How to Lower Your A1C: Tips from a Diabetes Educator
Your A1C is a blood test that shows your average blood sugar level over the past two to three months. For most adults with diabetes, keeping that number below 7% is the primary goal. That equates to an average blood sugar level of around 154 mg/dL.
The good news: small, consistent changes to your daily habits can make a meaningful difference. Kelly King, a registered dietitian (RD) and certified diabetes care and education specialist (CDCES) with the Texas Health Virtual Care Delivery team, shares practical strategies to help you lower your A1C and keep it there.
What is an A1C test and why does it matter?
The A1C test measures the percentage of hemoglobin in your red blood cells that has glucose (sugar) attached to it. Because red blood cells live roughly two to three months, the test gives you and your care team a reliable snapshot of how well your blood sugar has been controlled over that period.
“New red blood cells are created each day and live for two to three months, which is how the A1C test can provide a two- to three-month average of blood glucose,” says King.
Unlike a fingerstick check, which tells you your blood sugar at a single moment, A1C reflects your overall pattern. That makes it one of the most important tools for guiding diabetes management decisions, from adjusting medications to evaluating the impact of lifestyle changes.
What is a target A1C level?
A1C targets are not one-size-fits-all. Your doctor will work with you to set a goal based on your health history, age, and specific circumstances. The table below reflects the current guideline framework from the American Diabetes Association1 and Cleveland Clinic2.
| Patient Group | A1C Target |
|---|---|
| Healthy, non-diabetic adults | Less than 5.7% |
| Most adults with diabetes | Less than 7% |
| Older adults or those with multiple chronic conditions | Less than 8% |
“The target A1C is individualized,” says King. “For most people, based on guidelines from the American Diabetes Association, the target A1C is 7% or less. Those wanting tighter management, like individuals trying to become pregnant or healing a wound, may have a target of 6.5% or less. A1C targets tend to be higher, less than 8%, for those who are older or have multiple chronic illnesses.”
Your doctor will recommend checking your A1C every six months if your level is below 7%, or every three months if it is at or above 7%. Tracking your A1C alongside your daily blood sugar readings gives your care team the clearest picture of how your management plan is working.
If you are part of the North Texas community and are not yet connected with a diabetes care team, Texas Health offers resources to help you find the right support.
Meal planning for A1C management
What you eat has one of the most direct effects on your blood sugar, and therefore your A1C. But meal planning for diabetes does not mean eliminating entire food groups. The goal is balance.
Try the Plate Method
King recommends a simple visual framework for building balanced meals: “Following the Plate Method, which is half vegetables, a quarter protein, and a quarter carbohydrate, can help balance your meals by pairing carbohydrate intake with protein and healthy fats.” This approach helps prevent sharp blood sugar spikes after eating and helps you feel fuller for longer.
Prioritize fiber and reduce added sugar
Increasing your daily fiber intake to 25 to 30 grams and cutting back on added sugars from sweets and sugary beverages can have a meaningful impact on your A1C over time3. Fiber slows how quickly carbohydrates are absorbed, which helps keep blood sugar levels more stable.
Be mindful of carbohydrates, not avoidant
Carbohydrates raise blood sugar more than any other macronutrient, but they do not need to be eliminated. Pairing carbohydrates with protein and healthy fats slows their digestion and blunts the blood sugar response. Portion size and food quality matter more than avoidance.
Get moving
Physical activity is one of the most effective tools for lowering A1C. Exercise makes your body more sensitive to insulin, which means your cells can absorb blood sugar more efficiently.
“Exercise helps your body be more sensitive to insulin and can lower blood glucose levels during and up to 24 hours after exercise,” says King.
King recommends aiming for 150 minutes of physical activity per week, spread across a variety of movement types:
- Aerobic activity such as walking, swimming, or cycling
- Resistance training such as weightlifting or resistance bands
- Flexibility work such as yoga or stretching
“Finding an exercise you enjoy can help you stick with it,” King adds. Even a 30-minute walk five days a week can produce measurable improvements in blood sugar control.
Manage stress and prioritize sleep
Blood sugar does not only respond to food and exercise. Stress hormones and poor sleep quality can both push blood sugar levels higher, which in turn raises your A1C over time.
Managing stress
“Stress can increase blood glucose levels, which means it can also increase A1C,” King explains. “Finding ways to manage stress helps keep your blood glucose level and A1C in a better range.”
Strategies that may help include:
- Therapy or counseling
- Regular physical activity, including yoga
- Deep breathing techniques
- Talking with a trusted friend or family member
- Engaging in hobbies that bring enjoyment
Improving sleep quality
King notes that sleep quality is just as important as sleep quantity. “Without good quality sleep, you are less likely to engage in diabetes self-care because you are tired or less motivated, which can lead to higher blood glucose levels.”
