What is a normal a1c supposed to be

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You've probably had your blood glucose level checked — a quick prick of the finger and a drop of blood reveals how much sugar is in your bloodstream. This is a helpful tool for diagnosing and managing diabetes, but it only shows your blood glucose level at that moment. Unless you've fasted and timed the test correctly, it's not an accurate way to know how your body processes sugar all the time.

Your A1C level is your average blood glucose level over the past three months. Knowing this number helps your doctor find and treat diabetes (and prediabetes) before you experience serious complications.

Why Your A1C Level Matters

Diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Most cases of type 2 diabetes can be managed with diet, exercise, and medication, but uncontrolled blood glucose levels increase the risk for heart disease, stroke, eye problems, foot and leg amputations, and kidney failure.

Approximately 30.3 million Americans have diabetes — that's about 9 percent of the U.S. population. Of those living with diabetes, 7.2 million are undiagnosed. Another 84.1 million American adults have prediabetes, meaning they're at risk of developing diabetes without medical intervention and lifestyle changes. Regular A1C testing would help your doctor catch the disease early, often while it's preventable. If you've already been diagnosed with diabetes, your A1C tells your doctor whether the current treatment plan is working.

What the Numbers Mean

The A1C test measures how much glucose is attached to the hemoglobin in your blood. The results are reported as percentages. To diagnose diabetes with an A1C test, physicians use the following scale:

Normal: below 5 percent
Prediabetes: 5.7 to 6.4 percent
Diabetes: 6.5 percent or higher

It's recommended that diabetics maintain an A1C level below 7 percent to prevent complications.

7 Ways to Improve Your A1C

Whether you're managing diabetes or trying to avoid it, you can lower your blood glucose levels by:

1. Exercise

Physical activity helps your body use insulin more efficiently, so it can better process the glucose in your blood. Consistent exercise can lower blood glucose and improve your A1C. It also lowers your risk for heart disease, stroke, and other serious diseases for which diabetics are susceptible. Aim for 30 minutes of exercise at least five days per week.

2. Eat Right

Go easy on the sweets and sugary beverages, white breads, potatoes, pastas, starchy vegetables, and other carbohydrate-rich foods as these increase your blood sugar levels. Instead, opt for foods that are high in fiber, fruits and vegetables, small servings of lean meats and poultry, and low-fat milk or cheese.

3. Take Medications as Prescribed

Some people can manage diabetes and prediabetes with diet and exercise; others need medication. The right medication and dosage varies from person to person, so work with your doctor to create an individualized treatment plan, and then stick to it.

4. Manage Your Stress

Stress causes your body to behave as if you're under attack. To prepare for a fight-or-flight response, the body stores up energy in the form of glucose and fat. Over time, this can increase your A1C level. To reduce stress, make time to relax, spend time with people you love, and do things you enjoy. Mindful meditation and other relaxation techniques can also help. If you still feel chronically stressed, talk to your doctor.

5. Stick to a Schedule

If you go too long without eating, your blood glucose levels could drop too low. You'll also be more likely to overeat later, causing your blood sugar to spike. Plan to eat three well-balanced meals and two healthy snacks each day.

6. Drink in Moderation

Drinking alcohol can cause drops in your blood sugar, especially if you haven't eaten or if your glucose levels are already low. Otherwise, the American Diabetes Association recommends that diabetics follow the same guidelines as everyone else: no more than one drink per day for women and two drinks per day for men.

7. Monitor Your Numbers

If you've been diagnosed with diabetes or prediabetes, it's important to check your blood glucose levels as often as your doctor recommends to prevent spikes and dangerous drops. Your doctor will also want to keep a close watch on your A1C level to ensure your current treatment plan is keeping your condition under control.

Diabetes is a serious, lifelong condition, but with some healthy changes and the right care providers in your corner, you can still live a full and healthy life.

Overview

The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes. If you're living with diabetes, the test is also used to monitor how well you're managing blood sugar levels. The A1C test is also called the glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C or HbA1c test.

An A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated). Hemoglobin proteins in red blood cells transport oxygen.

The higher your A1C level is, the poorer your blood sugar control and the higher your risk of diabetes complications.

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Why it's done

The results of an A1C test can help your doctor or other health care provider:

Diagnose prediabetes. If you have prediabetes, you have a higher risk of developing diabetes and cardiovascular disease.
Diagnose type 1 and type 2 diabetes. To confirm a diabetes diagnosis, your doctor will likely look at the results of two blood tests given on different days — either two A1C tests or the A1C test plus another test, such as a fasting or random blood sugar test.
Monitor your diabetes treatment plan. The result of an initial A1C test also helps establish your baseline A1C level. The test is then repeated regularly to monitor your diabetes treatment plan.

