You've probably had your blood glucose level checked — a quick prick of the finger and a drop of blood reveals how much sugar is in your bloodstream. This is a helpful tool for diagnosing and managing diabetes, but it only shows your blood glucose level at that moment. Unless you've fasted and timed the test correctly, it's not an accurate way to know how your body processes sugar all the time.
Your A1C level is your average blood glucose level over the past three months. Knowing this number helps your doctor find and treat diabetes (and prediabetes) before you experience serious complications.
Why Your A1C Level Matters
Diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Most cases of type 2 diabetes can be managed with diet, exercise, and medication, but uncontrolled blood glucose levels increase the risk for heart disease, stroke, eye problems, foot and leg amputations, and kidney failure.
Approximately 30.3 million Americans have diabetes — that's about 9 percent of the U.S. population. Of those living with diabetes, 7.2 million are undiagnosed. Another 84.1 million American adults have prediabetes, meaning they're at risk of developing diabetes without medical intervention and lifestyle changes. Regular A1C testing would help your doctor catch the disease early, often while it's preventable. If you've already been diagnosed with diabetes, your A1C tells your doctor whether the current treatment plan is working.
What the Numbers Mean
The A1C test measures how much glucose is attached to the hemoglobin in your blood. The results are reported as percentages. To diagnose diabetes with an A1C test, physicians use the following scale:
- Normal: below 5 percent
- Prediabetes: 5.7 to 6.4 percent
- Diabetes: 6.5 percent or higher
It's recommended that diabetics maintain an A1C level below 7 percent to prevent complications.
7 Ways to Improve Your A1C
Whether you're managing diabetes or trying to avoid it, you can lower your blood glucose levels by:
1. Exercise
Physical activity helps your body use insulin more efficiently, so it can better process the glucose in your blood. Consistent exercise can lower blood glucose and improve your A1C. It also lowers your risk for heart disease, stroke, and other serious diseases for which diabetics are susceptible. Aim for 30 minutes of exercise at least five days per week.
2. Eat Right
Go easy on the sweets and sugary beverages, white breads, potatoes, pastas, starchy vegetables, and other carbohydrate-rich foods as these increase your blood sugar levels. Instead, opt for foods that are high in fiber, fruits and vegetables, small servings of lean meats and poultry, and low-fat milk or cheese.
3. Take Medications as Prescribed
Some people can manage diabetes and prediabetes with diet and exercise; others need medication. The right medication and dosage varies from person to person, so work with your doctor to create an individualized treatment plan, and then stick to it.
4. Manage Your Stress
Stress causes your body to behave as if you're under attack. To prepare for a fight-or-flight response, the body stores up energy in the form of glucose and fat. Over time, this can increase your A1C level. To reduce stress, make time to relax, spend time with people you love, and do things you enjoy. Mindful meditation and other relaxation techniques can also help. If you still feel chronically stressed, talk to your doctor.
5. Stick to a Schedule
If you go too long without eating, your blood glucose levels could drop too low. You'll also be more likely to overeat later, causing your blood sugar to spike. Plan to eat three well-balanced meals and two healthy snacks each day.
6. Drink in Moderation
Drinking alcohol can cause drops in your blood sugar, especially if you haven't eaten or if your glucose levels are already low. Otherwise, the American Diabetes Association recommends that diabetics follow the same guidelines as everyone else: no more than one drink per day for women and two drinks per day for men.
7. Monitor Your Numbers
If you've been diagnosed with diabetes or prediabetes, it's important to check your blood glucose levels as often as your doctor recommends to prevent spikes and dangerous drops. Your doctor will also want to keep a close watch on your A1C level to ensure your current treatment plan is keeping your condition under control.
Diabetes is a serious, lifelong condition, but with some healthy changes and the right care providers in your corner, you can still live a full and healthy life.
Hemoglobin A1C is a common blood test that measures blood glucose levels over the past two to three months.
While hemoglobin A1C testing is used to diagnose diabetes, it’s also used to monitor how well a diabetes treatment plan is working.
There are effective steps you can take to meet your A1C goal and reduce the risk of diabetes-related complications.
If you have prediabetes, diabetes, or are at risk of developing either, your healthcare provider may have mentioned your hemoglobin A1C (HbA1C or A1C) levels. You may have learned that your A1C should be lower. If you’re still unsure exactly what an A1C is and how you can lower it, read on for a simple explanation and 7 reliable tips.
What is hemoglobin A1C?
Your bloodstream is full of red blood cells. Red blood cells contain a protein called hemoglobin, which carries oxygen throughout your body. Glucose (sugar) also travels through your blood and can bind with hemoglobin. When the two come together, they create what’s called hemoglobin A1C. This is also known as glycosylated hemoglobin.
You may be wondering why your health care provider orders A1C testing every few months. It’s because the life of a red blood cell is about 3 months. Glucose that sticks to the cells during this period of time provides the average A1C value.
How are hemoglobin A1C levels measured?
An A1C test measures the amount of glycosylated hemoglobin in your blood. Your A1C is written as a percentage and gives you an idea of how well-managed your blood sugar levels are over a period of 2 to 3 months. It’s also one of the numbers healthcare providers use to diagnose prediabetes or diabetes.
How is the A1C test different from a blood sugar finger prick?
To measure your A1C level or blood glucose, you’ll have a finger-prick test or blood drawn from a vein. An A1C test is different from a blood glucose test. Here’s how:
A blood glucose test tells you what your glucose is right now.
