Everything You Need to Know About Your A1C Level

An A1C test is one of the primary tools for diagnosing diabetes and is key to understanding how well our bodies process sugar.

The A1C test is a blood test that measures your average blood sugar levels over the past 2 to 3 months. It’s an essential tool for keeping an eye on blood sugar levels, whether you live with type 1 diabetes, type 2 diabetes, or prediabetes.

Doctors use the test to diagnose prediabetes and diabetes. It can also be a tool for managing diabetes if you already have the condition. It’s unique from other blood tests because it measures your blood sugar levels over the course of several months.

This gives you a different perspective than readings from blood sugar meters, fasting blood sugar tests, or random blood sugar tests.

“A1C” refers to hemoglobin, a protein in your red blood cells that transports oxygen throughout your body. The A1C test determines what percentage of your red blood cells have glycated hemoglobin (sugar-coated hemoglobin), which provides a good insight into how your body processes sugar.

For more information on target levels to aim for, ways to safely lower your A1C, and more, read on.

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Understanding A1C levels

While a higher A1C level means you have a higher risk of developing diabetes, a variety of factors determine your personal risk level. These include your diet, level of activity, age, biological sex, and more.

Remember that the A1C test is a diagnostic tool for you and your physician to use to figure out a path forward. The results alone do not represent a definitive diagnosis or outlook.

For people with prediabetes, the same principle applies: Not everyone with prediabetes will go on to develop diabetes, and numerous lifestyle changes can help reduce the risk.

People with type 2 diabetes should have their A1C levels tested at least twice per year. Your doctor may use the results to help guide treatment plans and monitor your diabetes management.

How to lower your A1C level

If your A1C level is higher than desired, you can make several lifestyle changes to help lower it.

Decrease your overall calorie intake

According to a 2021 research review, several studies have shown that reducing your daily calories helps your body process sugar more effectively. Low calorie diets not only help your pancreas produce insulin, but they can also reduce your A1C levels and lead to weight loss if managed properly.

Consider working with a registered dietitian who specializes in diabetes, if you have access to one. They can help you figure out a meal or diet plan that works for you.

One way to reduce your calorie intake is to reduce the portion sizes of the foods you’re eating. The Diabetes Plate Method can help you make sure you’re filling your plate with a balanced amount of protein, carbs, and vegetables.

Talk with your doctor about a weight loss plan

Excess fat in the liver and pancreas can lead to decreased beta cell function in those organs, which can lead to insulin resistance and other issues, 2019 research suggests. By losing weight, it’s possible you can allow those beta cells to regain function and help your body process sugar better.

It’s important to recognize that a slow, gradual reduction in weight is usually best when it comes to successfully keeping the weight off. Talk with your doctor about your weight loss goals if you’re unsure how to get started.

Exercise

Both aerobic exercise and resistance training like weightlifting can help lower A1C levels. But even a brisk walk in the park or going for a quick bike ride is better than no exercise. Start small, and talk with your doctor before increasing your activity levels or starting a new exercise routine.

Medication

Insulin therapy and prescription drugs like metformin and miglitol can all help lower your A1C levels when used properly. As always, take them as prescribed by your physician.

Surgery

For certain people, surgery may be an option to lower your A1C and limit the progression of diabetes.

The term “bariatric surgery” refers to any surgery that alters your digestive system. Some forms, like gastric bypass surgery, have been shown to restore your body’s ability to process sugar through lower calorie intake and improved insulin sensitivity, according to research from 2010.

Frequently asked questions

Here are some more common questions and answers related to A1C levels.

How often should I get an A1C test?

If you have normal A1C levels but are over the age of 45, it’s generally a good idea to get an A1C test every 3 years. If you’re under the age of 45 and have other risk factors, it might be better to do it more often.

If you have prediabetes, you should probably get an A1C test every 1 to 2 years. Once again, if you have higher risk factors, more frequent tests could be beneficial.

If you have diabetes, your doctor will probably recommend getting an A1C test at least twice per year, and more often if you change medications or make other significant changes in your lifestyle.

If you take insulin or have difficulty keeping your A1C in your target range, more than twice per year might be appropriate.

How do A1C levels translate into an eAG reading that I’d see on my blood sugar meter?

If you regularly track your estimated average glucose (eAG), it’s helpful to understand how those readings translate into A1C and vice versa.

Below is a handy guide, and the American Diabetes Association also has a calculator for more precise conversions.

What other health factors could influence my A1C level?

While A1C tests are generally accurate, several other factors could influence your results. If you currently experience kidney failure, liver disease, or anemia, your A1C readings could be altered.

Certain medications can also impact A1C levels, as well as early or late pregnancy and blood transfusions. If your reading is atypical or you suspect that your level might be irregular, it’s a good idea to speak with your doctor about screening for these other conditions.