A1C FAQs

Table of Contents

How Often Should You Check Your A1C Score?

If you have prediabetes (i.e. an A1C score between 5.7 and 6.5 percent) you should check your A1C score once a year.

For people who have type 2 diabetes, check your A1C score twice a year if you don’t take insulin and your blood sugar level is consistently in target range, or check your A1C score four times a year if you use insulin to manage your diabetes and your blood sugar level is not consistently within the target range.

How Accurate are A1C Scores?

A1C scores are accurate up to .5%, so if you’ve scored a 6.89 percent, your actual score can be anywhere between 6.39 percent and a 7.39 percent. This is why doctors will test your A1C score twice before diagnosing you with diabetes – they want to make sure the reading is accurate.

There are a few common reasons why your A1C score will have errors or misreadings.

  • A1C tests for patients who experience chronic bleeding may yield a false low.
  • A1C tests for patients who have iron deficiency anemia may yield a false high.
  • If your body produces a form of hemoglobin variant different than the normal hemoglobin A, your test can be inaccurate. This is more likely for people of African, Southeast Asian or
  • Mediterranean descent. An example of hemoglobin variant is present in people with sickle cell disease, which changes the lifespan of red blood cells.
  • Patients who are going through hemodialysis might have false lows because the processes may be filtering the glucose out of the patient’s bloodstream.
  • Patients who have had a recent blood loss due to surgery or a heavy menstrual cycle may experience a false low.
  • Liver disease, sickle cell anemia and kidney failure can cause your reading to be inaccurate.

Additionally, your A1C percentage can be off by as much as half a percent based on the margin of error. While that might mean the difference between being diabetic and prediabetic, if you’re a half a percentage away from developing diabetes or prediabetes, you should make changes to your lifestyle to reduce your score.

How Do I Get My A1C Down?

According to the Joslin Diabetes Center at Harvard Medical School, a calorie-restricted diet can lower your A1C score. It is recommended that you restrict your diet to between 1,200 and 1,500 calories.

Your recent actions have a stronger impact on your A1C score than your actions further in the past. However, all actions from the last 3-4 months will have some type of effect on your A1C percentage score. Consider purchasing a blood glucose monitor to keep track of how your body reacts to changes on a daily basis and make modifications accordingly.

For example, test your body’s carb tolerance by checking your blood sugar before you eat, tracking your carbs in that meal and then testing your blood sugar every hour after. You want to hit your original number by hour three; otherwise, you need to reduce your calorie intake.

Ideally, your blood sugar will not go up more than 30 points after the meal. Your blood glucose should never be higher than 140, but you should aim for 120 or lower. If your blood glucose level is higher than 140 at any point, you should reduce your calorie intake.

A person with type 2 diabetes can lower their A1C score by losing 5 or 10 percent of body weight. One method is to avoid refined carbohydrates, which are high in sugar and calories. Reducing consumption of refined carbohydrates, like sodas, juices and desserts, can help you reduce your calorie intake, which helps you lose weight. Additionally, you’ll be reducing the amount of glucose your body has to manage.

You might also try to lower your weight by doing mild exercise, which has added benefits. Mild exercise increases insulin sensitivity in your cells, making it easier for the insulin to remove glucose from your blood. Also, your muscles use up glucose when you exercise, which can lower your blood sugar levels.

Vitamins, like Vitamin D, Calcium and Magnesium reduce your insulin resistance. Talk to a doctor or a nutritionist to learn about what proportions of each will be best for your body.

You should avoid stressful situations. When you’re stressed, your insulin levels fall to ensure that your body has sugar and energy readily available to fuel you. Additionally, growth hormone and cortisol levels rise, which causes body tissue to be less sensitive to insulin. Both of these effects last 6-8 hours and cause glucose to be more potent in the bloodstream.

