For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past three months. Called hemoglobin A1C, or A1C, this test can show you how well your type 2 diabetes management plan is working. Here’s what you should know about it and ways to make sure your A1C is in a healthy range. The A1C test results provide insight into how your treatment plan is working and how it might be modified to better control the condition. Often, your blood sample is sent out to a lab, though some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. While in-office tests can be used to monitor the disease, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that most point-of-care tests should not be used for diagnosis. That can only be done by lab tests certified by the NGSP, an organization that standardizes A1C test results. Any in-office test results pointing to a change in your health should be confirmed by conventional lab tests.
What Do Your 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. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. According to the ADA, an A1C level below 5.7 percent is considered normal; between 5.7 and 6.4 signals prediabetes; and over 6.5 percent indicates type 2 diabetes. For many people with type 2 diabetes, the goal is to reduce A1C levels. Your A1C goal is specific to you. Several factors come into play, such as your age, how advanced the diabetes is, and whether you have any other health conditions. If you can keep your A1C number below your goal — which, for many people with diabetes, is less than 7 percent, says Dodell — you can reduce the risk of complications, such as nerve damage and eye problems.
What Are Some Top Tips for Lowering A1C?
Your A1C score is a helpful tool, Dodell says, but it is not the only indicator of how healthy you are. For example, you could hit your A1C goal but still have wide fluctuations in your blood sugar levels, which is more common among people who take insulin. You’ll need to bring these day-to-day fluctuations under control, since they can lower your quality of life and increase your risk of complications, he says. Think of your diabetes as you would a job, Dodell says. 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 changes can help you improve your day-to-day blood sugar management and lower your A1C.
1. Start an Exercise Plan You Enjoy, and Do It Regularly
Find something you enjoy doing that gets your body moving, whether it’s taking your dog for a walk, playing a sport with a friend, or riding your bike. The ADA recommends getting 150 minutes of moderate exercise per week, says Jordana Turkel, a certified diabetes care and education specialist (CDCES) and registered dietitian at Park Avenue Endocrinology & Nutrition in New York City. Different types of exercise (both strength or resistance training and aerobic exercise) can lower your A1C by making your body more sensitive to insulin, Turkel says. She encourages her patients not to go more than two days in a row without exercising and to aim for two days of strength training per week. Be sure to check with your healthcare provider before embarking on an exercise plan, though. Together, you can come up with an individualized plan. And if you monitor your blood sugar daily, check it before and after exercise. As the ADA explains, exercise improves insulin sensitivity and lowers your blood sugar levels. In certain circumstances, though, stress hormones produced during more intense exercise can also increase blood sugar levels. In addition, other factors, such as what you eat before exercise and the timing of your workout, may also affect your numbers.
2. Eat a Balanced Diet With Proper Portion Sizes
It’s best to check with a CDCES or registered dietitian/nutritionist to determine what a balanced diet and appropriate portion sizes mean for you. But a great rule of thumb is to fill half of your plate with veggies, a quarter with protein, and a quarter with whole grains, says Turkel. If you like fruit, limit your portion to a small cup, eaten with a little protein or lean fat to help you digest the carbohydrates in a way that is less likely to spike your blood sugar. Also, avoid processed foods as much as possible, and try to avoid sugary sodas and fruit juice, which are high in carbs and calories, and thus can lead to spikes in blood sugar and contribute to weight gain, according to the ADA.
3. Stick to a Regular Schedule, So You Can More Easily Follow a Healthy Diet
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, Cleveland Clinic points out. This is especially true if you are taking insulin or certain other diabetes drugs. Your doctor can help you determine the best meal schedule for your lifestyle.
4. Follow the Diabetes Treatment Plan Your Healthcare Team Recommends
Diabetes treatment is very individualized, noted a February 2022 article in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. After all, factors including how long you’ve lived with the disease, your socioeconomic status, and any other conditions you’re living with can play a role in the best treatment approach for you. Your healthcare team will help you determine which steps to take to successfully manage diabetes. Always talk to your doctor before making any changes, such as starting a diet very low in carbohydrates or beginning a new exercise regimen. This is especially important before making any medication or insulin changes.
5. Check Your Blood Sugar Levels as Your Doctor Has Directed
Work with your doctor to determine if you should check your blood sugar — and how often. You may be tempted to pick up an A1C home testing kit, but Dodell says having your A1C checked by your doctor every three to six months is sufficient. A better idea is to use a continuous glucose monitor. He recommends checking your “time in range” to see if you are at the optimal level. For many people that is 70 to 180 milligrams per deciliter (3.9 to 10 millimoles per liter), according to ADA guidelines. Understanding your A1C levels is an important part of your overall diabetes management. If you have any questions about your A1C or what it means, don’t hesitate to ask your doctor. Additional reporting by Mikel Theobald
