How to lower your A1c

If a recent blood test showed your A1c is higher than it should be, you might be feeling panicked. After all, elevated glucose levels with prediabetes or type 2 diabetes can lead to serious health issues over time. But don’t let that panic overwhelm you. 

“There is a lot that a person with high A1c can do to manage and prevent complications of diabetes,” said Vanessa Infante, Ph.D., R.D., CDCES, and founder of The Prediabetes Dietitian. She explains that, like knobs on a control panel, you can make many small adjustments to your habits that can have a big impact on your A1c. The key is consistency: A1c is a three-month average of your blood sugar, so you need habits you can keep up with for the long run. Here’s what to focus on and how fast you can expect an improvement. 

Key takeaways

• A1c measures a three-month average of blood sugar levels and is useful for seeing how well your blood sugar is being controlled.

• Blood sugar can be affected by diet, physical activity, sleep, and stress.

• By making small, consistent changes over three months, you can start to see improvements in A1c.

A1c is shorthand for hemoglobin A1C or HbA1c, and it’s a test for measuring blood sugar, a key indicator for diabetes. You can think of the A1c test as a report card for your blood sugar. It’s not your glucose at a single moment in time. Instead, A1c shows how your blood sugar is over time (usually two to three months). 

So what counts as a “good” grade? For most adults without diabetes, here are the guidelines:

• Below 5.7% is considered normal.

• Between 5.7% and 6.4% falls into prediabetes territory.

• 6.5% or higher typically points to diabetes, although it will usually be confirmed with a second test before treatment decisions are made. 

Your doctor might set a different personal target depending on your health history, so it’s worth talking through what your number means for you.

Fun fact: Red blood cells live for about 120 days. That’s more than a random tidbit to stow away for trivia night. It can actually help you understand how to interpret your A1c test results — and the timeline for bringing an elevated A1c number down. 

The A1c test measures the amount of sugar that has attached itself to your blood’s hemoglobin (a protein in your red blood cells). And since those blood cells live for a few months, your A1c number gives you a big-picture view of glucose levels over the prior three months. Because of this, A1c is typically tested every three months, so you and your doctor can see how your blood sugar is trending over time.

This is also why you shouldn’t expect to see any meaningful changes in your A1c after a week or two of healthier habits. Instead, it takes months for your A1c to go down after changing your lifestyle.

Bodies are complex systems, and lots of factors determine the way your body uses sugar. That means if you’re trying to lower your A1c, you have lots of tools in your toolkit. A combination of lifestyle changes, including healthy eating, daily physical activity, adequate sleep, stress management, and weight management, can lower glucose levels and significantly reduce the risk of elevated blood sugar progressing to type 2 diabetes, according to Barbara Eichorst, M.S., R.D., CDCES, vice president of health care programs at the American Diabetes Association.

The key with any lifestyle change is to keep it small and buildable — something you can keep up with and add more changes on top of in a realistic way. “Small, realistic goals can be very powerful,” said Eichorst. “The goal is to identify changes that a person can incorporate into everyday life and maintain over time.”

One nutrition framework that many people find helpful is the balanced plate method: half non-starchy vegetables, a quarter lean protein, a quarter whole grains or starchy veggies. But keep in mind that there isn’t a single eating pattern that works for everyone. “Nutrition should be individualized based on a person’s health goals, preferences, culture, and lifestyle,” says Eichorst. “I encourage people to focus on the overall quality of their eating pattern and include nutrient-dense foods.”

Since A1c is roughly a 90-day average, it makes sense to set your A1c goals on the same timeline. We’ve broken down the most important steps to lowering your glucose levels each month so you know what to focus on.

Days 1–30: Build the foundation 

Just because there aren’t any quick fixes for lowering A1c doesn’t mean you can’t get some wins in early. In the first 30 days, don’t try to overhaul your entire life. Instead, get started by improving a few habits. 

• Nix sugary drinks. Liquids get absorbed into your bloodstream more quickly than solids, says Infante, so sodas, sweetened teas, sugary coffee drinks, and fruit juices will send your glucose soaring. One of the best changes you can make is to swap them out for water, sparkling water, or unsweetened options. You can do this gradually if needed. “My experience is that telling somebody to eliminate something completely might work short term, but longer term is not going to be sustainable,” said Infante. Drinking more water can also help you stay hydrated, which helps with glucose since your kidneys rely on water to help flush excess sugar. 

• Trade refined carbs for whole grain options. Replace white bread, white rice, white pasta, and flour tortillas with wheat bread, brown rice, whole wheat pasta, and corn tortillas. Since your body digests these more slowly, they don’t spike blood sugar in the same way. 

• Pick up your activity level. If you’re new to exercise, start by going on a short walk 10 to 15 minutes after eating. Doing that helps your muscles use up glucose right when those levels would otherwise spike. 

Even though you won’t get immediate gratification of a lower A1c number at this point, your daily glucose readings may start improving within days. Use that as motivation to keep going.

Days 31–60: Compound the habits

Month two is when you add on some habits that work a little more behind the scenes. 