If your score is higher than when you last checked, try to pinpoint what caused the change. In the last 3-4 months, have you experienced stressful events, poor exercise habits, poor eating and mess-ups with medication? These can all cause increased A1C levels. Once you understand what caused your A1C score to increase, you can figure out how to avoid what caused it to rise in the first place and begin decreasing the percentage of glucose in your hemoglobin.

Does the Department of Transportation have A1C regulations?

The Department of Transportation doesn’t have diabetes regulations for personal drivers licenses; however, the department does regulate commercial driver’s licenses. Part of the DoT’s Physical Qualifications and Examinations, people who have diabetes are not physically qualified to have a commercial driver’s license. Therefore, drivers must submit an exemption form through the Federal Diabetes Exemption Program in order to obtain a commercial driver’s license if they have diabetes.

Other commercial drivers with diabetes who take insulin must apply for an exemption from the Federal Motor Carrier Safety Administration. These exemptions are good for a maximum of two years. The administration requires that people with exemptions go through quarterly and annual medical monitoring and reporting in order to maintain the exemption from the Federal diabetes standard.

Insulin users must also participate in diabetes education programs every year to continue to participate in the exemption program. They must also be evaluated by a board-certified or board-eligible Endocrinologist to confirm that no medical problems related to diabetes will impair safe driving. These examinations are valid for 6 months and must be renewed if expired during the application process, which is relevant because the application can take up to 180 days to process.

People with A1C scores that are greater than 10 are not eligible for the exemption and cannot get a commercial driver’s license.

Can Diabetes be Reversed? / Can Diabetes Go Away? / Can Diabetes be Cured?

At the moment, you cannot cure your diabetes. You can cause your type 2 diabetes to go into remission, which would mean you don’t have any signs or symptoms of diabetes, but you would still have diabetes.

There are three forms of remission that your body can have: partial remission, complete remission and prolonged remission.

When you have partial remission, it means your blood glucose level or A1C score has been similar to that of a person who has prediabetes rather than diabetes for at least a year, and you haven’t been taking any medication to cause that. When your body is in complete remission, your blood glucose levels and your A1C score are normal. During complete remission, you’re not taking any medication, and tests seem to indicate that you don’t have diabetes for at least one year. Prolonged remission is the same as complete remission, but it has lasted longer. Prolonged remission lasts for a minimum of 5 years.

People who have experienced remission typically follow strict diets and personalized exercise routines.

Can A1C Scores Be Used During Pregnancy?

A1C scores can be used to monitor women with type 1 or type 2 diabetes. The A1C test is different for pregnant women than for most people. Red blood cells do not live as long in the body of a pregnant woman as they do in a not-pregnant woman. Red blood cells live only a few weeks in pregnant women as opposed to a few months in other people.

However, A1C tests are not often used for diabetes diagnosed during pregnancy, which is called Gestational Diabetes Mellitus (GDM). Instead, doctors use something called an oral glucose tolerance test (OGTT) which gives them information about how well your body processes the sugar in foods.

High A1C scores during the first three months of pregnancy can indicate a higher chance of a spontaneous abortion or birth defects for women with type 1 and type 2 diabetes. For pregnant women, it is best to keep an A1C score below 6 percent.

Studies indicate that when high blood glucose is treated aggressively and early on, treatment can quickly lower A1C levels in pregnant women. Treating high blood sugar can stop negative ramifications for pregnant women and their baby’s health.

If your considering becoming pregnant, you’re more likely to get GDM if you:

  • Are older 25
  • Are overweight before becoming pregnant
  • Have prediabetes
  • Have a close family member who has or had type 2 diabetes
  • Have had GDM during a past pregnancy
  • Have delivered larger than normal children in the past
  • Are black, Hispanic, Native American or Asian

Developing GDM can cause complications for your baby. It could cause your baby to grow larger than they’re supposed to and require C-section for birth. Your baby could have low blood sugar after birth because his or her insulin production was high while in the womb. After normal feedings and possibly other intervention methods, your baby’s blood sugar should return to normal. Your baby would also have a higher risk of becoming obese or developing type 2 diabetes throughout his or her life. If you develop GDM, follow treatment precisely. Untreated GDM could cause a baby’s death either before or shortly after birth.

