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What you need to know about the prediabetes A1C test

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Normal rangeDangerous rangeCan it go away?Summary
Prediabetes occurs when your blood sugar levels are high but not yet high enough for a diagnosis of diabetes. An A1C test can help identify levels and stop them from rising.
Medically reviewed by Lauren Castiello, MS, AGNP-C
Written by Rashida Ruwa, RN
Updated on April 11, 2023

A1C is a blood test that measures your average blood sugar levels. It’s also known as hemoglobin A1C, HbA1C test, or glycated hemoglobin test.

It’s expressed as a percentage that healthcare professionals use to diagnose and monitor diabetes. But they can also use it to detect prediabetes. The condition’s characteristics are elevated blood sugar levels that exceed the normal range but do not meet the diagnostic criteria for type 2 diabetes.

The test can measure your average blood sugar levels over the past 3 months.

When your A1C range is high, you are at a greater risk of developing complications related to diabetes, such as:

Prediabetes can often lead to diabetes with no obvious symptoms. The A1C test can help identify and manage symptoms and prevent them from progressing to diabetes.

Treatment for prediabetes involves lifestyle measures that can help lower blood sugar levels, such as:

Healthcare professionals might also prescribe medications like metformin (Riomet).

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What is a normal range of A1C? 

An image of someone checking their blood sugar levels.
Photography by Andriy Onufriyenko/Getty Images

The A1C test measures the percentage of hemoglobin coated with sugar, reflecting average blood sugar levels over the past three months. The normal range of A1C levels is typically below 5.7%.

For people with prediabetes, an A1C level of 5.7%–6.4% is high, putting them at a higher risk of developing type 2 diabetes. But A1C levels below 5.7% are typically healthy and suggest that blood sugar levels are within the normal range.

New research notes that maintaining a healthy A1C level can help reduce the risk of developing long-term complications associated with diabetes. This includes microvascular complications (which affect small blood vessels) that can cause coronary artery disease or stroke.

What is a dangerous range of A1C? 

An elevated A1C level indicates that blood sugar levels have been consistently high for the past 3 months, which can lead to serious health complications.

The dangerous range of A1C levels depends on the individual’s health status, but generally, an A1C level of 6.5% or higher would meet the diagnosis criteria for diabetes.

It also increases the risk of developing long-term complications associated with diabetes, such as:

A 2015 study notes that people with an A1C level of 6.5% or higher have a significantly increased risk of developing cardiovascular disease.

Typically, the danger of high A1C levels depends on several factors, such as:

  • age
  • overall health status
  • family history, as type 2 diabetes can sometimes be hereditary

Consider talking with a healthcare professional to determine a target A1C level appropriate to your needs.

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Can prediabetes go away? 

Managing prediabetes involves taking lifestyle measures to lower your blood sugar levels and reduce your risk of developing type 2 diabetes.

Here are some ways to help manage prediabetes.

Weight loss

Losing weight can improve insulin sensitivity and lower blood sugar levels. Even weight loss between 5%–10% can significantly improve blood sugar levels and reduce the risk of developing diabetes.

Consider speaking with a healthcare professional about whether weight loss would be right for you.

Healthy diet

Eating a healthy diet that is low in saturated and trans fats, but high in fiber and whole grains can help lower your blood sugar levels. Avoid sugary and processed foods and opt for whole, nutrient-dense foods, such as:

  • beans
  • berries
  • fish high in omega-3 fatty acids
  • nuts
  • leafy green vegetables

Exercise

Regular physical activity can improve insulin sensitivity, which allows the body to regulate blood sugar levels better and improve overall health. The Centers for Disease Control and Prevention (CDC) recommends at least 150 minutes of moderate-intensity weekly physical activity.

Quitting smoking

Smoking increases the risk of developing type 2 diabetes. If you’re smoking, consider quitting to help reduce this risk.

Managing stress levels

Stress can cause your blood sugar levels to rise, so managing stress through relaxation techniques such as meditation or yoga can help reduce cortisol levels and improve blood sugar management.

Medication

In some cases, your doctor may prescribe medication to help manage your blood sugar levels. One of the most commonly prescribed medications is metformin, which helps lower blood sugar levels by decreasing the amount of glucose produced by the liver.

Managing prediabetes requires a combination of lifestyle measures and, in some cases, medication.

Consider speaking with a healthcare professional to develop a personalized plan to manage your prediabetes and reduce your risk of developing diabetes.

Summary

Prediabetes is a condition characterized by elevated blood sugar levels that exceed a normal range yet do not meet the diagnostic criteria for type 2 diabetes. 

One of the primary ways to diagnose and manage prediabetes is by measuring A1C levels.

Consider talking with a healthcare professional to determine an appropriate target A1C level based on your health factors.

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