Managing diabetes can feel overwhelming, but understanding your A1c levels is a great place to start. A1c measures your average blood sugar levels over the past two to three months, giving you and your healthcare team a clearer picture of your overall diabetes management. Kelly King, a registered dietitian and certified diabetes care and education specialist with the Texas Health Virtual Care Delivery team, shares her top tips on how to lower your A1c and keep it managed over time.

What is a Target A1c Level?

When you eat carbohydrates, they break down into sugar, which enters the bloodstream and attaches to hemoglobin inside red blood cells. This is referred to as blood glucose, or blood sugar.

“New red blood cells are created each day and live for 2-3 months which is how the A1c test can provide a 2 to 3-month average of blood glucose,” King explains.

For most people with diabetes, the goal is to keep A1c below 7%, which equals an average blood sugar level of around 154 mg/dL. However, the target can vary.

“The target A1c is individualized,” says King. “For most, based on the 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.”

On the other hand, some people may have a higher goal. “A1C targets tend to be higher — less than 8% — for those who are older or have multiple chronic illnesses,” adds King.

It’s important to get your A1c checked regularly and work with your doctor to find the best target for you. The A1c along with your daily blood glucose level readings will assist your doctor in adjusting your medications or let you know how well you are doing.

You should get your A1c checked every 6 months if your A1c is less than 7% and every 3 months if it is greater than 7%.

Focus on Your Meal Planning

One of the most effective ways to lower your A1c is by adjusting your meal plan. However, contrary to popular belief, this doesn’t mean cutting out all carbs. Instead, King notes it’s more about balancing them with proteins and healthy fats.

She recommends trying the Plate Method: “Following the Plate Method — half vegetables, a quarter protein, and a quarter carbohydrate — can help balance your meals by pairing carbohydrate intake with protein and healthy fats.”

This helps prevent blood sugar spikes and keeps you feeling fuller for longer.

King also emphasizes the importance of fiber and reducing sugar. Increasing fiber intake to 25-30 grams per day and reducing added sugars from sweets and sugary drinks can be very effective in lowering A1c.

Get Moving

Physical activity plays a key role in lowering A1c because it helps your body use insulin better. Even a 30-minute walk five days a week can make a big difference.

“Exercise helps your body be more sensitive to insulin and can lower blood glucose levels during and up to 24 hours after exercise,” King adds.

She suggests aiming for 150 minutes of exercise per week, incorporating a mix of aerobic activities, resistance training, and flexibility exercises.

 “It’s important to get a variety of exercises, such as aerobic activities like walking or swimming, resistance training like weightlifting, and flexibility exercises like yoga or stretching,” says King. “Finding an exercise you enjoy can help you stick with it.”

Manage Stress and Sleep

Stress and sleep quality both have a significant impact on blood sugar levels.

“Stress can increase blood glucose levels, which means it can also increase A1c” King explains. “So, it’s good to find ways to help manage your stress to assist with keeping your blood glucose level and A1c managed.”

She suggests options like therapy, listening to music, exercise such as yoga, talking to a friend, deep breathing techniques, and engaging in hobbies you enjoy.

Additionally, King notes that sleep is just as important.

“It’s important to have good quality sleep to assist with blood glucose management,” she says. “Without it, you’re less likely to engage in diabetes self-care because you’re tired or less motivated, which can lead to higher blood glucose levels.”

Ways to improve sleep quality (to name a few) include creating a sleep schedule, exercising during the day, putting electronics away before bed, limiting caffeine, and speaking with your doctor if you believe you may need additional assistance.

Stick to Your Medications

If you’ve been prescribed medication to help manage your diabetes, it’s important to take it as directed.

“Oral diabetes medications can reduce A1c by 0.5-2%, and insulin can bring your A1c to target within three months if you are on the right amount,” explains King.

King knows there’s a variety of reasons why you may struggle to take your medication, from cost or side effects, to simply just forgetting.

If forgetfulness is an issue, King suggests setting reminders or using tools like a pill organizer. If there are concerns about cost or side effects, she encourages patients to speak with their doctor about alternatives.

“There are assistance programs, coupons, and even low-cost medication options available, so always talk to your doctor before stopping a medication.”

Track Your Progress

Monitoring your blood sugar regularly is key to lowering your A1c. Some people might only need to check once a day, while others — especially those using insulin — might need to check more frequently.

“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.

Tools like continuous glucose monitors (CGMs) or apps that sync with your glucose meter can also make tracking easier and more convenient.

Celebrate Your Successes

Lowering your A1c is a huge achievement! Once you reach your target, King advises taking time to reflect on the progress you’ve made.

“It’s essential to congratulate yourself and recognize all the positive changes you’ve seen. This will help keep you motivated to stick with the changes long-term,” she says.

But remember, it’s important to keep up with the healthy habits that helped you reach your goal.

“A common issue I see happen is people getting too relaxed with monitoring or their meal plan, slipping back into old habits,” she adds. “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 down the progression of complications.”

The Takeaway

Lowering your A1c takes time, but with a combination of healthy eating, regular exercise, stress management, and medications, you can improve your numbers and overall well-being. Work closely with your doctor or health care team to find the strategies that work best for you — and don’t forget to celebrate your successes along the way!

For more information about diabetes visit TexasHealth.org/Diabetes.