GDM can affect you too. Mothers that develop GDM can suffer from preeclampsia and subsequent gestational diabetes. When you have preeclampsia, you can experience high blood pressure and swelling in your legs and feet. It also causes there to be extra protein in your urine. Additionally, once you have GDM, you’re more likely to develop it in subsequent pregnancies and your more likely to develop type 2 diabetes.

Can I drink alcohol if I have high A1C test results?

You shouldn’t drink alcohol if you have high A1C test results. Sugary mixed drinks will raise your blood sugar. The alcohol can affect your liver’s ability to produce sugar and cause low blood sugar. More so, alcohol doesn’t mix well with most medications, including diabetes medications. If alcohol is truly important to your lifestyle, consult with a doctor about how often and how much alcohol you can. The doctor may switch you to a medication that isn’t strongly affected by alcohol.

Can A1C be lowered without medication?

You can reduce your A1C score without medication, but you should consult with a doctor to ensure that is the best course of action for you. After you talk to a doctor, he or she may recommend that medication is the best option for you. Nonetheless, your doctor will also recommend non-medicinal ways to lower your A1C score, like modifying your diet, participating in mild exercise and reducing stress.

You can reduce your A1C score through restricting your calories to between 1,200 and 1,500 calories a day. It’s generally safe to start by cutting 500 calories out of your diet per day. About 50 percent of your calories should come from carbohydrates, a third should come from fat and a fourth should come from protein.

You should also moderate your carb intake. You can test out what the right amount of carbs is for you by using a blood glucose monitor. Through this process:

  1. Test your blood glucose before you start eating.
  2. Enjoy a delicious meal and record what you eat in a food journal.
  3. An hour after eating, test your blood glucose level. Is it above 140? If your blood glucose is above 140, you ate too many carbohydrates in your meal. You should reduce them in a meal tomorrow and follow these steps again. If your score is below 140:
  4. Test your blood glucose two hours after eating. Has your blood glucose returned to the level it was at before you ate? If it has this is a good amount of carbohydrates for you to eat in a meal. If not:
  5. Test your blood glucose three hours after eating. Has your blood glucose returned to the level it was at before you ate? If it has this is a good amount of carbohydrates for you to eat in a meal. If not, you should reduce the carbs in your meal tomorrow and follow this process again.

You can also do blood glucose tests to see how your body reacts to some foods versus others. Consuming soda, juices, desserts and other refined carbohydrates will negatively affect your diet. After your testing, you can figure out which foods have the smallest impact on your blood glucose level? Those are the foods you should be eating in your diet!

Mild exercise causes your muscles to use up glucose, which can lower your blood glucose levels. Additionally, your body becomes more sensitive to insulin hormones. That makes it a lot easier for insulin to remove glucose from the bloodstream.

These steps will also help you lose weight. For people who have type 2 diabetes, losing 5 or 10 percent of your body weight can reduce your A1C score. People who have higher A1C scores will see more profound changes to their scores as they lose weight than people who have lower A1C scores, but on average people’s A1C scores drop by 0.1% for every 2.2 pounds they lose. That’s not necessarily because the weight was causing the diabetes but because the actions you take to lose the weight help reduce your blood glucose level.

Lastly, avoid stressful situations. Stress causes the body to reduce insulin levels and increase levels of growth hormone and cortisol. Your body wants you to have more glucose in your body to give you energy and help you cope with the stress. The growth hormone and the cortisol cause your body tissue to be less sensitive to insulin – the opposite effect as exercise. These effects can last for 6-8 hours. During that time your insulin will not be removing glucose from your blood, which will make it difficult for you to control your blood sugar.

How Can I Check My A1C at Home?

