Diabetes is a serious, chronic disease that can lead to many complications. When managed properly, diabetes does not have to control your life or ruin your health. Getting tested, especially if you are at risk for developing type 2 diabetes, is a proactive measure you can take for yourself and your future. In the early stages of diabetes, there are no symptoms. An early diagnosis helps you get treatment before complications occur.
The A1C test is a blood test that checks for type 2 diabetes. It is also used to see how well you are managing your diabetes if you have already been diagnosed. The test provides information about a person’s average levels of blood sugar over a two- to three-month period. The number is reported in the form of a percentage. The higher the percentage, the higher your average blood glucose levels are, and the higher your risk for either diabetes or related complications.
A1C is one of the primary tests used for diabetes diagnosis and management. It can test for type 1 and type 2 diabetes, but it can’t test for gestational diabetes. It can also be used to predict the likelihood that someone will get diabetes.
The A1C test measures how much glucose, or sugar, is attached to hemoglobin, the protein in red blood cells. The more glucose attached, the higher the A1C. This test is groundbreaking, as it 1) doesn’t require fasting, 2) gives a picture of blood sugar levels over a period of days and weeks instead of at just one point in time like fasting sugars, and 3) can be done at any time of day. This makes it easier to administer and easier to make accurate diagnoses.
According to the National Institutes of Health, a normal A1C is below 5.7 percent.
If your score is between 5.7 and 6.4 percent, the diagnosis is prediabetes.
Having prediabetes puts you at risk for developing type 2 diabetes within 10 years. The good news is that you can take steps to prevent or delay progressing to diabetes. If you test positive for prediabetes, it’s a good idea to get retested every year.
If your A1C is 6.5 percent or above, you will probably be diagnosed with type 2 diabetes. If you have diabetes, you can reduce the risk of complications by keeping your A1C levels below 7 percent.
You can lower your A1C by making small changes to your exercise regimen, diet, medication, and overall lifestyle. If you already have diabetes, find out your personal optimal levels. People at risk for hypoglycemia, for example, may not safely keep their A1C level below 7 percent.
1. Make a plan.
Take stock of your goals and challenges with a diabetes management planning worksheet. A plan will help you answer questions to discover your biggest challenges, like weight loss, exercise, coping with stress, or eating healthfully. It will also help you set a goal, and suggest small steps you can take to achieve that goal in a reasonable amount of time.
2. Create a diabetes medical management plan.
If you have diabetes, create a diabetes management plan with your doctor. It should include emergency contacts, medical instructions, a medication list, target blood glucose levels, and instructions on how, and how often, to test. Keeping everyone on the same page is the best way to manage diabetes safely and bring down A1C levels.
3. Track what you eat.
Use an online tool or print out a chart to record what you eat and when. Tracking what you eat makes you aware of foods and behaviors you can change to decrease your score. This can also help you monitor your carbohydrate intake, which is important for managing blood sugar.
4. Eat more healthfully.
Take in fewer calories than you burn, eat less saturated fat, and eat fewer processed foods. Take a tip from Michael Pollan’s book “Food Rules”: “If it came from a plant, eat it; if it was made in a plant, don’t.”
You do not need to avoid eating “healthy” carbs to lower your A1C. Managing diabetes and lowering A1C is about monitoring how many carbohydrates you are eating at one time. It is beneficial to choose healthier, nutrient-dense carbs like fruits or sweet potatoes, but make sure to account for how much of them you are eating at one time. Most need about 45–60 grams of carbohydrates per main meals, and about 15–30 grams for each snack. If you want to enjoy watermelon, for example, account for about 11 grams of carbs per 1 cup diced.
It has been proven that a plant-based diet that focuses more on unsaturated fats is better for blood sugar management and heart health.
5. Set a weight loss goal.
Losing weight is important, but you can’t manage diabetes with fad diets. Lifelong changes are the key. A healthy, whole food-based eating plan that is low in fat and calories, and that works with your lifestyle, will help you to make a change for life. Keep a fat and calorie counter on hand to help you make smart choices. Even a 5- to 10-percent loss in body weight decreases chances of getting diabetes by 58 percent. Small amounts make a big difference.
6. Get moving.
Increase your activity level to get your A1C level down for good. Start with a 20-minute walk after lunch. Build up to 150 minutes of extra activity a week. Get the okay from your doctor to increase your activity level first. In the Diabetes Prevention Program at the University of Pittsburgh, being more active was key in reducing the risk of developing diabetes. Remember: Anything is better than nothing. Getting up for two minutes every hour has been shown to help reduce the risk of diabetes!