Can You Lower Your A1C? A Realistic Action Plan for Blood Sugar Control

17 Sep 2025 By Catherine Madaffari, M.D.

Can You Lower Your A1C? A Realistic Action Plan for Blood Sugar Control

The A1C test is a crucial tool for monitoring long-term blood sugar control, especially for individuals with prediabetes or diabetes. Elevated A1C levels indicate higher average blood sugar levels over the past 2-3 months, increasing the risk of serious health complications like heart disease, nerve damage, and kidney disease. The good news is that, yes, you can often lower your A1C through lifestyle changes, medication, and diligent management. This article provides a realistic and actionable plan to help you achieve better blood sugar control and reduce your A1C levels. Why Does My Blood Sugar Fluctuate So Much An Expert Explains

Understanding A1C and Why Lowering It Matters

A1C, also known as glycated hemoglobin, measures the percentage of your red blood cells that have glucose attached to them. Higher glucose levels in your blood lead to a higher A1C percentage. Healthcare professionals use A1C to assess how well your blood sugar has been managed over time.

Lowering your A1C is important for several reasons:

Reduces Risk of Complications: Better blood sugar control can significantly decrease the likelihood of developing diabetes-related complications.
Improves Energy Levels: Stable blood sugar can lead to increased energy and overall well-being.
Enhances Quality of Life: By managing diabetes effectively, you can lead a healthier and more active life.

Phase 1: Dietary Changes – Building a Foundation for Lower A1C

Diet plays a fundamental role in lowering A1C. It's about more than just avoiding sugar; it's about adopting a balanced eating pattern that supports stable blood sugar levels.

1. Focus on Complex Carbohydrates

Replace simple carbohydrates (white bread, sugary cereals, pastries) with complex carbohydrates that are digested more slowly.

Examples:
- Whole grains: Brown rice, quinoa, oats, whole-wheat bread.
- Legumes: Beans, lentils, chickpeas.
- Non-starchy vegetables: Broccoli, spinach, cauliflower, bell peppers.

Benefit: Complex carbs provide a steady release of glucose into the bloodstream, preventing rapid spikes in blood sugar.

2. Emphasize Fiber-Rich Foods

Fiber slows down glucose absorption and can improve insulin sensitivity. Aim for at least 25-30 grams of fiber per day.

Examples:
- Fruits: Apples, berries, pears (eat the skin when possible).
- Vegetables: Broccoli, Brussels sprouts, carrots.
- Whole Grains: Oats, barley, whole wheat bread.
- Legumes: Lentils, kidney beans, black beans.

Action Tip: Start your day with a bowl of oatmeal topped with berries and nuts. This will provide a sustained energy release and keep you feeling full for longer.

3. Incorporate Lean Protein

Protein helps stabilize blood sugar levels and can improve satiety.

Examples:
- Poultry: Chicken, turkey (skinless).
- Fish: Salmon, tuna, cod.
- Lean Beef and Pork: Choose leaner cuts and trim excess fat.
- Plant-Based Protein: Tofu, tempeh, lentils, quinoa.

Healthy Recipe: Grilled salmon with roasted asparagus and quinoa – a balanced meal packed with protein, fiber, and healthy fats.

4. Limit Added Sugars and Processed Foods

Added sugars and processed foods often lead to rapid spikes in blood sugar and provide little nutritional value.

Avoid:
- Sugary drinks: Soda, juice, sweetened tea/coffee.
- Candy and sweets: Cakes, cookies, pastries.
- Processed snacks: Chips, crackers, packaged baked goods.

Smart Swap: Replace sugary soda with water infused with lemon and cucumber. Swap processed chips for a handful of almonds or a small apple.

Example of a Diabetes-Friendly Meal Plan:

Scientific Evidence on Diet and A1C:

A meta-analysis published in the "Journal of the American Medical Association" found that dietary interventions focusing on low-carbohydrate diets could significantly lower A1C levels in individuals with type 2 diabetes ( JAMA. 2018;320(20):2095-2104). The Complete Guide To Blood Sugar Control For Persons With Type 2 Diabetes

Phase 2: Exercise – Increasing Insulin Sensitivity and Burning Glucose

Physical activity is a critical component of any A1C-lowering strategy. Exercise improves insulin sensitivity, meaning your body becomes more efficient at using glucose, which leads to lower blood sugar levels.

1. Aim for Regular Aerobic Exercise

Aerobic exercise helps burn glucose and improve cardiovascular health.

Recommendations: Aim for at least 150 minutes of moderate-intensity aerobic exercise per week. How To Talk To Your Doctor About Your A1C And Blood Sugar Goals
Examples:
- Walking: A brisk walk in your neighborhood or at a park.
- Jogging: If you’re able, jogging can be a highly effective workout.
- Swimming: A great low-impact option.
- Cycling: Whether indoors or outdoors, cycling is a great cardiovascular workout.

Tips for Starting:

Start slowly and gradually increase the duration and intensity of your workouts.
Find an activity you enjoy to make it more sustainable.
Set realistic goals and track your progress.

2. Incorporate Strength Training

Strength training builds muscle mass, which helps your body use insulin more effectively.