Practical steps to improve sleep include creating a consistent sleep schedule, avoiding screens before bed, limiting caffeine in the afternoon and evening, and exercising during the day. If you suspect a sleep disorder may be contributing to poor sleep, speak with your doctor.
Stay consistent with your medications
For many people with diabetes, medication is a critical part of reaching and maintaining an A1C target. Taking your prescribed medication as directed is not optional, it is foundational.
“Oral diabetes medications can reduce A1C by 0.5 to 2%, and insulin can bring your A1C to target within three months if you are on the right amount,” King explains.
King recognizes that staying consistent with medication is not always straightforward. Common barriers include cost, side effects, and simply forgetting a dose. Her guidance:
- For forgetfulness: use a pill organizer or set a daily phone reminder
- For side effects: speak with your doctor before stopping any medication; alternatives are often available
- For cost concerns: ask your care team about patient assistance programs, manufacturer coupons, or lower-cost medication options
“There are assistance programs, coupons, and even low-cost medication options available, so always talk to your doctor before stopping a medication,” King says.
Track your blood sugar regularly
Monitoring your blood sugar is essential to understanding how your daily choices affect your A1C. How often you check will depend on your treatment plan.
“If you can, rotating your checks between times like before a meal, two hours after your first bite, and at bedtime can give you a better understanding of how your blood sugar fluctuates throughout the day,” says King.
For those who want more continuous data, continuous glucose monitors (CGMs) provide real-time blood sugar readings without repeated fingersticks. Apps that sync with glucose meters can also make tracking more convenient and help you spot patterns over time. Talk to your doctor about whether a CGM is appropriate for your situation.
Celebrate your progress and stay consistent
Reaching your A1C target is a meaningful accomplishment, and it is worth recognizing. King encourages patients to pause and acknowledge what they have achieved.
“It is essential to congratulate yourself and recognize all the positive changes you have seen. This will help keep you motivated to stick with the changes long-term,” she says.
Reaching your goal is not the end point, it is confirmation that your approach is working. King notes a common pattern she sees: “People getting too relaxed with monitoring or their meal plan, slipping back into old habits. Reaching your target A1C goal should motivate you to keep going. This is proof that your efforts are working to help maintain your overall health and delay, prevent, or slow the progression of complications.”
Frequently asked questions about A1C and blood sugar management
How long does it take to lower your A1C?
Lowering your A1C takes at least two to three months to show up in a test result, because A1C reflects your average blood sugar over that entire period. Most people who make consistent changes to diet, activity, and medication adherence begin to see meaningful improvement within three to six months. The exact timeline depends on how far above target your A1C is and how many changes you implement.
What foods lower A1C most effectively?
No single food lowers A1C on its own, but a dietary pattern that emphasizes non-starchy vegetables, lean protein, healthy fats, and high-fiber carbohydrates consistently supports better blood sugar control. Reducing added sugars and sugary beverages has one of the most direct impacts on A1C. Using the Plate Method, which is half vegetables, a quarter protein, and a quarter carbohydrate, is a practical framework for building blood-sugar-friendly meals.
Can exercise alone lower A1C?
Exercise can meaningfully lower A1C on its own, but it works best as part of a broader management plan that includes meal planning and, when prescribed, medication. Physical activity improves insulin sensitivity, which helps your cells absorb blood sugar more efficiently. The effect can last up to 24 hours after a workout. Consistent aerobic exercise, resistance training, and flexibility work, totaling at least 150 minutes per week, is the recommended target.
What is considered a dangerously high A1C level?
An A1C above 9% is generally considered to indicate poorly controlled diabetes and carries a significantly elevated risk of complications including nerve damage, kidney disease, and cardiovascular problems. An A1C above 6.5% is used as one of the diagnostic criteria for type 2 diabetes. If your A1C is very high, your doctor may recommend more aggressive treatment changes, including medication adjustments, in addition to lifestyle strategies.
How often should I get my A1C checked?
How often you need an A1C test depends on how well your diabetes is currently controlled. If your A1C is below 7%, testing every six months is typically sufficient. If your A1C is at or above 7%, or if your treatment plan has recently changed, your doctor will likely recommend testing every three months. Always follow your care team's guidance on testing frequency.
Is a CGM better than a traditional glucose meter for tracking blood sugar?
Continuous glucose monitors (CGMs) and traditional fingerstick meters serve different purposes. A CGM provides real-time blood sugar data throughout the day and night, which can reveal patterns that single-point checks miss. Traditional meters are less expensive and still effective for basic monitoring. Whether a CGM is the right choice for you depends on your treatment plan, how closely you need to monitor your blood sugar, and your insurance coverage. Discuss the options with your doctor to determine what fits your situation best.
References
- American Diabetes Association. What is the A1C Test?
- Cleveland Clinic. A1C
- Science Direct. Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes
- Mayo Clinic. A1C test