Today’s technology makes it easy for people with type 2 diabetes to check their blood sugar (also called blood glucose) at home. But checking your A1c levels often means going to the doctor’s office. Many people on DiabetesTeam feel nervous before these visits because they worry about what their A1c results will show, especially if they’ve been working hard to lower their numbers through exercise and healthy eating.

“I’m due soon for another A1c test — stressful!” one DiabetesTeam member wrote. Another said, “I was so hopeful that my A1c yesterday would drop to maybe 6.9. But no, it was 7.2. In May, it was 7.3. I was sure I had eaten fewer carbs since then. Do I need to give up more carbs?”

If you’re working on lifestyle changes to reduce your A1c levels, it helps to know how long it may take for your A1c levels to improve. Let’s start by learning more about A1c.

What Is A1c?

A hemoglobin A1c test, often shortened to A1c or HbA1c, shows your average blood sugar level over the past two to three months. Your doctor will give you the result as a percentage after doing a blood test. In general, a lower percentage means your blood sugar levels are under better control.

Monitoring A1c allows your healthcare provider to diagnose prediabetes and diabetes. Once you’ve received a diagnosis, they’ll keep tracking your A1c levels to make sure your diabetes is under control.

Doctors generally use the following guidelines when checking A1c levels during diagnosis:

• 5.7 percent or below — Healthy range
• 5.7 percent to 6.4 percent — Prediabetes
• 6.5 percent or higher — Diabetes

After a diagnosis of type 2 diabetes, the general A1c goal is to keep it below 7 percent. For people over 75, especially those taking medications that can cause hypoglycemia (low blood sugar) — such as insulin or sulfonylureas — the target is usually raised to below 8 percent to help avoid low blood sugar. (Note that while sulfonylureas remain available as generic medications, several brand-name versions have been discontinued.)

Episodes of low blood sugar can affect your A1c level, potentially making it appear that your diabetes is well controlled — even if it’s not — especially if your doctor is unaware of these episodes. In older adults, low blood sugar can also raise the risk of falling.

If your A1c levels are significantly above your target range, you may have an increased risk of health issues. These other health problems include eye issues, kidney disease, stroke, heart disease, digestive problems, and neuropathy (nerve damage). By tracking your A1c levels, your doctor can stay on top of how your diabetes is progressing and try to prevent these complications.

Physical Activity, Diet, and A1c

Managing your A1c levels may take trial and error. Your diabetes care team will work with you on a diabetes treatment plan that may include:

• Taking medication, such as pills or insulin
• Participating in a regular exercise routine
• Starting a new, diabetes-friendly eating plan

Some people may be able to lower their A1c through diet and exercise alone, without taking medication, but this approach isn’t suitable for everyone. Always check with your doctor before making any changes to your treatment plan.

“My doctor told me I needed long-acting insulin, quick-acting insulin, and metformin,” one DiabetesTeam member said. “I negotiated a three-month reprieve from medications. She said if I got my A1c down to 6.1, I could gain another three months. Three and a half months later, my A1c was 4.9 and has been in the fives since — no diabetes medications!”

Whether someone with type 2 diabetes can stop taking medicine depends on their health and situation. Talk to your doctor about your goals and interests to develop a treatment plan tailored to your situation.

Diet and A1c

Your doctor or registered dietitian will help you create a diabetes eating plan that fits your lifestyle, goals, and preferences. No single diet has been shown to work best for everyone with type 2 diabetes. Some studies have shown that both low-carb and low-fat diets are useful in improving A1c levels.

The American Diabetes Association lists the following diets as helping reduce A1c levels:

• The Mediterranean-style eating plan focuses on eating more plant-based foods, whole grains, olive oil, and fish while limiting dairy, eggs, red meat, wine, and honey.
• The vegetarian or vegan meal plan emphasizes plant-based foods, avoiding meat, seafood, and poultry.
• The low-carb eating plan limits carbohydrate intake to 26 percent to 45 percent of your total calories, focusing on nonstarchy vegetables and proteins.
• The very-low-carb meal plan restricts carbohydrates to less than 26 percent of total calories.

Exercising To Lower A1c

Your doctor can help you figure out what kind of exercise to do and how often, especially if you’re trying to lower your A1c levels. In general, adults with type 2 diabetes are advised to:

• Perform 150 minutes or more of moderate to intensive exercise during the week.
• Exercise at least three days a week.
• Avoid going more than two days in a row without exercising.
• Choose an exercise intensity that matches your fitness level, health, and personal needs.

How Long Do A1c Changes Take?

The degree and speed of A1c improvement will vary based on your baseline A1c, type of diabetes, how well you stick to lifestyle changes, and whether you’re taking medications. One study showed that consistent changes in diet and regular physical activity helped people with type 2 diabetes lower their A1c levels within three months.

Another study evaluated people with untreated A1c levels between 6 percent and 6.9 percent who followed a low-carb diet (consuming less than 40 carbs daily for the first three months and less than 60 carbs a day for the next three months). They compared the A1c outcomes of participants who ate the low-carb diet against those who ate a regular diet. They found that those who ate the low-carb meal plan had bigger A1c reductions at both three months and six months than those who ate their usual diets.

Several DiabetesTeam members have shared their results with lowering their A1c levels:

• “My A1c was 6.9 percent in August of 2016. Diet and weight loss got it down to 5.7 percent three months later, and between now and then, it has hung around in the 5.4-to-5.8 range. I have my annual A1c check next month, and my Libre 2 is calculating that I will be sub-6 percent, which is my current target.”
• “My A1c was 14 percent at diagnosis. With diet, exercise, and antidiabetes meds, I’m at 6.7 percent A1c now.”
• I was initially diagnosed at 6.4 percent last October. Three months later, I was at 6.1 — another three months, I hit 5.9. Then, after nine months, I was at 5.7. I was able to lower it by diet and exercise.”

Talk With Your Doctor

Not everyone with type 2 diabetes will have the same experiences. That’s why it’s important to talk to your healthcare provider to get a personalized plan to lower your A1c. They can help you create a treatment program that may include diet, exercise, and medications. They’ll be able to advise you about how long it may take to see your A1c numbers decrease.

Find Your Team

On DiabetesTeam, the social network for people with diabetes and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Have you tried lowering your A1c levels by dieting and exercising? How long did it take? Share your experience in the comments below, or start a conversation by posting on your Activities page.