Recommendations: Aim for strength training at least two days per week.
Examples:
- Weightlifting: Using free weights or weight machines at the gym.
- Bodyweight exercises: Push-ups, squats, lunges.
- Resistance band exercises: A portable and convenient option.

Safety Note: Consult with a healthcare professional before starting a new exercise program, especially if you have pre-existing health conditions.

3. Break Up Sedentary Time

Prolonged sitting can negatively impact blood sugar control. Try to break up your sedentary time throughout the day.

Strategies:
- Set a timer: Stand up and move around every 30 minutes.
- Walk during phone calls: Instead of sitting, pace around while you’re on the phone.
- Take the stairs: Opt for the stairs instead of the elevator whenever possible.

Practical Tips:

Join a Fitness Class: Group fitness classes can provide motivation and structure.
Find an Exercise Buddy: Working out with a friend can help you stay accountable.
Track Your Activity: Use a fitness tracker or app to monitor your progress.

Scientific Evidence on Exercise and A1C:

Research published in the "Diabetes Care" journal indicates that both aerobic and resistance training can improve glycemic control and lower A1C levels ( Diabetes Care. 2010;33(1):e147-e154).

Phase 3: Medication and Monitoring – Working with Your Healthcare Provider

While lifestyle changes are crucial, medication and regular monitoring are essential aspects of managing A1C levels, especially for those with diagnosed diabetes.

1. Adherence to Prescribed Medications

If you have been prescribed medication for diabetes (e.g., metformin, sulfonylureas, insulin), it’s vital to take it as directed.

Set reminders: Use pill boxes or smartphone reminders to ensure you don’t miss doses.
Understand your medications: Know why you are taking each medication and any potential side effects.
Communicate with your doctor: If you experience side effects, discuss them with your healthcare provider; they may be able to adjust your medication or dosage.

2. Regular Blood Sugar Monitoring

Monitoring your blood sugar levels provides valuable feedback on how your body responds to diet, exercise, and medication.

Frequency: The frequency of monitoring depends on your individual needs and medication regimen.
Tools: Use a glucose meter to check your blood sugar at home. Continuous Glucose Monitoring (CGM) systems provide real-time glucose readings and trends.
Record your results: Keep a log of your blood sugar readings to share with your healthcare provider.

Target Blood Sugar Ranges:

Fasting: 80-130 mg/dL
2 hours after meals: Less than 180 mg/dL

Important: Work with your healthcare team to determine your individualized target blood sugar ranges.

3. Work Closely with Your Healthcare Team

Regular appointments with your doctor, diabetes educator, and registered dietitian are crucial for optimal blood sugar management.

Discuss your A1C goals: Set realistic goals for lowering your A1C.
Review your medication regimen: Ensure your medications are effectively managing your blood sugar.
Get personalized advice: Tailor your diet and exercise plan to your individual needs and preferences.

4. Stress Management

Chronic stress can raise blood sugar levels by increasing the release of stress hormones like cortisol.

Stress-Reduction Techniques:
- Mindfulness Meditation: Practice mindfulness to reduce stress and improve emotional well-being.
- Yoga: Combines physical postures, breathing exercises, and meditation.
- Deep Breathing Exercises: Simple and effective for calming the nervous system.
- Hobbies: Engage in activities you enjoy to reduce stress.

5. Sleep Hygiene

Poor sleep can impact blood sugar levels and insulin sensitivity.

Tips for Better Sleep:
- Maintain a Consistent Sleep Schedule: Go to bed and wake up at the same time each day.
- Create a Relaxing Bedtime Routine: Take a warm bath, read a book, or listen to calming music.
- Optimize Your Sleep Environment: Keep your bedroom dark, quiet, and cool.
- Limit Screen Time Before Bed: Avoid using electronic devices for at least an hour before bed.

Potential Complications and Considerations:

Hypoglycemia (Low Blood Sugar): Be aware of the symptoms of hypoglycemia (shakiness, sweating, confusion) and how to treat it.
Individual Variability: Everyone responds differently to dietary changes, exercise, and medication.
Consultation with Healthcare Professionals: It’s critical to have a healthcare team guiding and individualizing your A1c lowering approach

Measuring Success and Staying Motivated

Lowering A1C is a marathon, not a sprint. It requires commitment, consistency, and patience.

1. Track Your Progress

Keep track of your blood sugar readings, A1C levels, exercise habits, and dietary choices. This will help you identify what’s working and what’s not.

2. Celebrate Small Victories

Acknowledge and celebrate your successes, no matter how small. This can help you stay motivated.

3. Stay Positive

There will be ups and downs. Don’t get discouraged by occasional setbacks. Focus on what you can control and keep moving forward.

4. Join a Support Group

Connecting with others who are managing diabetes can provide valuable support and encouragement.

5. Reassess and Adjust

Regularly reassess your plan and make adjustments as needed. What works for one person may not work for another. Be flexible and willing to adapt.

By adopting these lifestyle changes and working closely with your healthcare team, you can take control of your blood sugar levels and significantly lower your A1C. Remember, it’s about making sustainable changes that you can maintain for the long term. Each small step you take contributes to a healthier future.