It seems everywhere I hear people talking about their Hemoglobin A1c tests, concerned about being pre-diabetic, and not really sure what it all means. Your answers are here!
The Hemoglobin A1c test, or H-A1c, measures the average amount of glucose in your blood over the past 3-4 months. It is not altered by what you ate for breakfast the day of the test, or what you are the day before. And many doctors are now looking at it much more closely, moving more and more people into the pre-diabetic or “pre-pre-diabetic” range if it gets a little high.
So, a few years ago any number under 6 was fantastic, and a level under 7 was nothing to worry about. The diabetes epidemic in this country has changed those views, and now many physicians want to see their patients with H-A1c levels under 5.6. By making dietary changes at this point, many people can avoid developing Type 2 Diabetes and the health complications that go along with it. Yes, you can lower this number just by changing up your diet a little.
If your levels have come back higher than you and your physician want them to be, the first thing to do is look at your lifestyle over the past three months or so. If you had your test done in January, this result will reflect the months of October, November and December. Not exactly most people’s healthiest time of year. Halloween, Thanksgiving, you get my drift. If that is the case, throw away the leftover candy, cut out the extra breads and sweets, and test again in June. You may be just fine.
If not, or if your levels are too high and have been steadily moving upward, here’s what to do:
- Cut way back on sugar. Candy, cookies, ice cream, all those things. Have an occasional dessert with dinner, but cut out all the little sweets during the day. And the late night sweets. Keep your hands busy, go to bed early, have some herbal tea – whatever works. Sugar is like that friend who pretends to be nice then spreads your secrets around town. Dump her.
- Limit starches like bread, white rice and white potatoes. No more than one starch per meal; and avoid bread when you can. Simple starches in these refined foods are quickly converted to glucose in your bloodstream. Switch to whole grain starches like quinoa, brown rice, farro, wheat berries, and polenta. Sweet potatoes are fine. Their fiber slows digestion, meaning fewer spikes in blood sugar. Pasta is actually fairly easy on the blood sugar (as far as starches go), do you don’t have to avoid it completely.
- Add plenty of vegetables at lunch and dinner. I am not worried about “sugary” vegetables like carrots – that is not what got you here. Try for four or more servings of veggies a day.
- Have two servings of whole fruits each day, and limit juice. While fruit can be sweet and sugary, cut out the added sugars and white starches first. Fruits are so full of vitamins and antioxidants they should be the last things on your list to cut. Apples, pears, and berries are best for lowering blood sugar.
- Cut out sugary drinks. Soda, lemonade, coffee drinks, sweetened tea, and flavored waters can all cause big spikes in blood sugar and significantly raise your H-A1C levels. This is a no-brainer that will deliver big results.
- Add beans and legumes as protein sources. Their fiber can really modulate blood sugar levels.
After three months of following these guidelines, have another test. Your levels should go down, and you will probably be feeling better, too.
If you want the scienc-y details on the test, here you go. Hemoglobin is the molecule in red blood cells that delivers oxygen to the cells throughout our bodies; in adults about 98% of our hemoglobin is Hemoglobin A, and about 7% of that is Hemoglobin A1. Glucose molecules tend to stick to Hemoglobin A1, especially Hemoglobin A1c (we have A1a, A1b, and A1c), and once they are stuck they are very difficult to unstick. This is called glycosylation.
So the Hemoglobin A1c test measures the amount of glycosylated Hemoglobin (GHb) in our blood stream. This value is reflected as a percentage – the percent of Hemoglobin A1c that has been glycosylated. Since our red blood cells have a lifespan of 100 – 120 days, this percentage reflects what has been going on in our bloodstream for the past 3-4 months.
The higher the amount of glucose in our blood at any one time, the more Hemoglobin gets glycosylated. That is why spikes in blood sugar bump up this number. Smaller, steady amounts of glucose in the blood keep it normal.
This test is also used to see how well diabetes treatment is controlling blood sugar levels. It sure would be nice to see that become much less necessary.
