Diabetes is a serious, chronic disease that can lead to many complications. But diabetes doesn’t have to control your life. Getting your A1c level tested, especially if you’re at risk for developing type 2 diabetes, is a good way of taking care of yourself. An early diagnosis helps you get treatment before complications can occur.
The A1c test is a blood test that screens for diabetes and shows how well you’re managing the condition. The test provides information about a person’s average levels of blood sugar over a two- to three-month period before the test.
The number is reported as a percentage. If the percentage is higher, so are your average blood glucose levels. This means your risk for either diabetes or related complications is higher.
A1c is one of the primary tests used for diabetes diagnosis and management. It can test for type 1 and type 2 diabetes, but not for gestational diabetes. The A1c test can also predict the likelihood that someone will develop diabetes.
The A1c test measures how much glucose (sugar) is attached to hemoglobin. This is the protein in red blood cells. The more glucose attached, the higher the A1c.
The A1c test is groundbreaking because:
- It doesn’t require fasting.
- It gives a picture of blood sugar levels over a period of weeks to months instead of at just one time, like fasting sugars.
- It can be done at any time of day. This makes it easier for doctors to give and make accurate diagnoses.
Having prediabetes puts you at risk for developing type 2 diabetes within 10 years. But, you can take steps to prevent or delay developing diabetes. If you test positive for prediabetes, it’s best to get retested every year.
You’ll probably receive a diagnosis of type 2 diabetes if your A1c is 6.5 percent or higher. For many people with established diagnosis of diabetes, keeping your A1c levels below 7 percent can reduce the risk of complications.
You can lower your A1c by making changes to the following:
- exercise regimen
If you already have diabetes and are taking medications that can cause low blood sugar levels, find out your optimal levels. In people at risk for hypoglycemia, for example, it may not be safe to keep their A1c level below 7 percent.
The medications that lower fasting blood sugars will also lower your A1c level. Some medications primarily affect your blood sugars after a meal, also called post-prandial blood sugars. These medications include Januvia (sitagliptin), repaglinide, and others. While these medications don’t significantly improve fasting glucose values, they still lower A1c level because of the decrease in post-meal glucose spikes.
Here are six ways to lower your A1c:
1. Make a plan
Take stock of your goals and challenges with a diabetes management planning worksheet. A plan will help you figure out your biggest challenges, like:
- losing weight
- coping with stress
- eating a healthy diet
Planning will also help you set goals. Form small steps you can take to achieve your goals in a reasonable amount of time.
2. Create a diabetes management plan
If you have diabetes, create a diabetes management plan with your doctor. Your plan should include:
- emergency contacts
- medical instructions
- medication list
- target blood glucose levels
- instructions on how to test
- information on how often to test
- plan on how to correct low blood sugars
Keeping everyone on the same page is the best way to manage diabetes safely and bring down your A1c levels.
3. Track what you eat
Use an online tool or print out a chart to record what you eat and when you eat. Tracking what you eat makes you aware of foods and behaviors you can change to decrease your A1c. This can also help you monitor your carbohydrate intake, which is important for managing blood sugar.
4. Eat a healthy diet
To eat a healthy diet, do the following:
- Take in fewer calories than you burn.
- Eat less saturated fat.
- 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 from a plant, don’t.” So, you don’t need to avoid eating “healthy” carbs to lower your A1c.
Managing diabetes and lowering A1c is about monitoring how many carbs you’re eating at one time. It’s beneficial to choose healthier, nutrient-dense carbs, like fruits or sweet potatoes. But make sure to account for how much of them you’re eating at one time.
Most people need about 45 to 60 grams of carbs per main meals and about 15 to 30 grams for each snack. If you want to enjoy watermelon, for example, account for about 11 grams of carbs per 1 cup diced.
5. Set a weight loss goal
Losing weight is important if you’re overweight. But you can’t manage diabetes with fad diets. Lifelong changes are key. Eating healthy, whole foods low in fat and calories that work with your lifestyle will help you make a change for life.
Keep a fat and calorie counter 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 confirmation from your doctor first before you increase your activity level. In the Diabetes Prevention Program at the University of Pittsburgh, being more active was key in reducing the risk of developing diabetes.
Remember: Any exercise is better than no exercise. Even getting up for two minutes every hour has been shown to help reduce the risk of diabetes.