In this article, let us see "10 well-proven steps to lower A1C" Why should you lower your A1C? What should be your A1C number? How long it takes to reduce your A1C levels? And finally, don’t try achieving your target A1C with too much hypoglycemia.
Let us, start with;
How to lower A1C?
To lower A1C, blood sugar levels should maintain within the target range without low (hypo) or high (hyper). Naturally, you may want to ask, how to keep blood sugar within a healthy range?
A low-carbohydrate diet, in combination with regular exercise, can help lower your HbA1c.
On the other hand, a high-carb diet causes blood glucose spikes and needs more insulin, thus it is challenging to maintain blood sugar. If you reduce your insulin requirement (i.e. low carb diet), then it is easier to prevent hypo or hyper, thus able to maintain a better blood sugar level.
Why should you lower your A1C?
High A1C increases the chances of developing diabetes complications of heart, kidney, eyes, and nerves.
The clinical trials; the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) have found a correlation between lowering A1C with a decrease in diabetes complications. Also, for lowering every 1% of the A1C can reduce complications as below:
- Eye disease by 76%
- Nerve damage by 60%
- Heart attack or stroke by 57%
- Kidney disease by 50%
Achieving your target A1C is one of the most important things you have to do to improve your long-term health.
What should be your A1C number?
The clinical studies and Dr. Richard K. Bernstein's experience confirmed that an optimal A1C target is 4 to 4.6%. This A1C target helps to avoid diabetes complications and provides the longest life expectancy.
However, the right A1C for you is based on five crucial things:
- Your age,
- Ability to identify hypoglycemia,
- The frequency of hypoglycemia,
- Other health conditions you have, and
- Expected life expectancy.
Optimal A1C is better if you can achieve it without any hypoglycemia risk. If you cannot be able to identify your early symptoms of hypo, then you should aim for a slightly higher A1C. Discuss with your healthcare professionals to help set a perfect A1C goal for you.
Everyone agrees elevated blood sugar leads to diabetic complications. The blood sugar goals advised by the American Diabetes Association (ADA), the Canadian Diabetes Association (CDA) & the Australian Diabetes Association (ADS) are on the higher side.
It is always preferable to maintain the blood glucose level in the range of healthy non-diabetic individuals to avoid diabetes complications. Healthy non-diabetics fasting blood sugar stay within 70 to 100 mg/dL or 3.8 to 5.5 mmol/l. After meals (post-meal) it can rise to 120 mg/dL or 6.7 mmol/l and drops below 100 mg/dL or 5.5 mmol/l within two hours.
Know your limits, but never stop trying to exceed them. However, don’t fix any target that is hard to achieve.
It may make you disappointed and lose heart to deliver it again. Instead, aim for an easy target, once you realized it, you would gain knowledge and confidence to proceed to the next level.
10 Sure Tips to Lower Your A1C
Firstly, don’t get discouraged over your numbers. Trends are more concerned than a single test.
Many people with diabetes frequently ask; my numbers are high! How can I lower my A1C? To solve a problem, you should dig up to the root of the problem instead of just hacking at the leaves. So, start from scratch to analyze the problematic areas to correct them to achieve your target A1c.
Achieving your set target is not an easy job. It requires patience, interest to learn, ability to analyze, willpower to accept failures and stick with the plan.
Below are the ten well-proven steps to lower A1C:
1. Carefully choose food
Food has a direct impact on blood glucose and, subsequently, A1C.
Choose a healthy diet: Avoid sugar, refined carbs, and factory-made foods. However, you can enjoy it on rare occasions during festivals; occasionally, high BS does not cause significant damage. Still, you should practice limit; otherwise, your blood sugar level may get disturbed, and become difficult to bring it back to track. An adequately chosen Diabetes diet is effective in blood-glucose management and achieving target a1c.
Low-carb or low-fat diet, which one to choose? - Type 2 diabetes has a problem with carbohydrate metabolism. For type 1 diabetes high carb diet makes it difficult to manage BS. So, whether you are type 1 or type 2, a low-carb or reduced-carb diet is the best. However, don’t lose the nutritional benefits of vegetables, fruits, nuts, seeds, and greens. You can lower your carb in steps until you reach your A1C goal.
Choose your carb wisely - Laying off the simple carbohydrates help a lot. Refined and processed carbs like white bread, white rice, chips, soda, cookies, and sweets cause blood glucose spikes, and are also, it is found to increase the risk of diabetes, heart disease, inflammation, and obesity.