An A1C test gives an average blood glucose level over a long period of time.
Both of these tests provide important information about your body’s ability to regulate blood glucose.
What does it mean to have high or low A1C?
Having a high A1C value means that you have too much sugar in your blood and may have prediabetes or diabetes. Let’s take a look at the A1C target numbers.
A normal A1C is below 5.7%.
If your A1C is between 5.7% to 6.4%, this suggests that you have prediabetes.
If your A1C is 6.5% or higher, this suggests that you have diabetes.
If you have diabetes, your treatment goals will target a certain A1C level. If, despite treatment, your A1C is higher than what is safe for you, that’s a sign you and your care team need to make some changes.
This is important because high glucose levels in the body can raise your risk of:
The American Diabetes Association (ADA) sets guidelines for healthy A1C targets in people with diabetes. Based on your medical history and other current medical conditions, your healthcare provider may prefer that you aim for a less strict or more strict A1C.
For an average, non-pregnant adult diagnosed with diabetes, the ADA recommends a target A1C of less than 7%. Older adults with multiple medical problems or cognitive/functional issues may have higher A1C goals in the 8.0% - 8.5% range.
How do I lower my hemoglobin A1C levels?
It’s important to understand that lowering your A1C levels is a gradual (slow) process. As discussed, your A1C, unlike a blood glucose test, measures your average blood sugar over a period of 2 to 3 months. This means, it can take up to 3 months to notice significant changes in your A1C.
Below are 7 different ways you can work on lowering your A1C over time.
1. Diet
Diet is an important factor when it comes to your blood sugar. You probably know that carbohydrates (sugars) can raise your blood sugar levels. But your body also needs a certain amount of carbs to function properly. A tip for meeting your body’s needs while keeping carb intake under control is to eat more protein, non-starchy vegetables, and low-sugar fruits. This includes:
Nuts
Legumes, like beans and lentils
Poultry, like meat and eggs
Vegetables, like leafy greens, bell peppers, and squash
Berries
Cheese
Do your best to avoid carbs and ultra-processed foods like:
Candies
Cakes
White bread
Rice
Pasta
As you check your blood sugar after meals, you should start to see patterns in how specific foods affect your blood glucose.
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GoodRx Health information and resources is reviewed by our editorial staff with medical and healthcare policy and pricing experience. See our editorial policy for more detail. We also provide access to services offered by GoodRx and our partners when we think these services might be useful to our visitors. We may receive compensation when a user decides to leverage these services, but making them available does not influence the medical content our editorial staff provides.
2. Exercise
Your body normally produces a hormone called insulin. It helps the glucose move from your blood to your cells to use for energy. With diabetes, the pancreas doesn’t make enough insulin, or the body doesn’t respond to it normally. This is also known as insulin resistance. It’s one of the causes of high blood glucose and high A1C levels. Exercise can help to lower A1C levels by jumpstarting your body’s natural insulin activity.
As a general rule, doing physical activity if you have diabetes is important. Recommendations include at least 150 minutes of moderate physical activity per week. This can be broken down into 20 to 25 minute segments of activity every day. Examples include:
Brisk walking
Cycling
Swimming
Housework
Dancing
3. Weight loss
Since everyone has a different body structure, weight loss is specific to you as an individual. A study has shown that weight reduction of 5% to 7% may be enough to lower the risk of Type 2 diabetes in people who are at high risk and/or have prediabetes.
If you already have Type 2 diabetes, weight loss can help you lower the quantity or frequency of your medications. Using the diet and exercise recommendations above can help achieve these weight loss goals.
Of note, weight loss won’t affect the risk of having Type 1 diabetes.
4. Medications for high A1C
For people with Type 1 diabetes, and some people with Type 2 diabetes, medications may be needed to help lower A1C. But remember, these medications don’t work unless you take them consistently. Whether or not you feel fine, you are at risk for serious complications if your A1C levels are high. Take your medications the way they are prescribed to you. If side effects or cost concerns keep you from taking your medications, let your healthcare provider know.
5. Follow up with your healthcare provider
Communication with your healthcare provider is important in monitoring your A1C levels and diabetes treatment. Your provider may schedule an appointment with you every 2 to 3 months. That’s because it takes about that long to see changes in your A1C. Attending these follow-up visits can help you find out if your A1C levels are headed in the right direction.
6. Manage stress and mental health
According to the ADA, stress can directly impact your blood sugar levels. When your body is under stress, it gets ready to either fight or run from the source of stress. Your body needs energy in the form of glucose to do this, so a hormone called cortisol is released to raise sugar levels in your blood. In turn, this makes your A1C go up, too.
Since day-to-day life can be stressful, finding ways to manage and lower stress is key to maintaining healthy A1C levels. You might enjoy calming activities like:
Walking
Reading
Singing
Knitting
Writing
Try a few different soothing activities to discover what type of stress management works best for you.
7. Find a community for diabetes self-management
If you have prediabetes or diabetes, you’re not alone. Connecting with others in similar situations can be an effective way to find support, stress relief, and accountability. Plus, you’ll likely learn tips and strategies that can help you better manage your diabetes. Ask your healthcare provider about support groups or meetups for people with diabetes.
The bottom line
If you live with diabetes or prediabetes, lowering your hemoglobin A1C level can help to reduce the risk of diabetes-related complications. Learn more about what an A1C test is and follow our 7 proven steps to lower your A1C. You can make a difference in your diabetes management and overall health today.
GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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