How to Lower A1C?

Published April 20th, 2020 by Bridget Reed
Fact Checked by
Bridget Reed
Medically Reviewed:
Camille Freking
Updated Date: May 13th, 2021

If you’re one of the 34.2 million Americans suffering from diabetes, lowering your A1C should be high on your priority list. Nearly 10.5 percent of the population has diabetes, including 26.8 million people who have been diagnosed and an estimated 7.3 million who are undiagnosed. Keeping your A1C levels in check is critical to prevent complications of diabetes and live a healthy life. If you’re interested in finding out how to lower your A1C, we have ten great tips to help.

What Is Diabetes and What Causes It?

Diabetes is a condition that causes our bodies not to properly process the food we use as energy. The majority of our food is turned into glucose, a type of sugar, which allows our bodies to easily use it for energy. Our pancreas is responsible for making a hormone called insulin that helps our cells absorb glucose for energy. However, people with diabetes either do not make enough insulin or do not use their own insulin properly, which causes a buildup of sugar in the blood. The cause of diabetes depends on which type of diabetes you have: type 1 or type 2.

Doctors and scientists are not entirely sure of the cause of type 1 diabetes. However, researchers do understand that the body’s immune system attacks and destroys the cells in our pancreas that produce insulin, leaving diabetic individuals with little or no insulin and causing sugar to build up in the bloodstream. Scientists believe that type 1 diabetes is caused by a combination of genetic and environmental factors. The American Diabetes Association estimates that about 1.6 million Americans, including 187,000 children and adolescents, have type 1 diabetes.

Type 2 diabetes occurs when your cells start resisting the action of insulin and your pancreas is unable to make enough insulin to overcome the effect, thus causing sugar to build up in the bloodstream. Type 2 diabetes is more commonly linked to environmental and lifestyle factors than type 1 diabetes, but scientists believe genetic and environmental factors both play an important role. People who are overweight are at a significantly higher risk for developing type 2 diabetes, although it is possible to have type 2 diabetes without being overweight.

What Is Your A1C and What Does It Measure?

When it comes to understanding your risk for diabetes, the A1C test is considered the “most valuable player” in terms of testing options for physicians. A1C tests are blood tests that are capable of identifying prediabetes, which means you are at a reduced risk of developing Type II diabetes down the road, and it can also be used to diagnose type 1 and type 2 diabetes. If you have diabetes and are working to manage your condition, the A1C test can tell how well your treatment is working overtime. 

Your A1C test measures your average blood sugar level over the past two to three months. Specifically, your A1C is a measure of what percentage of your hemoglobin (a protein in your red blood cells that carries oxygen) is glycated or coated with sugar.  Your risk for developing diabetes or diabetes complications increases the higher that your A1C number is. Prediabetic patients should have their A1C checked once a year, while patients that have their type 2 diabetes under control should generally have their A1C levels checked twice per year. People with type 1 diabetes or those with uncontrolled type 2 diabetes or who use insulin to control their diabetes should be checked four times per year. People who are struggling to manage their condition may be checked more frequently.

What Is the Normal Range for A1C?

The normal range for A1C is 5.7 percent; patients with an A1C below 5.7 percent are not considered at risk for developing diabetes. People with an A1C between 5.7 percent and 6.5 percent are considered prediabetic, meaning they are at high risk for developing diabetes in the future unless substantial lifestyle changes are made. Patients with an A1C of 6.5 percent or greater, measured twice, are considered diabetic. An A1C level above eight percent indicates that a patient’s diabetes is not well controlled and the patient is at a higher risk of developing complications from diabetes.

When it comes to setting goals for an A1C target number, there is no “perfect number” for diabetic patients when it comes to setting a target level for your A1C after being diagnosed with diabetes. Target levels for diabetic patients vary depending on the patient’s age and other factors, so targets may vary from person to person. However, in general, most adult patients diagnosed with diabetes should aim for an A1C of less than seven percent. 

What Happens When Your A1C Is Too High?

When a patient’s A1C numbers are too high, they are at risk of developing complications of diabetes. Uncontrolled diabetes can have life-threatening consequences; diabetes was the direct cause of death for 83,564 people in 2017, making it the seventh leading cause of death in the United States. Diabetes was mentioned as a contributing cause of death in 270,702 death certificates during the same year, and it is estimated that diabetes is underreported as a cause of death. Long term diabetic complications develop gradually and can eventually become disabling or life-threatening if not controlled. Possible complications include:

  • Nerve damage: High blood sugar can damage the walls of the capillaries that nourish your nerves, causing tingling, numbness, burning, or pain. Nerve damage typically occurs in the legs and begins at the toes, gradually spreading upward. Untreated nerve damage can cause a patient to lose all feeling in the affected limbs and can ultimately lead to digestion issues, including nausea, vomiting, diarrhea, or constipation. It may lead to erectile dysfunction in men.
  • Eye damage: High blood sugar can damage the blood vessels of the retina, eventually causing blindness. It also increases the likelihood of developing cataracts and glaucoma.
  • Skin issues: Diabetes causes increased susceptibility to skin issues, including bacterial and fungal infections.
  • Alzheimer’s disease: Type 2 diabetes has been found to increase the risk of some types of dementia, including Alzheimer’s disease, although doctors are currently unsure as to why. It appears that the risk increases the higher your blood sugar level is.
  • Cardiovascular disease: Diabetic people are at a significantly higher risk of many types of cardiovascular issues, including heart disease with chest pain, stroke, heart attack, and narrowing of the arteries.
  • Kidney damage: High blood sugar damages the tiny blood vessel clusters in your kidneys that are responsible for filtering the waste from your blood. When the kidneys are severely damaged, kidney failure or irreversible kidney disease may occur, requiring dialysis or a transplant.
  • Foot damage: Poor blood flow to the feet, combined with nerve damage, increases the likelihood of foot complications in diabetic patients. People with diabetes may find that cuts and blisters heal poorly and develop into serious infections, sometimes requiring amputation of the toes, feet, or legs.
  • Hearing impairment: People with diabetes are at an increased risk of developing hearing problems.
  • Depression: People with both type 1 and type 2 diabetes are more likely to develop depression, which can affect diabetes management.