Choose unrefined carbs that retain their fiber, vitamins, minerals, and other natural compounds, which promotes health. Prefer low glycemic index foods such as beans, seeds, whole grains, vegetables, and fruits.
Consistent with your carb intake – Plan to eat the same amount of carbs at every meal on all days. It can help achieve your target a1c because your body finds it easy to handle. For this, you need to learn carb counting in your meals.
Restrict calorie intake: A study shows restricted calorie intake leads to a healthier life and the best life expectancy. Calorie restriction helps to lower your blood sugar & A1C; also, it improves health in unexpected ways.
Have meals at the same time every day: Taking your meals on time could stop BS fluctuation. But, if you wish, you can skip dinner with just a glass of warm milk with a pinch of turmeric.
Try achieving your target by changing your diet, their combination, timing, and or its frequency.
2. Food that might help lower A1C
A1C lowering Foods: Certain foods and herbs can help lower your A1C. Functional foods are avocados, berries, cold-water fish, fiber-rich grains, legumes, nuts, green tea, spinach, cocoa, red wine, and vinegar. Useful herbs are cinnamon, fenugreek, and garlic. Try incorporating these into your regular diet.
Dark Chocolate - Type 1 diabetes patients who consumed dark chocolate 25 grams per day for 2 to 5 times per week have shown a significantly lower in A1C.
Drink More Water - A study showed that 1 cup of plain water per day was associated with a -0.04% lower A1C in men. So, drinking more water can support lowering your A1C.
3. Increase physical activities
Exercise reduces insulin resistance and helps to move the glucose better into the muscles with lesser insulin requirements.
Exercise helps lower your A1C: Exercise burns more sugar, thus helping lower your blood sugar and A1C. Exercise for diabetes makes you physically & mentally feel better and stress-free. This peaceful state helps lower blood glucose spikes. If you build muscles, then it increases your calorie consumption, which in turn contributes to maintaining good BS.
Aerobic exercise, resistance training, and their combination were associated with declines in A1C levels in type 1 & type 2 diabetics.
Exercise has shown more benefits in shorter bouts of 10min with higher intensity.
4. Lose weight if you are overweight
Losing weight helps achieve A1C: Losing weight reduces insulin resistance in type 2 diabetes, thus drop in BS and A1C. In obese type 1 diabetes, losing weight reduces the total insulin requirement and better blood sugar control.
Studies show 5 to 10% weight loss makes a massive health benefit; they need less medicine, better BS & A1C, reduced complications, and lowers cholesterol & blood pressure.
5. Minimize & manage stress smartly
Stress or other psychological problems leads to disturbance in the blood sugar, which in-turn disturb A1C.
Psychological problems fluctuate A1C: Stress, depression, anger, anxiety, and panic can fluctuate your BS and A1C. The stress puts you on the fight or flight response mode; this makes your number become crazy and would not stabilize.
Many studies confirm a negative mindset affects your number even if you are perfect in other things. The positive thoughts make a massive benefit in attaining optimal A1C and improved wellness. Stress increases hormone secretion, which makes it harder for insulin to perform its regular duty.
Keep yourself cool using music, dancing, aerobics, yoga, and meditation.
6. Get Restful Sleep
During sleep, the body performs detoxification and repair. So, sleep duration & quality is essential for better A1C and overall health.
Studies show type 1 diabetes sleeping more than 6 hours had lower A1c levels. Similarly, getting restful sleep (good quality sleep) had a lower A1c. Another study shows both shorter sleep duration of less than 5h and longer sleep duration of more than 9h were associated with an increased A1c in type 2 diabetes patients.
7. Exposing to Sunlight
Studies found vitamin D plays a vital role in insulin production and has a positive association with insulin resistance.
Vitamin D supplementation decreases A1c levels in children and adolescents with type 1 diabetes. Enhanced vitamin D supplementation also improves A1c in type 2 diabetes.
Regular exposure to the sun is the most natural way to get the required vitamin D. Plan to receive 10 to 30 minutes of sunlight most of the day in a week, to fulfill the recommended vitamin D requirement.
8. Understand influencing factors
Many things may affect your blood sugar. They are food type, calorie intake, eating time, routines, stress, infection, sleep quality, illness, weather, pollution, and electromagnetic radiation. Try to figure out which one affects you the most and learn how to reduce its influence.
