The hemoglobin A1c (glycated hemoglobin, HbA1c) is a biochemical marker that shows long-term glucose control over 90 days. HbA1c is one of the tests used for diabetes diagnosis and monitoring blood glucose control in diabetic patients. This article will cover different A1c levels and ways to reduce them for better blood glucose control. 

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Understanding A1c Levels

Hemoglobin is a protein that carries oxygen in the blood. While carrying oxygen to tissues, hemoglobin gets coated by blood sugar. Higher blood sugar levels cause higher glucose coating of hemoglobin, resulting in increased HbA1c levels.¹ The A1c test is used to evaluate the risk of diabetes, diagnose diabetes, and monitor blood glucose in diabetes patients. 

According to the American Diabetes Association, diabetes patients with well-controlled blood glucose levels should get HbA1c levels checked twice a year. On the other hand, patients with poor blood glucose control or changing medication are advised to get HbA1c levels checked every three months. 

The A1c blood test results indicate:

• Normal HbA1c if your blood sugar test result is below 5.7%
• Prediabetes if your result is between 5.7% to 6.4%
• Diabetes if your results are 6.5% or higher

The Importance of Reducing Your A1c Levels

Poor blood glucose control is associated with diabetes complications such as retinopathy, neuropathy, and nephropathy. Reducing HbA1c levels can improve blood glucose control and slow disease progression. 

Lower HbA1c levels are also associated with better metabolic health. A cohort study monitoring newly diagnosed type 2 diabetes patients for five years concluded that patients with higher values of HbA1c had significantly increased risk for elevated LDL cholesterol (also known as bad cholesterol) and triglycerides levels.² 

9 Ways to Lower Your A1c Levels

Diabetes care involves a combination of medication treatment and lifestyle intervention. All combine to contribute to better glucose management. Here are nine ways to support your diabetes treatment.

1. Exercising

Physical activity and healthy eating are standard for better glucose control. ADA guidelines recommend aerobic and resistance training for type 2 diabetes patients. A meta-analysis of twenty-six studies investigated the dose-dependent effects of supervised aerobic training on HbA1c in type 2 diabetes patients. The results showed that only 30 minutes/week of supervised aerobic training for 12 weeks improved HbA1c levels; however, the effects were higher for 100 min and above weekly supervised aerobic training.³ 

Another meta-analysis also concluded that supervised aerobic or supervised resistance training significantly reduced HbA1c levels compared to no exercise; however, better improvements were reported for combined training.⁴

2. Be Careful With Supplements

Some supplements may be marketed as easy solutions to improve blood glucose or lower HbA1c levels. Although certain supplements, including but not limited to vitamin D, omega-3, and zinc, might improve HbA1c levels, strong evidence is lacking. Therefore, it's essential to consult your doctor before taking dietary supplements to reduce HbA1c levels.⁵ 

3. Adapting Healthy and Balanced Nutrition 

Following a personalized nutrition plan can support better glucose control. Nutrition is one of the most significant contributors to blood glucose control. Adapting a nutrition plan to diabetes medication and eating a well-balanced meal can prevent spikes in blood glucose and contribute to blood glucose control in the long term.

4. Set Realistic Weight Loss Goals

Weight loss can contribute to lower blood sugar. A model-based analysis based on the data from more than seventeen thousand patients showed that every 1 kg lost was expected to result in an estimated 0.1% drop in HbA1c levels. Overweight and obese patients are advised to lose weight. Although weight loss can contribute to better glucose management, it's essential to set realistic weight loss goals to gain long-term adaptations to healthy eating and maintain a healthy weight.⁶

5. Maintain a Healthy Weight

Maintaining a healthy weight can contribute to better glucose management and may reduce the risk of diabetes complications.⁷ A continuous glucose monitor (CGM) can help you reach weight loss goals by minimizing blood sugar spikes.

