Getting your A1C levels tested regularly is important if you are at risk of prediabetes or type 2 diabetes. But what if your A1C levels are high and you don’t have diabetes?
There are a few reasons why you may have high A1C levels that aren’t related to diabetes. There may even be some reasons why A1C readings may be inaccurate. For this reason, it may be important to assess and explore more than just your A1C level when determining your risk for things like prediabetes and diabetes.
Before these markers progress to other health problems, making healthy lifestyle interventions can help you lower your A1C levels and consequently can reduce your risk of diabetes developing down the line.
Wondering what strategies you can use that might help you keep your A1C levels in a healthy range? Read on to learn more about healthy A1C levels, and what you can do to improve your overall health and wellness.
What are A1C Levels and Why Do They Matter?
Your A1C level, also called hemoglobin A1C or HbA1C, is a measurement of your average blood sugar level over the past 3 months. Instead of measuring the amount of glucose in your bloodstream, your A1C level represents the percentage of hemoglobin in your red blood cells that are coated in sugar.
Hemoglobin is a protein found in your red blood cells. When sugar enters your bloodstream, it can attach itself to hemoglobin. Everyone has some amount of sugar attached to the hemoglobin in their blood cells, but people with high blood sugar levels have more.
What Should My A1C Levels Be?
A blood test of your A1C levels (or average blood glucose level) is used to diagnose prediabetes and diabetes. The A1C test is also used to help people with diabetes and their healthcare teams manage their condition.
According to the American Diabetes Association, these are the ranges of A1C levels:
- An A1C level of 5.7 percent or below is considered normal
- An A1C level between 5.7 and 6.4 percent is considered prediabetes
- An A1C level of 6.5 percent or higher is considered diabetes
If you have a higher than normal A1C level, you should work with your healthcare provider to determine an A1C goal based on your unique needs. If you’ve not gotten your A1C levels tested recently, check out our handy calculator to see how you can calculate an estimate of your A1C value.
I Don’t Have Diabetes — Why Might My A1C Levels be High?
Anemia and Other Deficiencies
Iron deficiency anemia is a common condition that is associated with falsely elevated A1C levels. Studies have also shown that anemia that occurs as a result of vitamin B12 and folate deficiencies can also raise A1C levels. Asplenia, or disorders of the spleen, also raise A1C levels.
Certain Health Conditions
Hypertriglyceridemia (too many fats in the blood), hyperbilirubinemia (also called jaundice), and uremia (abnormally high levels of waste in the blood, caused by kidney dysfunction) can all falsely elevate A1C levels.
Finally, some medications and chemicals can falsely elevate A1C. This can include lead poisoning, salicylates like aspirin, and opioids, and ingestion of vitamin C.
How to Lower A1C Levels for People Without Diabetes
If you don’t have diabetes but your blood sugar or A1C levels are consistently high, there are a few lifestyle changes that can help lower A1C down to a healthy range.
1) Eat Healthy, Stay Healthy
Eating a healthy diet is one of the most important things you can do when it comes to managing blood sugar. This can include a focus on protein, non-starchy vegetables, whole grains, and low-fat dairy or fortified dairy alternatives, while limiting refined carbs and sugary foods and drinks.
Because your body breaks down most carbohydrates into glucose, the amount and type of carbs you eat have a high impact on your blood sugar. Certain carbohydrates, including added sugars, white rice, and bread products that contain white flour, are absorbed by the body very quickly and can lead to higher and/or more frequent spikes in blood sugar if eaten consistently.
The Importance of Fiber and Protein
When it comes to maintaining healthy blood sugar levels, fiber and protein can both play a crucial role. Fiber is a carbohydrate that isn’t digested or absorbed by the body, and it can help keep you satiated and slow down the absorption of glucose in your blood.
Fiber is mainly found in nutrient-rich plant foods, like:
- Fruits and vegetables
- Whole grains
Protein is also a crucial part of a healthy diet. It is required by the body to help build and repair tissue, make and regulate hormones, and maintain organ function. Protein can also help keep glucose levels stable. Here are some good sources of lean protein to consider including in your diet:
- Beans and lentils
- Fish and seafood
- Uncured and lean red meats and poultry
2) Make a Meal Plan and Stick to it
Designing a meal plan with a dietitian or nutritionist can be a great way to make sure you are getting enough nutrient-dense foods in your diet. A meal plan can also help you recognize the amount of food you are actually eating and monitor your portion sizes.
