How to Lower Your A1c Level

When you have diabetes, you probably know you should check your blood sugar regularly. Your doctor will also recommend that you take an A1c blood test a few times a year, with a goal of lowering the results to help protect your health. And there’s a lot you can do to move toward meeting that goal.

Unlike a regular blood sugar test, the A1c test measures the amount of sugar that clings to a protein, called hemoglobin, in your red blood cells. The test shows your average blood sugar levels over the past few months, so you know how well your diabetes is under control.

In general, the goal for your A1c is to be lower than 7%. Exactly how much lower will depend on your individual treatment plan. When you take steps to get your A1c in a healthy range, you lower your risk of complications such as nerve damage, eye problems, and heart disease.

Your doctor will let you know the best target for your A1c. How do you get there? Here are a few tactics to try, in addition to taking any medications your doctor prescribes.

Get some new kitchen gear. You’ll want to get a set of measuring cups and a kitchen scale if you don’t already have them. These will help you with your portion sizes. Your blood sugar will go up if you eat more food than your body needs. Keeping servings in check is a good way to reduce your A1c level.

At first, it’s a good idea to measure your food to give you an idea of what healthy portion sizes look like for different foods. That’s where the measuring cups and scale come in handy. You may be surprised at first to see what one serving looks like, especially of high-carb items like cereal, rice, and pasta. But this will help ensure you don’t eat more than you intend to.

Be carb smart. It’s true that carbohydrates affect your blood sugar more than other nutrients you eat. Chances are that if you overdo starchy carbs on a regular basis, your A1c number will start to creep up. But remember, all carbs aren’t a problem. You want ones that have a lot of fiber and nutrients, more than those that just serve up starch.

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Tweak your plate. Experts advise filling about half your plate with vegetables that are low in starch, such as carrots, greens, zucchini, or tomatoes. One-quarter of your plate should be a lean protein like chicken or tofu, and the last quarter should be whole grains like brown rice or quinoa.

Make a plan. The guidelines for what to put on your plate give you a lot of flexibility. But even though it sounds simple, you’ll probably be better off if you plan your meals. Why? If you skip set menus and eat on the fly, it’s easy to end up with calorie-dense, high-carbohydrate food choices -- like fast food, bagels, and frozen pizza -- that will cause your blood sugar and A1c numbers to soar.

Instead, at the start of each week, pencil in a rough plan for what foods you’ll eat at each meal and what groceries you’ll need. This way, you’ll be prepared with plenty of choices that limit post-meal blood sugar spikes. A Mediterranean diet, which is low in saturated fat and high in vegetables and fruit, reliably lowers A1c numbers.

Maybe downsize your weight loss goal. Not everyone with type 2 diabetes is overweight. But if you are, you may not need to drop as much as you think to make a difference in your A1c level.

If you’re overweight, diabetes doctors will often recommend you try to lose just 5% to 10% of your current weight. Here’s why: As you shed extra pounds, the insulin in your body lowers your blood sugar levels more efficiently, which will cause your A1c levels to drop over time. In one study, people with type 2 diabetes who lost 5% to 10% of their body weight were three times as likely to lower their A1c by 0.5%.

You may have a different goal for your weight or other health considerations on your mind. Ask your doctor to help you make a weight loss plan that matches your overall goals.

Rethink your exercise plan. Other than upgrading your nutrition, exercise is one of the most important habit changes you can make to lower your A1c. But don’t just grind it out on the treadmill, or you’ll miss another effective workout: strength training.

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No offense to the elliptical machine or your cycling class. You can choose whatever type of exercise you prefer as long as it’s a challenging workout. Both aerobic exercise and resistance (weight) training lower A1c levels if they’re part of a regular routine.

There’s solid science to support how much working out helps you whittle down your A1c level. Since exercise prompts your muscles to take up sugar from your bloodstream, it helps your blood sugar levels drop more quickly after you eat a meal. As you make exercise a regular habit, you’ll see a downward trend in your A1c numbers.

Never miss your meds. You can reliably lower your A1c through diet and exercise. But if your doctor has prescribed medication, such as metformin, miglitol, or insulin, it’s important to take them exactly as prescribed. If you miss doses regularly, your blood sugar numbers may creep up and cause your A1c to rise. But if you follow the medication plan that your doctor recommends and go to every appointment, your blood sugar should stay under control -- and your lower A1c number will reflect that. If your goal is to cut down on, or even stop needing, your meds, tell your doctor that you want to work toward that. But don’t stop them on your own.

Be savvy about supplements. Many dietary supplements say they’ll lower your A1c. But there’s not always much research to back that up. Still, some may have promise. These include berberine, made up of extracts from a variety of plants, and coenzyme Q10 (CoQ10), an antioxidant that reduces inflammation in your body. Cinnamon may also lower A1c levels over time. As with any supplement, it’s best to check with your doctor first.

Put your plan on repeat. Stick with it and give it time. Since your A1c level reflects your average blood sugar over several months, it’s going to take that long for your A1c to drop. You won’t do everything perfectly, and that’s OK. Just keep moving in the direction you want to go in. And rest assured: Your A1c number will come down, and it’ll be worth it.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on September 16, 2019

Sources

SOURCES: 

Mayo Clinic: “A1C Test,” “Hyperglycemia in Diabetes,” “Diabetes Diet: Create Your Healthy Eating Plan.”

Merck Manual: “Formation of Blood Cells.”

National Institutes of Health: “The A1C Test and Diabetes.”

Harvard T.H. Chan School of Public Health: “Carbohydrates and Blood Sugar.”

Joslin Diabetes Center: “Key to Success: Portion Control.”

Pakistan Journal of Medical Sciences: “Effect of Vitamin D Supplementation on Reduction in Levels of HbA1 in Patients Recently Diagnosed with Type 2 Diabetes Mellitus Having Asymptomatic Vitamin D Deficiency.”

Utah.gov: “How Can You Lower Your A1C To a Healthy Number?”

Diabetology and Metabolic Syndrome: “Resistance Exercise Training Lowers HbA1c More Than Aerobic Training in Adults With Type 2 Diabetes.”

American Diabetes Association: “Medication Management: What Are My Options?”

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