Medically reviewed on October 19, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Blood sugar levels play an important role in maintaining the body’s balance of energy.  But consistently dealing with high blood sugar can affect your health and make you more likely to develop diabetes, particularly if you don’t seek treatment and/or adjust your lifestyle.
Fortunately, there are plenty of tools to help you measure and manage high blood sugar and related conditions. The HbA1c test, also known as an A1c test, is one of them.
If you’re at risk for diabetes, an HbA1c test can help assess your likelihood of developing diabetes and prediabetes through blood glucose measurement. If your results consistently show elevated glucose levels, there are key lifestyle changes you can take to lower your blood sugar naturally.
Keep reading to learn how healthy eating and an active lifestyle can help keep HbA1c levels optimal and your glucose in check.
What is HbA1c?
HbA1c (also referred to as A1c, hemoglobin A1c, or glycated hemoglobin) is a blood test that measures the levels of glucose attached to hemoglobin in the bloodstream over a period of a few months. This test helps to provide a bird’s eye view of blood sugar levels over time, or as an average, rather than at a specific moment.
It’s important to note that an HbA1c test differs from a glucose test. While both tests are associated with diabetes care and maintenance, there are notable differences between the HbA1c test and the glucose test:
- Glucose test – If you have diabetes or are close to someone who is diabetic, you’re probably familiar with glucose testing. A blood glucose test measures the amount of sugar in the blood and is used to keep diabetes under control. Whether via a finger prick or a wearable sensor, monitoring glucose levels helps people with diabetes to avoid potentially dangerous health emergencies like hypoglycemia.
- HbA1c test – HbA1c tests can provide critical information for preliminary diabetes risk and can be a good measure of progress over time. If you have or are at risk for prediabetes or diabetes, an HbA1c test may be recommended by your healthcare provider to help assess risk factors. While a glucose test monitors current or acute blood sugar levels, an HbA1c test will give a three-month average to better understand how you’re maintaining your blood glucose levels.
Which test is right for me?
According to the CDC, an A1c test is recommended for all adults over the age of 45 at least once every three years. The HbA1c test is also recommended if you are under the age of 45 but have any of the following risk factors for type 2 diabetes: 
- Direct family member with type 2 diabetes
- Minimal physical activity
- Gestational diabetes or birthed children weighing over 9 pounds
If you’re already diagnosed as diabetic, your healthcare provider may recommend an HbA1c test more frequently in conjunction with your daily glucose monitoring. This test can help you to have a more accurate understanding of how well your blood sugar levels are being maintained both in the short and long-term.
How to lower HbA1c through lifestyle changes
HbA1c can be an important indicator of prediabetes and diabetes before you start to experience noticeable symptoms. If your test comes back with a result that exceeds the acceptable range, you can take steps to lower your HbA1c levels and keep diabetes at bay or under control without using insulin as a treatment modality.
#1 Follow a glucose or carbohydrate-friendly diet
If you’re at risk for diabetes or have already been diagnosed, monitoring your food intake is a must. Controlling the types of foods that go into your body can help to keep your glucose levels at an acceptable level.
Here are two ways you can use nutritional changes to support a glucose-friendly diet: 
- Avoid foods high in sugar (carbohydrates) – Limit your intake of sweets, sugary drinks, and simple/refined carbohydrates like white bread, white flour pastas, and white potatoes. While it may be challenging at first to reduce your consumption of many of these types of high carb foods, managing your intake of sugar-laden and starchy foods is an important step in balancing your blood sugar levels. You may be surprised to find that one other food may affect blood sugar levels—coffee. [Does caffeine affect blood sugar](https://www.everlywell.com/blog/hba1c/does-caffeine-affect-blood-sugar)? Surprisingly, the answer is yes.
- Choose foods that can help with glucose maintenance – Instead of processed carbs and sugary drinks, opt for whole foods rich in proteins and complex carbohydrates that take longer to break down in your system. Legumes, lean proteins, whole grains, and select dairy products are all excellent additions to a nutritious, glucose-friendly diet.
One study suggests that a plant-based diet is best for diabetes management. This is due to the increased intake of beneficial whole foods and reduced intake of animal-based foods that trigger blood sugar spikes in a plant-based diet.  While there isn’t a single miracle food that will lower your HbA1c instantaneously, eating a nutrient-rich diet can help to lower blood sugar levels over time and set you on the right path for glucose consistency and optimization.