When it comes to meal planning, the USDA recommends:
- Write down the meals you plan to have and when, including breakfast, lunch, dinner, and snacks.
- Take note of what you already have in your freezer, pantry, and fridge.
- Make a grocery list such as this prediabetes food list, and organize it by food group to make shopping easy.
- Buy a combination of fresh, frozen, and non-perishable foods. Eat the fresh foods first so they don’t go bad, and stock your freezer and pantry with items you can eat later.
- Plan for leftovers by making larger recipes so you’ll have enough servings for more than one meal.
3) Personalized Fitness is the Way Forward
A lack of appropriate exercise can lead to an increased risk of high blood sugar. When you exercise, your cells’ sensitivity to insulin increases to better enable your body to use the available glucose in your blood.
Even if you have no available insulin, your cells are able to use glucose for energy when your muscles contract during physical exercise. Moderate activity, like walking, stretching, and moderate weight lifting with light weights are the most likely to positively affect blood sugar.
But more exercise isn’t always better for glucose balance. If you are overtraining or improperly fueling for workouts, this added stress can potentially impair glucose tolerance. It’s all about finding the right approach for your body.
4) Get Help From an Expert
It’s always important to consult a doctor and a qualified nutritionist when it comes to making decisions about your health and diet. Only a qualified health professional can diagnose and treat serious health conditions.
As a member at Nutrisense, you are paired with a complimentary nutritionist to help you set sustainable goals and stay accountable to them. They can also offer you expert advice on how to design and stick to a healthy diet or exercise routine to support balanced blood sugar and benefit your overall health.
5) Be Smart with Medications and Supplements
If you’re having trouble lowering your blood sugar with dietary changes or lifestyle interventions, your doctor may prescribe medications to help. There are several medications that are often used to treat high A1C or blood sugar levels. These include things like alpha-glucosidase inhibitors, biguanides, bile acid sequestrants, dopamine-2 agonists, DPP-4 inhibitors, and more.
Though some supplements like berberine have been used to lower glucose levels, it’s wise to consult a qualified healthcare provider before beginning any supplements. Some supplements like melatonin or others may have the potential to raise glucose levels in certain people. It’s also worth considering that any drug or medication that is poorly tolerated by the body may trigger a stress response, which may contribute to elevated glucose for some people.
6) Prioritize Your Mental Health
Chronic stress can lead to insulin resistance, which makes it harder for your cells to use blood sugar as energy. To learn more about some of the symptoms of chronic stress and learn some tips for managing it, take a look at our article on managing stress.
7) Monitor Your Blood Sugar Levels
Checking your blood sugar often is a good way to make sure you are informed about your blood sugar levels and prevent blood sugar spikes. A continuous glucose monitor, or CGM, is a tool that can give you blood sugar readings throughout the day.
A CGM is a small sensor that stays on the back of your arm and measures your blood sugar levels in real-time, 24/7. Knowing how your blood sugar reacts to certain lifestyle factors like diet and exercise can be a powerful tool in maintaining healthy life-long habits.
8) Consistency is Key
Remember that your A1C levels are a reflection of your blood sugar over time. Making consistent healthy choices is the best way to form habits that keep your blood sugar at healthy levels. It can also take a while to see results, so don’t give up if you don’t see changes right away. Keep going and don’t get discouraged!
Engage with Your Blood Glucose Levels with Nutrisense
Your blood sugar levels can significantly impact how your body feels and functions. That’s why stable blood glucose levels can be an important factor in supporting overall wellbeing.
With Nutrisense, you’ll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.
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Heather is a Registered and Licensed Dietitian Nutritionist (RDN, LDN), subject matter expert, and technical writer, with a master's degree in nutrition science from Bastyr University. She has a specialty in neuroendocrinology and has been working in the field of nutrition—including nutrition research, education, medical writing, and clinical integrative and functional nutrition—for over 15 years.