Any questions? Let me know. I have answers. Oh, how I have answers.
dean floriano says
had a a1c level of 5.8 on july 1st,started a juicing diet of fruits for breakfast,a light very lowfat sugarfree lunch then a dinner juice of all veggies since july 13,going for new labs after sept 19th,will a1c drop even tho all the morning juices?havent had ANY treats or sweets other than the a.m.juice which is 1 apple 1 peach 2 carrots half a cucumber 1 lime 1 orange let me know your thoughts ,appreciate it so much,dean
The juicing will not bring your Ha1c level down as much as eating whole fruits and vegetables will. You need the fiber from the whole foods to slow down the absorption of sugar into the blood. Try adding some beans and whole grains to your plan, they are both excellent at moderating blood sugar, and switch to whole fruits and veggies rather than just the juice. Good luck!
I am a sitter for a patient who has adult onset diabetes. She claims that it is “under control” yet she drinks 8-12 soft drinks daily and gives herself at least 5 insulin shots to counteract the effect on her glucose level. I have tried numerous ways to talk to her about this. She denies that there is a problem while she has huge ulcers on her trunk, face and limbs. She believes she has everyone fooled but she is killing herself. Any suggestions, ideas how to reach her?
Oh, Renee, this is such a hard situation. If her doctor explains to her how this behavior is hurting her body, she may be open to change. Often people think that as long as they get their blood sugar down after a spike they are fine, but really those spikes cause problems that can be severe. Maybe try giving her some flavored (but not sweetened) iced tea to try. A positive attitude and an acceptable alternative may help. Good luck!
Hello! Would you mind if I share your blog with my facebook group?
There’s a lot of folks that I think would really enjoy your content.
Please let me know. Thanks
Absolutely! Thank you!
dean floriano says
thanks for the info.still juicing,best thing EVER get sugar out of your diet,all sugar not just high fructose any corn products as well,sugar is the worst thing you can do to your body’. eat an apple or orange for sweet attacks nuts are a good substitute for chips
How about Palm sugar? I have heard that it’s safe for diabetics.
Excellent question! Palm sugar is sugar, and acts the same way as other sugars in the body.
What do you think about A1c?
You would recommend taking cinnamon in capsule form?
Hemoglobin A1c measures our blood sugar levels over the past 3 months, on average. Cinnamon in capsule form has gotten mixed results in clinical trials. The best thing to do is use cinnamon as you normally would on your food and to eat a whole-food diet rich in plant foods and naturally occurring fiber. I hope this helps!
Hello, I writte from Spain
Can you recommend me some diet or some webpage on what kind of foods are better to lower the A1c
Cinnamon in capsule form is tricky, and the research is mixed. I recommend fixing the diet, and then trying something like cinnamon if its not enough.
Hi Pilar, whole natural foods that are good sources of fiber are best to lower A1C. Foods like beans, nuts, whole grains, vegetables and fruits are the best. Good luck!
Ramon Melena says
i just took a couple blood tests and my A1c is a 5.6. Although it is technically at a normal range, it is close to the high. Why? My diet is not that crazy, I don’t eat bread, rice, avoid processed foods (even fast foods entirely), I only drink water (don’t drink alchohal), no sodas, teas, juice, etc. Not a fan of sweets to begin with. Lastly my daily consumption is chicken or fish with veggies for lunch and dinner, egg whites in the morning, and the occasional cheerios with almond milk (unsweetened).
In closing, WHAT THE EFF IS GOING ON WITH ME?
There are a few things that may be the culprit. It looks like you may not be getting enough fiber, so try adding more whole grains and legumes like beans to your diet. Oatmeal and other whole-grain cereals make a better breakfast than egg whites, and have some fruit too. I hope this helps.
My fasting blood sugar level is 64. I am not diabetic, but my A1C is 6.3 and seems to be my norm. However, my doctor wants that reduced. How do I reduce my A1C without lowering my already low blood sugar levels???
This sometimes happens when blood sugar is on a roller coaster between high and low. The best way to even it out is to eat a diet high in natural fiber. This means eating lots of fiber-rich foods like beans, vegetables, fruits, nuts and whole grains. Avoid simple sugars and refined carbohydrates (foods make with white flour and white rice). That should help reduce your A1C without lowering your fasting blood sugar.
Ricardo vanreil says
I took the A1c test but I ate breakfast and drank coffee before the test. The result was 6.3. Was the test affected by my eating two hours before?
I just tested a1c of 6.8
And hemoglobin of 180
But I wasn’t told of the upcoming test and didn’t fast and to boot had a sugary coffee both the night before and the morning prior to the test.