In addition to managing what foods you eat, it’s also important to manage your portions. The amount of carbohydrates you intake directly affects the amount of glucose in your blood, as eating too much at once can throw your blood sugar levels out of balance. While you may be able to still enjoy some sweet treats in moderation, planning your portions can help to reduce their impact on your blood sugar levels.
#2 Exercise regularly
Staying physically fit is always a recommended part of living a healthy lifestyle. When it comes to individuals who are at risk for prediabetes or diabetes, exercise is even more important because of how it can aid in reducing blood sugar.
According to the American Diabetes Association, there are two main ways exercise aids in lowering blood sugar: 
- Increased sensitivity to insulin allows muscle cells to take up more insulin as opposed to when the body remains stationary.
- Muscle contractions help the cells to use glucose without the need for insulin both during and after a workout.
Consistent physical activity can help not only in the short term to maintain glucose daily—but also in the long term, it can help lower your HbA1c. The good news is you don’t have to follow one specific exercise regimen to manage blood sugar levels. Any activity that keeps you moving will work, including:
- Practicing yoga
- Walking on a treadmill
- Hiking at your local park
- Lifting weights
#3 Maintain a healthy weight
Maintaining a healthy weight goes hand-in-hand with a nutritious diet and regular exercise—so if you’re following the first two tips, you may naturally find it easier to manage your weight. Research has shown the positive effect of weight loss in overweight individuals with type 2 diabetes on lowering HbA1c levels. 
Actively pursuing a healthy weight can benefit not just diabetes risks or symptoms but many other aspects of your overall health and wellness. Alternatively, if you notice rapid, unexplained weight loss, check with a healthcare provider, as this could also be a symptom of diabetes.
#4 Avoid habits that can raise your HbA1c
There are other steps to consider when pursuing a healthy lifestyle as well. Two lifestyle factors that could affect your HbA1c are smoking and stress. Stress has plenty of detrimental effects on the body. But can stress raise blood sugar? Stress can cause the blood sugar to rise, so actively pursuing ways to reduce stress triggers in your environment could be beneficial in lowering your HbA1c.
Kicking unhealthy habits can be more helpful than you think. In a recent study, smokers were found to be twice as likely to have elevated, prediabetic HbA1c levels than non-smokers. 
How long does it take HbA1c levels to go down?
When you’re attempting to lower your HbA1c levels through positive lifestyle changes, don’t expect immediate results. Instead, recognize that you’re making changes that will become long-term solutions to blood sugar management.
That said, taking another HbA1c test after several months of healthy lifestyle changes may help you to gauge your progress in managing healthier blood sugar levels. But don’t be discouraged if you don’t see a huge improvement right away. What matters most is that you continue to consistently follow those healthy habits and lower your HbA1c over time.
Keep your glucose in check with the help of Everlywell
If you have any risk factors for diabetes, consider taking steps to lower your HbA1c and naturally reduce your risk of developing diabetes. If you’re currently managing diabetes, the same lifestyle changes could help you to maintain more consistent blood glucose levels.
Our at-home HbA1c Test is an easy way to measure and assess your A1c maintenance and from the comfort of home.
At Everlywell, we provide you with the tools to aid you on the path to wellness, including vitamins, supplements, and at-home diagnostic testing. Our full range of tests can help give you the knowledge and power to take control of your health.
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- Hantzidiamantis PJ, Lappin SL. Physiology, Glucose. PubMed. Published September 20, 2021. URL. Accessed September 27, 2022.
- CDC. All About Your A1C. Published 2018. URL. Accessed September 27, 2022.
- Medline. Diabetic Diet. Published 2019. URL. Accessed September 27, 2022.
- McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. Journal of geriatric cardiology : JGC. 2017;14(5):342-354. doi:10.11909/j.issn.1671-5411.2017.05.009. Accessed September 27, 2022.
- Blood Sugar and Exercise | ADA. diabetes.org. URL. Accessed September 27, 2022.
- Gummesson A, Nyman E, Knutsson M, Karpefors M. Effect of weight reduction on glycated haemoglobin in weight loss trials in patients with type 2 diabetes. Diabetes, Obesity and Metabolism. 2017;19(9):1295-1305. doi:10.1111/dom.12971. Accessed September 27, 2022.
- Vlassopoulos A, Lean ME, Combet E. Influence of smoking and diet on glycated haemoglobin and “pre-diabetes” categorisation: a cross-sectional analysis. BMC Public Health. 2013;13(1). doi:10.1186/1471-2458-13-1013. Accessed September 27, 2022.
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