How Can You Lower Your A1C?

It’s important to lower your A1C in order to reduce your risk of developing complications from diabetes, but achieving lower A1C levels won’t happen overnight. Lowering your A1C will require a lifestyle change along with other aspects of an overall diabetes management plan, but it is possible. Here are ten tips for how to lower your A1C.

  1. Check your carbs: People with diabetes are often told to carefully watch their carbohydrate intake, as carbs affect blood sugar levels more than other nutrients like fat and protein. However, carbohydrates themselves are not the problem. You’ll want to avoid eating starchy carbs, like lots of white bread and pasta, but eating complex carbohydrates full of fiber and nutrients is considered healthy. It may be as simple as switching out your white bread for a whole grain option and limiting your portions.
  2. Meal plan: As the saying goes, if you fail to plan, you plan to fail. Meal prepping is a critical ingredient to success for diabetics looking to lower their A1C numbers because it ensures that you’ll practice healthy eating. When you’re starving and looking to grab a meal quickly, you’re more likely to make poor choices and end up with high-calorie, high-carb meals that will cause your blood sugar to shoot up. Remember, lowering your A1C won’t happen overnight, so learning to meal plan is an important part of your long-term game plan for success. You may want to consult with a registered dietitian to help you create a low carb diabetes diet that will help you decrease your body weight. 
  3. Measure your portions: We tend to think about measuring out portion sizes in terms of counting calories for weight loss, but watching your portions can also help you lower your A1C. Eating more food than your body needs can cause your blood sugar to spike, increasing your A1C over time. Measuring your portions is especially important when it comes to high-carb items like rice and pasta. We often eat significantly more than one serving without even realizing it simply because we don’t know what a serving size actually looks like. Weighing and measuring your portions will help you get a handle on your eating and keep your carbs under control.
  4. Divide your plate: An easy way to ensure you’re maintaining a healthy diet is to divide your plate into portions. Half of your plate should be filled with low starch vegetables like zucchini, carrots, or spinach. One-quarter of the plate should be comprised of lean protein like chicken, fish, or tofu, while the other quarter should consist of whole grains like wild or brown rice or quinoa for a perfectly balanced diet.
  5. Set a small weight loss goal: It might seem like you need to drop a ton of weight to make a substantial difference in your A1C, but studies show that you can make a big difference in your blood sugar by losing just five to ten percent of your current weight if you are overweight. Insulin is able to manage blood sugar levels more efficiently when you lower your weight through physical activity, which will cause your A1C levels to drop over time. What’s important is that you set a small goal and stick to it. Setting a goal to lose 50 pounds and becoming discouraged quickly won’t help you, but sticking to your plan and losing 15 to 20 pounds could make a huge difference.
  6. Find support: Being diagnosed with diabetes or prediabetes can be overwhelming and scary, but you don’t have to manage your condition alone. More than ten percent of the U.S. population has some form of diabetes, so look for support groups or meetup groups designed for people with diabetes. You can ask your healthcare provider for information about local groups or look online for virtual support to help you manage diabetes. A support group will help you stay motivated and accountable, plus offer a sounding board when you’re feeling frustrated and a place to celebrate your victory when you see your A1C drop.
  7. Switch up your exercise: Increasing your activity level is second only to managing your diet when it comes to effective ways to lower your A1C. Whether you choose to log miles on the treadmill or roads or you’d rather swim or strength train, any kind of exercise will help you lower your A1C. What’s most important is that your exercise be fun and challenging, so don’t feel like you have to do something you hate just to see your numbers drop. Try taking a dance class, adding weight lifting into your routine, or kickboxing - whatever gets you up and moving.
  8. Research supplements carefully: There are plenty of supplements out there that will promise to lower your A1C, but the research is still inconclusive. Some studies have shown that CoQ10 helps with blood sugar control by lowering your blood sugar, preventing blood sugar spikes, and reducing inflammation in your body, while others show that cinnamon can help. Regardless of which supplement you use, supplements alone will not be enough to manage your A1C, so make sure you use them only as part of a broader plan and talk to your doctor first.
  9. Take your meds: It should go without saying, but if you take diabetes medications, it should be taken exactly as prescribed each day. If you miss a dose of your medication, your blood sugar numbers could go up, and missing doses regularly will cause your A1C to rise. You may be able to work towards a goal of getting your diabetes managed well enough to reduce or even stop your medication, but only your doctor should make that decision about your treatment plan. Never skip, reduce, or stop your meds without a doctor’s approval.
  10. Stick to it: Rome wasn’t built in a day, and your A1C won’t be lowered overnight. Your A1C reflects the average level of your blood sugar over the course of several months, so expect it to take at least that long for your numbers to drop. You don’t have to be perfect, just stay consistent and you’ll see results.

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