Now my PCP wants me to start injections once a day. Am I wrong to want a retest under fasting conditions to gain a more accurate assessment?
Veronica Brooks says
I have a a1c of 6 1. I m currently stopping eating bread for breakfast. Incorporporatibg more fuit . Diabetes ran heavily on my dad’s side who died from covid last year. Is it good to eat bananas and oranges and grapes for fruit
Hello! All fruit is part of a healthy diet, especially whole, natural fruits!
You should let your doctor know that your test was not fasting, although for the hemoglobin a1c it won’t change the result. It will change your serum glucose number, which could alter your medication prescription.
Eating doesn’t impact our A1C score much, but it will change the serum glucose (blood sugar) number, so always let your doctor know if you fasted before your test or not.
hello,my A1C was 8.0,im 61 years old and need to find the best diet to bring these numbers down,i also have high blood pressure and high triglycerides.
I recently found out from my nurse practitioner that my A1C test done at the end of January which I never had and never even heard of before, ( I only had the 12 hour glucose fasting test through the years that had always been normal, and I last had it done in May 2018 and I wasn’t on any high blood pressure medicine yet, until 6 or 7 months later,) taken at the end of January was 6.4 and she had told me weeks ago that my test showed that I’m prediabetic, and I told her that is a scary bad number, but she wasn’t that concerned and I told her that Dr.Ken Berry in great youtube videos, National Institute of Health studies etc and great site kidney.org and other medical sites say that even with prediabetes permanent damage has already been done to your kidney’s, heart, and blood vessels, but she said she didn’t think permeant damage has been done, I now know I have it and I’m trying to improve it with diet and exercise. She told me that she herself has type 2 diabetes and that she’s in her 60’s but she looks like she’s in her 40’s,and that she got it from being pregnant and that both her parents had it.
I told her that Halloween after trying to stick to a diet for a period again, I cheated and ate a lot of chocolate candy, and then a day before the A1C test, and days in a row up to this I ate almost two bags of chocolate candy and I also ate a ton of other sweets like cookies,some I baked myself with part a 1/2 cup of sugar and 1/2 cup of Splenda, and brownies and chocolate chip,chocolate chocolate chip cookies made with olive oil and part sugar and part Splenda,but there is also a lot of sugar in the chocolate chips too, and Brownies made this way,and a chocolate cake with no butter or eggs just 6 table spoons of olive oil,and I used a 1/2 cup of sugar and a 1/2 cup of Splenda, but I made homemade frosting sometimes with sugar free Swerve which was too chalky by itself, and other times I made it just with confectioners sugar or part Swerve part sugar.
I didn’t tell my nurse practitioner all of these sweets I ate during these 3 months,just all of the chocolate candy at the end of October into early November,and again the whole week of the Ac1 test including a day or 2 before I ate up almost 2 bags of dark chocolate mint Kit Kats,and I asked her if this would effect my A1C test result and she said yes it would, and I also ate more candy,and a lot of non dairy ”ice cream” because I can’t have any dairy products except yogurt,but the second ingredient in the non dairy ”ice cream” is sugar which I made the mistake of not looking to see this but I told her that the sugar shouldn’t have stayed in my blood stream though and I’m sure that it didn’t in the past, and she said no your pancreas would have pumped it all out, but as people get older this often changes.The Center For Disease Control says that the higher your A1C number the higher you’re risk for becoming a type 2 diabetic!
I try to stay away from sugar foods for a period but I crave them all of the time and then when I cheat and start to eat them again I go overboard and overdose on it.
My weight had been up recently the highest it’s ever been and it’s been almost this high for the last 2 years,but I’ve been very much struggling with being over weight for the last 23 years since I was 34,before that I had never been over weight or had to diet, I ate anything and everything with no exercise in my 20’s,and not that much in my teens,and I always stayed stably thin and I could never gain weight if I had tried. I also have lower back Degenerative Disc Disease which caused me to lose at least an inch of height and that’s also worse for my BMI weight.
Before the Corona virus pandemic I was walking everywhere including far sometimes because I don’t drive, But I haven’t walked anywhere in 2 years but I’m doing some exercises in my home.