6. Limit Your Alcohol Intake

Managing blood glucose levels while drinking alcohol can be challenging. Although alcohol is not entirely forbidden for most diabetes patients, patients are warned for moderation and caution due to hypoglycemia risk. It's best to talk to your healthcare professional about your drinking habits and get instructions about precautions you can take.⁸

7. Keep Track of Your Carbs Intake

Carbohydrates increase blood sugar levels more than protein and fat does. That's why opting for low glycemic index foods and complex carbohydrates is recommended. Some studies also suggest that low-carbohydrate diets may reduce HbA1c levels. However, with a well-planned nutrition plan, you can eat carbohydrates within the recommended range and control blood glucose levels.⁹

8. Try Portion Control

Portion is as essential as the ingredients of a meal. Even if your meals are made of well-balanced carbohydrates, protein, and fat, eating excess can cause higher blood glucose levels and weight gain. 

9. Do Not Forget Your Medication

Medication is a crucial part of the treatment plan. It's important not to fall for magical supplements or dieting plans without a scientific background. Good adherence to medication combined with healthy nutrition and physical activity is the most established way to control diabetes. Ensure you always take your medication according to your doctor's orders and consult your doctor if you consider changing medication or dosage.

<p class="pro-tip"><strong>Learn More: </strong><a href=working-out-and-blood-sugar>7 Tips for Managing Blood Sugar During and After Workouts</a>.</p>

Lowering Hemoglobin A1c: Foods to Eat and Avoid

A healthy and balanced diet is essential for better blood glucose management. Eating complex carbohydrates, lean protein, healthy fats, fruits, and vegetables while limiting added sugars is recommended; however, a personalized nutrition plan supports an individual's nutritional needs and requirements. 

Foods to Eat

Diabetes patients can eat almost all food in moderation. Guidelines emphasize eating complex carbohydrates, lean protein, healthy fats, fruits, and vegetables. Foods to eat may include but are not limited to:

• Berries: They are generally low in sugar and glycemic index and high in polyphenols. Luckily, your option is not limited to only berries. Other low glycemic index fruits included but not limited to apples, pears, apricot, oranges.
• Non-Starchy Vegetables: The CDC's healthy eating guidelines for diabetes recommend filling half of your plate with non-starchy vegetables such as spinach, broccoli, and green beans. Fruits and vegetables provide micronutrients and antioxidant compounds that can help decrease cell damage and inflammation.¹⁰
• Legumes and Beans: They are plant-based protein sources that are rich in fiber and nutrients. Filling one-quarter of the plate with lean protein such as chicken, eggs, tofu, and beans is advised.
• Fish: Fish is a source of omega-3 fatty acids and minerals such as calcium, phosphorus, iodine, and selenium. 
• Cheese: Cheese and other dairy products are good sources of protein and calcium. When choosing yogurt, remember to look for those without added sugars.
• Nuts: Nuts are a great source of healthy fats and minerals such as potassium, magnesium, selenium, and zinc. 

Foods to Avoid

Still having a poor diet, consuming added sugars, and excess calories can cause poor disease prognosis, contributing to poor blood glucose management, increased risk of complications, and other health conditions such as nerve damage, heart disease, and kidney disease. Therefore, eating less of high glycemic index foods, processed foods added sugars, and unhealthy fats can help improve HbA1c levels. 

High glycemic index foods can cause spikes in blood glucose levels. Replacing high glycemic index and sugar-added foods with complex carbohydrates can help better blood sugar control. Foods to limit may include but are not limited to:

• White bread
• Pasta
• Candy
• Rice
• Cakes
• Processed meats

Remember, you don't have to eliminate food from your diet altogether. Instead, you can choose healthier alternatives, such as whole-grain bread instead of white bread. Minimizing restrictions as much as possible may support long-term adaptation to a healthy and balanced diet. 

Using a CGM with Signos: Real-Time Data, Backed by AI

Diabetes treatment involves medication and lifestyle changes. Since different medications are available, choosing the one that suits an individual diabetic patient is an important part of the treatment. Many new medicines are in development or are newly available. Signos' experts can help you acknowledge alternative medications to manage diabetes. 

Signos pairs a real-time glucose biosensor with AI trained on tens of millions of data points to deliver personalized, science-backed guidance for weight management and health. See exactly how your body responds, and take action.

Learn how it works. Ready to get started? Join now.

To learn more about glucose levels and health, check Signos' blog, which features many articles created by experts in the field.

<p class="pro-tip"><strong>Also Read: </strong><a href=how-can-i-lower-my-type-2-diabetes-naturally>Lowering Type 2 Diabetes Naturally: 8 Ways to Lower Blood Sugar</a>.</p>