How often you need the A1C test depends on the type of diabetes, your treatment plan, how well you're meeting treatment goals and your primary care doctor's clinical judgment. For example, the A1C test may be recommended:

Once every year if you have prediabetes
Twice a year if you don't use insulin and your blood sugar level is consistently within your target range
Four times a year if you take insulin or have trouble keeping your blood sugar level within your target range

You may need more-frequent A1C tests if your doctor changes your diabetes treatment plan or you begin taking a new diabetes medication.

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How you prepare

The A1C test is a simple blood test. You don't need to fast for the A1C test, so you can eat and drink normally before the test.

What you can expect

During the A1C test, a member of your health care team takes a blood sample by inserting a needle into a vein in your arm or pricking your finger tip with a small, pointed lancet. If the blood is taken from a vein, the blood sample is sent to a lab for analysis.

Blood from a finger prick may be analyzed in your doctor's office for same-day results. This in-office test is only used for monitoring your treatment plan, not for diagnosis or screening.

Results

A1C test results are reported as a percentage. A higher A1C percentage corresponds to higher average blood sugar levels. Results for a diagnosis are interpreted as follows:

Below 5.7% is normal.
5.7% to 6.4% is diagnosed as prediabetes.
6.5% or higher on two separate tests indicates diabetes.

For most adults living with diabetes, an A1C level of less than 7% is a common treatment target. Lower or higher targets may be appropriate for some people.

The target of less than 7% is associated with a lower risk of diabetes-related complications. If your A1C level is above your target, your doctor may recommend an adjustment in your diabetes treatment plan.

A1C and self-monitoring

A part of your treatment plan will include self-monitoring at home with a blood glucose meter or other device. Your health care team will direct you on how often and when you should test your blood sugar.

Your self-monitoring device reports your blood sugar levels in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L). The measurement shows your blood sugar level at the time you do the test. Therefore, there is some variability throughout the day based on eating, exercise, stress and other factors.

Self-monitoring helps you make choices about diet and exercise and daily treatment goals, but it also helps you track whether you are meeting your A1C target. For example, if your A1C target is below 7%, your self-monitoring blood sugar levels should be, on average, below 154 mg/dL (8.6 mmol/L).

A1C test results generally correspond with the following results of blood sugar levels:

A1C level	Estimated average blood sugar (glucose) level
6%	126 mg/dL (7 mmol/L)
7%	154 mg/dL (8.6 mmol/L)
8%	183 mg/dL (10.2 mmol/L)
9%	212 mg/dL (11.8 mmol/L)
10%	240 mg/dL (13.4 mmol/L)
11%	269 mg/dL (14.9 mmol/L)
12%	298 mg/dL (16.5 mmol/L)

Limitations of the A1C test

Some factors may interfere with the accuracy of A1C test results. These include:

Pregnancy
Recent or heavy blood loss
Recent blood transfusion
Conditions that result in insufficient red blood cells (anemias)
Hemoglobin variants

The most common form of the oxygen-transporting hemoglobin protein is called hemoglobin A. The presence of other variants of the protein may result in inaccurate A1C test results. Hemoglobin variants are more common among people of African, Mediterranean or Southeast Asian descent.

If you have a hemoglobin variant, your test may need to be sent to a specialized lab or you may need a different test for diagnosis and monitoring of diabetes.

Jan. 30, 2021

How can I get my A1C down quickly?

7 Ways to Improve Your A1C.

Exercise. Physical activity helps your body use insulin more efficiently, so it can better process the glucose in your blood. ... .

Eat Right. ... .

Take Medications as Prescribed. ... .

Manage Your Stress. ... .

Stick to a Schedule. ... .

Drink in Moderation. ... .

Monitor Your Numbers..

What is an acceptable A1C level for a diabetic?

The goal for most adults with diabetes is an A1C that is less than 7%. If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range. If you have an A1C level of 6.5% or higher, your levels were in the diabetes range.

Can you have a high A1C and not be diabetic?

Yes, you can have a high A1C level and not have diabetes. This is because an A1C test measures the amount of glucose that's attached to hemoglobin. So anything that affects hemoglobin can alter the results. Certain medications, such as steroids, can also raise blood glucose levels in people who don't have diabetes.