The basics of the A1C test — and how to lower your A1C levels


Doctor visiting patient

About one in 10 Americans has type 2 diabetes, a condition in which the body has trouble regulating and using glucose — a type of sugar that serves as the primary source of energy for our cells.

Glucose comes from the foods we eat and travels through the bloodstream to our cells. When there’s not enough glucose in the blood, it can negatively impact the way a person thinks and the way his or her body functions. And too much glucose in the blood can lead to health problems and permanent damage to important body parts such as the kidneys, blood vessels, eyes, and nerves.

What is an A1C test and why is it important?

One of the best tools that health care providers have to determine a patient’s risk for developing diabetes is known as an A1C test. This is a blood test that measures the average levels of glucose in the blood for the preceding three months. The test is important because the higher the levels of glucose found in the blood, the higher a patient’s chance of developing diabetes-related complications.

What does an A1C test measure?

Also referred to as a hemoglobin A1C or HbA1C test, an A1C test examines the red blood cells in your body, looking for a protein called hemoglobin. This is because, when glucose is ingested and enters the bloodstream, it attaches to the hemoglobin in your blood for transport to your cells. We all have glucose attached to the hemoglobin in our red blood cells, but having especially high or low levels of it can be problematic.

What do my A1C test results mean?

A1C test results are given as a percentage — and the higher the percentage measured and reported by the test, the higher the average glucose levels in the blood have been for the past three months. (The red blood cells in your body live for about three months, and glucose sticks to the hemoglobin in the red blood cells for as long as they’re alive.)

A1C levels in the blood are considered normal when they are below 5.7%. Levels between 5.7% and 6.4% are indicative of prediabetes — and when those higher levels are found, lifestyle changes are often recommended to lower your risk of developing type 2 diabetes. And when A1C levels reach 6.5% or higher, it indicates possible diabetes, often resulting in the use of prescription medications or insulin therapy in an effort to prevent diabetic complications. (Insulin, a hormone produced by the pancreas, helps regulate the amount of glucose in the blood. A synthetic or animal-derived version is often used to treat diabetes.)

The American Diabetes Association recommends that patients strive to keep their A1C levels below 7%, which is indicative of good diabetes control. A1C levels at 9% or higher are widely considered dangerous, raising the risk of diabetes complications such as kidney failure, nerve damage, and blindness.

How can I lower my A1C?

Whether you’ve been diagnosed with diabetes and are trying to keep its symptoms under control or are looking to prevent the development of diabetes, making healthy lifestyle choices can help you reduce your blood sugar levels. Some of the ways to lower your A1C levels include:

  • Eating a balanced diet — Choosing foods that are low in sugar, salts, and fat can help reduce A1C levels, as can eating lots of fresh fruit, vegetables, beans, nuts, and whole grains. Also, eating foods that are high in fiber can be helpful, as these take longer for the body to break down — providing you with energy and lowering the chances of your blood sugar spiking.
  • Getting regular exercise — When muscles are active, they tend to do a better job of breaking down sugar to produce energy, in addition to more efficiently using insulin to process the glucose in your blood. Experts recommend that we shoot for a minimum of 150 minutes of moderate exercise or 75 minutes of intense exercise each week.
  • Managing stress — High levels of stress have been shown to increase blood sugar and A1C levels in the body over time. But by getting enough quality sleep each night and successfully managing our stress triggers — for instance, by declining to take on excessive responsibilities at work and at home — we can lower our levels of chronic stress. Other ways to fight stress include taking time to relax, spending time with loved ones, doing things we enjoy and practicing mindful meditation techniques.

Need expert guidance on managing your A1C levels? Wilmington Health can help.

The specialists in the Wilmington Health Endocrinology Department are well-versed in the management of diabetes, including helping patients reach their A1C goals and keep their A1C levels in check. To schedule an appointment with a provider, contact the Endocrinology Department today.