Hemoglobin A1c (normally called A1c) is a blood test that reflects how high your blood sugar levels have been over the past 3 months. When blood sugar levels rise too high they attach themselves to some of the red blood cells (RBC), and then stay in the blood until they are replaced with new RBC (about every 3 months). A1c is a strong indicator for diabetes and heart health, so it is important to know what your A1c level is.
In people without diabetes, a healthy A1c level is less than 5.0% (less than 4.5% is ideal). In a recent large study of A1c levels, researchers found that for every 1.0% increase in A1c above 4.5%, the risk of a heart attack more than doubled. That means that an A1c level of 5.5% or 6.0% is high risk.
People with diabetes have high A1c levels – 8-9% and higher. This is consistent with the fact that diabetics are very high risk for heart disease. High blood sugar levels damage the arteries in the heart, brain, kidneys, and eyes. Keeping your blood sugar in healthy ranges is very important for preventing health complications. Diabetics are encouraged to monitor their blood sugar levels closely and to keep their A1c levels down to 6.0-6.9%, or as close as possible without causing hypoglycemia. If you have diabetes, have your A1c checked regularly.
How do you lower A1c levels?
- Lose excess body weight if overweight.
- Be physically active. Aim for 30-60 minutes of moderate to vigorous activity daily. Start gradually and build up to an active lifestyle. Get your doctor’s guidance if you are currently inactive or have health problems.
- Eat more high-fiber foods. Foods that are especially helpful include oat bran, steel-cut oats, brown rice, fresh fruits, vegetables, and legumes (e.g., beans, peas, lentils, garbanzos, soy).
- Choose foods that have a low glycemic index (GI). These are generally whole foods, such as brown rice, whole-grain bread, vegetables (except potatoes), high-fiber fruits, legumes, nuts, and seeds.
- If diabetic, test your blood sugar levels regularly and adjust your medication to match both your physical activity levels and the amount of carbohydrates in your diet. as recommended by your doctor. The National Diabetes Education Program (NDEP) makes the following general recommendations on blood sugar levels in diabetics:
- Plasma glucose levels before meals should be 90-130 mg/dL
- Peak plasma glucose levels after a meal should be less than 180 mg/dL
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