There are home tests that you can purchase at your local pharmacy. They typically cost about half of what a hospital test costs and use a smaller amount of blood. Many at home kits have been cleared by the FDA and meet the standards of the National Glycohemoglobin Standardization Program for measuring A1C. There are multiple brands available like CVS, Walgreens and others.

Should I See a Diabetes Nutritionist?

What you eat and how much you weigh are influential contributing factors to diabetes. Seeing a nutritionist and following their advice can help lower your A1C score. A registered nutritionist can help you plan out your meals and when you eat them to ensure that you are giving your body the energy it needs while working to reduce the amount of sugars that you eat.

Some nutritionists have even undergone exams to become certified diabetes educators, meaning they are experts in teaching people about diabetes.

You should not use a nutritionist as a substitute for a doctor. You should always consult with and follow the advice of your doctor first.

Why Does Diabetes Cause Thirst?

When there’s a lot of glucose in your bloodstream, your kidneys step in to help filter it out through your pee. In order to cause you to pee, your kidneys have to filter out water from your blood. Your body naturally triggers your thirst in order to add water back into your bloodstream.

If you ignore that thirst and don’t drink water, your body can get the needed water from your saliva or your tear ducts. This is a common reason why people experience dry eyes and dry mouth.

Why is Diabetes on the Rise with Kids?

One of the major contributing factors for diabetes is a person’s weight. Fatty tissue is resistant to insulin, which means the more fatty tissue you have in your body, the harder it is for insulin to remove glucose from your blood.

Children having type 2 diabetes has increased alongside the percentage of children who are obese.

Additionally, technology is more prevalent in the lives of children than ever before. Less of them are engaging in physical activity and outdoor play. Physical activity causes a person’s cells to become more sensitive to insulin, making it easier to remove the protein from the bloodstream. The prevalence of physical activity in the lives of children in the past could have been a factor in decreasing their likelihood of type 2 diabetes.

What Diabetes Are You Born With?

People are born with type 1 diabetes. Type 1 diabetes is caused by genetics and it is impossible to prevent. While genetic factors can contribute to the development of type 2 diabetes, other factors are also at play, like stress levels, eating patterns and exercise habits.

What’s the Difference Between Type 1 Diabetes and Type 2 Diabetes?

Type 1 diabetes occurs when your body isn’t producing enough or any insulin. It’s considered an autoimmune disease because your immune system is attacking the cells in your pancreas that are supposed to create insulin. Only about 5 percent of the people who have diabetes have type 1 diabetes.

On the other hand, type 2 diabetes occurs when the body is resistant to insulin. Instead of providing energy to your cells, glucose builds up in your bloodstream and your insulin hormone doesn’t have the power to allocate it where it needs to go. The majority of people with diabetes have type 2 diabetes. Typically, your pancreas responds by producing more insulin to handle these heavy levels of glucose; however, at a certain point, your body cannot make enough insulin to handle the glucose.

Which Diabetes Needs Insulin?

People who have type 1 diabetes always need insulin because their bodies don’t produce any. Insulin injections allow people with type 1 diabetes to regulate their blood sugar. Insulin is also prescribed to people with type 2 diabetes when other medications aren’t working properly. It is important for people with both types of diabetes to note that when you take insulin, you’re at risk for hypoglycemia, so you need to monitor your blood sugar and symptoms carefully.

Why Does Diabetes Make You Tired?

When you have diabetes, your body becomes resistant to insulin. The insulin hormone is what regulates and controls your blood sugar. That means your glucose is stuck in your blood and cannot travel to your cells. Glucose is what fuels your body and gives you energy. When the glucose isn’t delivered to your cells, your diabetes can make you feel tired.

Can Diabetes Cause Depression?

A chronic disease is one that lasts for more than three months, and according to the National Institute for Health and Care Excellence, people with chronic physical health problems are three times more likely to have depression. Unfortunately, diabetes is a chronic disease. The complications associated with diabetes serve as triggers for depression. For that reason, people who have diabetes are more likely to have depression.

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