Food type: Avoid foods that are allergic to you. Also, certain foods might cause more BS spikes; find and avoid them.
Eating time: Maintain regular eating time every day. Avoid late-night eating that might disturb your BS as well as your health. It is better to complete your dinner before 9 pm and should not eat after 10 pm.
Thyroid problems: Have you had your thyroid checked lately? A slightly low level may cause spikes in BS along with a little weight gain.
Infection of any form raises BS levels: Also, high blood sugar level increases infection risk. You can even suspect infection if your glucose level is spiked without reason. Beware of oral diseases; brush twice daily, floss after meals, and scrap tartar & plaque regularly.
Maintain room temperature: Cold weather may increase A1C levels. For every 1°C decrease in temperature, there was an increase in the risk of A1C of more than 7%
Avoid air pollution: Air pollution was associated with higher A1c. Keep your living space cleaner. If possible, get an air purifier.
Reduce exposure to electromagnetic radiation: Exposure to high electromagnetic radiation is associated with elevated levels of A1c. You can reduce electromagnetic radiation by limiting the sources, reducing exposure time, increasing the distance from the source, and using radiation shields.
9. Achieving your target BS
Try to maintain your BS as close to the healthy non-diabetic range. If you are experiencing frequent hypoglycemia, then you should be lenient until you can able to avoid lows.
What to do if experiencing frequent High & Low BS? - If you find it difficult to control your BS due to successive highs & lows, then you need to start from scratch. If you are type 1 diabetes, then begin again ultimately by determining your basal and bolus rates.
Setting the right basal rate is more important to avoid both highs & lows and is the foundation on which the bolus dosing works.
10. Proper treatment to lower A1C
Follow your treatment plan: Diabetes treatment is highly individualized. You & your healthcare provider can determine the steps you need to take to manage diabetes successfully. Always discuss with your healthcare team before making any changes.
Medication is not everything: Many patients think medicine or insulin can fix diabetes. It is only a small part of diabetes management. You need to support it with a proper diet and physical activity for it to work and produce the expected result. Many type 2 diabetes can control BS without medicine through a synergic combination of healthy eating and exercise. In the case of type 1 diabetes, this synergic combination helps lower the insulin dose.
A slight modification in the treatment makes a significant difference: Sometimes changing the insulin treatment, dosage, or timing can make a huge difference. Just by shifting your insulin shot to 15 minutes before your meal can help stop BS spikes after eating. Try achieving your target A1C by modifying your diabetes medication or insulin - dose, type, timing, and or frequency.
Avoid mistakes: Periodically confirm that your glucose meter is accurate. Be sure you are pricking your finger correctly. Choose the proper lab for error-free A1C results. Be careful about the expiry date of the medicines & test strips.
Don't expect too much too soon: Do not rush to see results. Instead, be slow and consistent to achieve a permanent, stable result. To make a lasting change, take small steps, and set achievable goals. If you try more than you can handle, you might end up quitting. Don't set unrealistic goals, instead set reachable goals based on your potential.
Every individual is different, “Your Mileage May Varies YMMV.” So, an easy A1C target for your friend is not that easy for you and vice versa.
How long it takes to lower your A1C levels?
Is it possible to lower A1C levels overnight? It is impossible to drop your A1C overnight. Unlike your blood sugars which can go up or down within minutes, your A1C will take weeks to change. A1C value is a measure of your average blood sugar for the past three months. So, if your A1C is 10% or higher, then it is possible to lower it within one to two months. However, if your A1C is at 7%, it may take longer to lower.
Health problems such as gastroparesis can make it tougher to achieve the A1C target.
In such a case, you need to fix a slightly lenient a1c goal.
Don’t try achieving your target A1C with much hypoglycemia.
Your A1C level might be 5.6%, but if you achieve this with a lot of low blood sugar, then it is not suitable for your health. Because, what is essential is time-in-range, which refers to the percentage of time your blood sugar is within your target range.
For example, see the graph with three blood sugar fluctuations. You should prefer to achieve line 3, which is the best one, and not the 1, which is the worst. Because all the time the blood sugar in the line 3 is within the target range of blood sugar. Line 2 has few out of target range and line 3 has the highest fluctuation with many highs and lows.
Achieving a target A1C with many blood sugar highs and lows is not beneficial to your health; instead, try achieving a1c with blood sugar always or mostly within the target range.
My best wishes for you to reach your target A1C most healthily.