I’m 56 I’ll be 57 in April and I had been thin all of my life until I was 34 and had to go on a diet for the first time in my life, I had always been thin eating tons of fattening foods and doing no exercise at all, not even walking and I have been struggling with being over weight ever since. And I do walk everywhere since I don’t drive, I don’t walk that often but when I do it’s far but my weight went up the highest it’s ever been in the last 2 years, it went up in 2020 the same year I started skipping periods for 2-3 months,and in March it will be a year since I got my period,and I haven’t walked to stores or anywhere since early March 2020 since the Corona virus pandemic started but I’m doing some exorcise in my home though.
My mother had two children, and was on diet pills when she was pregnant with me, and she was thin in her 20’s too, but became very over weight, about same age my weight problem began, and she never ate a lot either and she was somewhat more over weight because she was 2 and half inches shorter than me. I have lost at least an inch of height due to degenerative disk disease in my lower back too, which only makes it worse with my BMI and weight. I don’t look obese or anything though, but I really wish I had my old fast metabolism back! My father said it’s in my genes from my mother and that I inherited my mother’s slow metabolism, I never had any children though, and yet it still happened to me at a young age. My former internist always said that my metabolism slowed down, and that most people’s metabolism’s slow down as they age, and she said she had countless patients that were thin when they were younger, and then ended up over weight.
She had her first child at age 35,and her second in her late 30’s,but she was still thin at 40,but she said that when she was in college she used to be able to eat 2 cheese steaks at once and gain no weight, but that if she did that now she would gain weight easily.
But I started to go to her when I was only 38 and my weight problem began when I was only 34 as I said. If I haven’t eaten any fattening foods for a month or more, my size 12or 14 ( in the last 2 years my size got even bigger than this), miss’s pants fit, but as soon as I eat even two really fattening foods just in one day my pants are tight, digging into my waist and leaving red marks around them and it takes me about 5 days to a week to get it back down and I have to hardly eat anything to do it.
When I was thin, I could eat anything and everything and I stayed a size 6 in my teens, and an 8 in my early and mid 20’s.By my late 20’s I was now a size 10. Several other doctors, including endocrinologists and quite a few non doctors said the same thing about my metabolism slowing down, but I still think it slowed down way too much too soon. My thyroid has been checked a ton of times through the years and it’s normal so that isn’t the problem either.
Also the year 2020 my weight went up the highest I started to skip my periods for 2 and three months for the first time and this month is a year since I’ve gotten it so I’m going into menopause and my metabolism has gotten even slower in the last several years.
Also are red potatoes OK to eat including making ”French Fries” in an air fryer just sprayed with olive oil? I looked up online months before my A1C result what potatoes have less starch and carbs, to try to keep my weight down some and health sites say red potatoes. Are baked potato chips and whole wheat bread and whole wheat pasta OK too?
As my father so rightly said,You go to a restaurant and they don’t have low fat low calorie foods because nobody wants it,and it’s so true they would go out of business. And my father also said that my stepmother used to cook the low fat low calorie healthy foods for company that she cooks for she and my father,but my father told her to stop doing it because they didn’t like it, and I asked him how did he know they didn’t like it, and he said because they never said It’s so good or it’s delicious, they just didn’t say anything, so she always cooks full fat only for company.
@laura, a healthy diet can help with all of these issues. You can start with my book, Calm Your Inflammation. Hopefully, it will work for you!
Denise, thank you for posting my comments, I was really hoping for your response though like you did give to many others on here and do you think my 6.4 score back at the end of January was due to me over dosing on tons of sugar foods repeatedly? I was just weighed by my nurse practitioner and she said I lost a good amount of weight, I haven’t eating sugar foods for many months, and I exercise sometimes in my apartment, she wants me to have a new blood test including the A1c in a month. She recently told me that she isn’t diabetic, that from diet (which she never gave me any advice on) she got her levels down to prediabetic levels.
Is Swerve and Monk fruit a safe alternative to baking and using sugar?
I made a typing mistake, I meant I haven’t been eating sugar foods in many months.
Also I had looked up a while before I even had my a1c test, what potatoes are less carbs and starch to try to keep my weight down, and it said red potatoes, are they OK to eat and what about whole wheat bread I really like Arnold’s whole wheat sandwich thins, and I switched to whole wheat and also multi grain pasta long before I had this test. I recently discovered I like Yams better than Sweet potatoes are they as OK to eat?