5 ways to lower A1C and manage your blood sugar levels

It is important to lower A1C levels if you have diabetes.

To lower A1C levels, you may need to lose weight, exercise regularly, regulate your carbohydrate intake, take insulin, or take medications like metformin. A1C levels measure your blood sugar over a period of about 12 weeks and are an important indicator for people with type 1 or type 2 diabetes and for those at risk. This article was reviewed by Jason R. McKnight, MD, MS, a family doctor and assistant clinical professor at the Texas A&M College of Medicine.

Check out Insider's Insider Reference Library for more advice. An A1C test measures the amount of glucose in your blood for the past 12 weeks. This is important as it provides a long-term measurement of blood sugar levels that is used to diagnose and treat diabetes or prediabetes.

For people with type 1 or type 2 diabetes, A1C levels should be measured about every three months. If you're at increased risk, get your A1C measured twice a year, says Dr. Charles Richardson, CEO of Cleveland Diabetes Care.

Early detection of high blood sugar levels through an A1C test can help reduce the risk of health complications from diabetes such as heart or kidney disease. Here's what you need to know about A1C levels and how to lower them. What is A1C?

A1C represents the amount of glycated hemoglobin in your blood. This is the amount of glucose that becomes bound to hemoglobin, a protein found in red blood cells. During the normal 90-day red blood cell life cycle, glucose binds faster in people with higher blood sugar levels, explains Richardson. A1C measures the percentage of red blood cells with hemoglobin that is coated with sugar and is an important marker of blood sugar.

Otherwise, healthy adults who are overweight - a risk factor for type 2 diabetes - should have their A1C measured every three years by having a doctor order blood tests to test A1C. People who have no risk factors for diabetes and who are not overweight do not need to have their A1C checked unless they or their doctor has cause for concern. People with diabetes should have A1C checked about every three months, and more often if they have trouble controlling their blood sugar or if they change their diabetes treatment.

Normal A1C values Your A1C scores can show: Normal: 5.6% or less Prediabetes: 5.7% to 6.4% Diabetes: 6.5% or higher

If you are diagnosed with diabetes or prediabetes, your doctor will work with you to set an individual goal for your A1C levels. Most people with diabetes have a target A1C of less than 7%. Doctors might set a higher goal for people with other health problems like heart disease.

If you have diabetes or prediabetes, lowering your A1C is important. According to the American Diabetes Association, every one percentage point decrease in A1C can lower the risk of long-term complications from diabetes by 40%.

According to Richardson, the amount that is considered a significant reduction varies from person to person. Therefore, you should work with your doctor to set a personal goal. Dropping your A1C by half a percentage point can have significant benefits, he says.

How to lower A1C

Your A1C levels will decrease when you decrease your average blood sugar level. This can be done through lifestyle changes and medication.

"With a multidisciplinary approach that includes optimal nutrition, implementation of an exercise plan, and diabetic medication, most patients can lower hemoglobin A1C," says Richardson.

Here are some of the most effective ways to lower your A1C levels:

1. Lose weight Losing weight can help you better control your blood sugar and lower your A1C levels. A 2012 study published in the journal Diabetes Education found that losing 10% body weight in patients with type 2 diabetes was associated with a 0.81% decrease in A1C levels.

2. Exercise regularly "Exercise helps the body absorb glucose from the bloodstream and can help the body access and use glucose more efficiently," said Claudia Hleap, a Philadelphia-based dietitian who works regularly with patients to monitor their A1C levels to lower. A 2017 study published in BMJ Open Diabetes Research and Care tracked 65 patients with type 2 diabetes over a period of eight years. One group did 90-minute training sessions three times a week. Their A1C levels dropped between 1.11% and 1.84%, and the researchers concluded that people who exercised reduced their A1C more consistently than those who didn't. 3. Count carbohydrates Working with a nutritionist to create a nutrition plan can help lower A1C levels. People with diabetes and prediabetes in particular need to monitor the amount of carbohydrates they eat as carbohydrates have the greatest impact on blood sugar. "It is important to get a nutrition education to understand how eating certain foods affects your blood sugar," says Hleap. "Knowing this, it is important to switch to a consistent and controlled carbohydrate diet in order to bring about lifelong sustainable diet changes." A 2014 scientific review published in The Lancet Diabetes and Endocrinology found that people with type 1 diabetes who counted carbohydrates reduced their A1C levels by 0.64% more than people who did not count carbohydrates. For more information on how many carbohydrates to have per day, read if you are diabetic.

4. Take oral diabetes medication

Oral diabetes medications like metformin can lower your A1C levels. A much-cited scientific study from 2012 in Diabetes Care found that metformin reduced A1C by an average of 1.12% in people with type 2 diabetes.

In addition, a 2019 study published in the Pakistan Journal of Medical Sciences tracked 200 patients with type 2 diabetes. All of them saw their A1C levels drop within three months of taking metformin at the dose their doctors prescribed, with the largest drop being seen in people with higher starting A1C levels.

5. Use insulin

If your initial A1C levels are above 9% - most common in people with previously undiagnosed diabetes - your doctor may recommend starting insulin right away. A 2010 scientific review published in Diabetes Technology and Therapeutics found that insulin therapies reduced A1C in type 2 diabetics by an average of 1.4%.


Measuring A1C levels is an important way to monitor prediabetes and reduce the risk of diabetes complications. Working with a nutritionist and your doctor can help you come up with a plan to lower your A1C levels. However, patience is also important, says Hleap. "Your hemoglobin A1C won't change overnight," she says. "It's important to make small and realistic changes, step by step, to ensure that the changes you make to your diet and exercise program are sustainable over the long term. Implementing these suggestions takes time. Attitude is important and these changes are based long term".

Posted on 2020.09.08

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