• Lift some weights. Twice a week, start doing strength training, which can improve insulin sensitivity. Muscle tissue is fueled by glucose, so the more muscle you build, the more efficiently your body can clear sugar from your bloodstream — even on rest days. 

• Zoom in on certain nutrients. This is a good time to focus on eating protein and fiber at each meal. They both help slow down the digestion process and blunt glucose spikes. They also help you feel fuller longer, which means you’ll be less likely to reach for a spontaneous snack. 

• Think about sleep and stress management. Ignoring either of these important health factors can send stress hormones like cortisol climbing, which can quietly push blood sugar up no matter how well you’re eating.

By the end of this month, you might notice that your fasting and post-meal blood sugar numbers are trending downward, and you might even lose some weight — both signs that the changes you’ve made are taking hold. 

Days 61–90: Lock it in and re-test

Month three is all about locking in your new habits. The name of the game here is consistency, so be sure your new routines actually work for your life so you will stick to them for the long haul. 

Keep moving, but be careful not to overdo things and increase your physical activity too quickly. An injury or sore, overworked muscles can lead you to skip your workout and derail the new routines you’re settling into.

Work with your doctor to schedule an A1c test after the 90-day mark. At that point, you may start to see meaningful improvements in your blood sugar numbers based on these lifestyle changes. Together, you and your clinician can talk about whether you should adjust the plan.

If your doctor has diagnosed you with prediabetes, that is the perfect moment to get serious about having healthier habits. That’s because, for many people, it is possible to reverse prediabetes with lifestyle changes. The landmark Diabetes Prevention Program Outcomes study showed that a group of people who made lifestyle changes, including improving their diet and increasing their exercise level (with a goal of at least 7% weight loss and a minimum of 150 minutes of physical activity each week), were 58% less likely to develop type 2 diabetes after three years.

Blood sugar is often the highest in the morning due to something known as the dawn phenomenon. This is natural — it’s caused by hormonal changes linked to your circadian rhythm — and isn’t necessarily something to worry about. But if you’re concerned about how high your blood sugar is spiking in the morning, a good place to start is to make smart breakfast choices. Choose foods that will give your body the nutrients it needs (protein and fiber!) without the added sugars and simple carbohydrates that can make blood sugar climb even higher. 

It’s also worth looking at your nighttime routines. For example, you can experiment with eating dinner earlier in the evening, going for a walk after dinner, or skipping your usual late-night snack to see if that helps with your morning high blood sugar.

A1c targets are individualized, and no article on the internet (even this one) can tell you with certainty what is right for your body. Your doctor will tell you whether the standard A1c goal of below 5.7% makes sense for you. 

For some people, healthy lifestyle behaviors aren’t enough to get to the goal. If you are struggling to manage your A1c naturally, medications like metformin and GLP-1s can help, and your doctor will be able to guide you in deciding if medication makes sense for you. “Medication decisions are considered based on more than A1c alone,” said Eichorst. “Cardiovascular and kidney health, weight goals, risk of hypoglycemia and other health conditions, treatment burden, cost, and individual preferences can all influence which treatment is most appropriate.”

Once your doctor prescribes you a diabetes medication, don’t stop taking it or change your regimen without talking to them first. Managing blood sugar correctly can be a nuanced thing, and you want your doctor on board with any decisions you make.

Depending on your needs, Weight Watchers can give you an assist while you work to lower your A1c. Here’s how:

• If you have diabetes: Members on the Weight Watchers Diabetes Program had a 0.75 drop in A1c after just six months.* Moreover, another study showed that those who paired the Weight Watchers Diabetes Program with continuous glucose monitoring (CGM) had a 0.9 drop in A1c in six months.** This tailored plan offers guidance for blood-sugar-friendly eating, along with goals for key nutrients and activity. You also get access to Workshops and Coaches for support when you need it, and if you have an eligible model, you connect your CGM to the WW app and have your most important data all in one place. 

• If you have prediabetes: The Weight Watchers Core+ Program can help you create healthier habits and improve your A1c. Recognized by the CDC as a Diabetes Prevention Program, it’s proven to help with weight loss and can help lower glucose levels in those with prediabetes.

• If you want 1x1 support: No matter your program, working with a registered dietitian can help make implementing diet changes for a lower A1c feel easier. You can access one through Weight Watchers even if you aren’t a member, and your appointments may cost as little as $0 with qualifying insurance (copays, coinsurance & deductibles may apply). 

A1c measures your blood sugar levels over time, and it’s a key indicator of diabetes risk. People with an elevated A1c who don’t yet have diabetes could improve their blood sugar levels by making consistent changes to diet and exercise. And even those with diabetes can see a meaningful improvement in A1c by prioritizing healthy habits. Because it takes three months to start to see an improvement in A1c, finding habits you can stick with is key. Whether you’re living with prediabetes, type 2 diabetes, or no type of diabetes, Weight Watchers can help you change your lifestyle in ways that support your health and improve your A1c.