your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months, called the A1C test. This provides a more accurate picture of how well your type 2 diabetes management plan is working.

Taking the A1C Test

If your diabetes is well controlled and your blood sugar levels have remained stable, the American Diabetes Association recommends that you have the A1C test two times each year. This simple blood draw can be done in your doctor's office. A1C test results provide insight into how your treatment plan is working or might be modified to better control the condition. Your doctor may want to run the test as often as every three months if your A1C is not within your target range.

What the A1C Results Mean

The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 percent signals pre-diabetes. Type 2 diabetes is diagnosed when the A1C is over 6.5 percent. For many people with type 2 diabetes, the goal is to lower A1C levels to a healthier percentage.

Your A1C goal is specific to you. Several factors come into play such as your age, how advanced your diabetes is, and any other heath conditions you have. A common A1C goal for people with diabetes is less than 7 percent, Dodell says. If you can keep your A1C number below your goal, you help to reduce the risk of diabetes complications, such as nerve damage and eye problems.

Tips for a Lower A1C

Your A1C score is a valuable part of the diabetes control picture, Dodell says, but it is not the only indicator of your health. Someone who has wide fluctuations in blood sugar levels may have an A1C at goal because the average is good. However, these day-to-day fluctuations can lower your quality of life and increase your risk of complications, he says.

Diabetes can be a tough condition to manage, Dodell says. He tells his patients to view diabetes management like a job. It takes work, but the time and effort you put into it can result in good control and an improved quality of life. “The key to reaching your A1C goal is trying to follow a healthy lifestyle,” he says.

Making these healthy changes can help you improve your day-to-day blood sugar management and lower your A1C:

• Move more. Try to get at least 30 minutes of exercise five days a week. This doesn’t have to be formal exercise, Dodell says. Find something you enjoy doing that gets your body moving — take your dog for a walk, play a sport with a friend, or ride a stationary bike indoors or a regular bike outdoors.
• Eat a balanced diet with proper portion sizes. You can load up on non-starchy vegetables, but be mindful of serving sizes when eating fruits, lean proteins, fats, and complex carbohydrates like bread, potatoes, and other starches. Using a salad plate instead of a full-size dinner plate can help prevent overeating. Avoid processed foods as much as possible and say no to sugary sodas and fruit juice. A diabetes educator or dietitian may be able to help if you’re unsure about a good diabetes diet.
• Stick to a schedule. Skipping meals, letting too much time pass between meals, or eating too much or too often can cause your blood sugar levels to fall and rise too much. Your doctor can help you determine the best meal schedule for your lifestyle.
• Follow your treatment plan. Diabetes treatment is very individualized. Your doctor will help you determine the steps you need to take to successfully manage your diabetes. Always talk to your doctor before making any changes.
• Check your blood sugar as directed. Checking blood sugar on your own is still necessary, even if your doctor is monitoring your A1C levels. Keeping a journal of your blood sugar levels can tell you and your doctor how certain activities affect your blood sugar. It can also help determine an ideal eating schedule and alert you to foods that cause blood sugar spikes.

Understanding your A1C levels is an important part of your overall diabetes management. If you have any questions about your A1C levels or what they mean, don’t hesitate to ask your doctor.

Last Updated: 09/16/2014