Lowering your A1c is entirely possible with the right combination of dietary changes, physical activity, sleep, and sometimes medication. Most people can expect to see meaningful results within three months, since the A1c test reflects your average blood sugar over roughly a 90-day window. That timeline is tied to the lifespan of your red blood cells, which regenerate every 90 to 120 days. So any change you make today won’t fully show up on a lab test until your next blood draw, typically three months later.
A normal A1c falls below 5.7%, prediabetes ranges from 5.7% to 6.4%, and diabetes is diagnosed at 6.5% or higher. If you already have diabetes, the American Diabetes Association recommends aiming for below 7% as a general target, though your doctor may set a different goal based on your age, health, and risk of low blood sugar episodes.
Cut Back on Carbohydrates
Reducing carbohydrate intake is one of the most effective dietary strategies for lowering A1c. In a study published in BMJ Open Diabetes Research & Care, people with type 2 diabetes who followed a low-carbohydrate, high-fat diet saw their A1c drop by an average of 1.29 percentage points compared to a usual-care group. Over a full year, the reduction reached about 1.5 points. That’s a substantial change, enough to move many people from poorly controlled diabetes into their target range.
You don’t necessarily need to go ultra-low-carb to see benefits. The key is replacing refined carbohydrates (white bread, sugary drinks, white rice, pastries) with foods that release sugar more slowly. Vegetables, legumes, nuts, and whole grains all have a gentler effect on blood sugar. When you do eat carbohydrates, pairing them with protein or fat slows digestion and blunts the post-meal spike.
Soluble fiber deserves special attention. It forms a gel-like substance in your gut that slows carbohydrate absorption, which directly smooths out blood sugar swings. Aim for 6 to 8 grams of soluble fiber per day. Good sources include oats, beans, lentils, apples, and flaxseed.
Exercise Consistently
Regular physical activity lowers A1c by helping your muscles pull sugar out of the bloodstream more efficiently, both during and after exercise. The good news: strength training and cardio are equally effective at lowering A1c. A meta-analysis comparing resistance training to aerobic exercise found no significant difference between the two. So the best exercise for your blood sugar is whichever type you’ll actually stick with.
That said, combining both forms of exercise tends to produce the best overall health outcomes. A practical approach might look like three days of brisk walking, cycling, or swimming alongside two days of bodyweight exercises or weight lifting. Even short bouts of movement after meals, like a 10 to 15 minute walk, can meaningfully reduce post-meal blood sugar spikes. Consistency matters more than intensity. Regular moderate activity five days a week will do more for your A1c than occasional intense workouts.
Fix Your Sleep
Sleep is an underappreciated factor in blood sugar control. Getting fewer than six hours per night is associated with higher fasting glucose levels and reduced insulin sensitivity, meaning your body needs to produce more insulin to keep blood sugar in check. Over time, this extra strain contributes to higher A1c readings.
The relationship works in the other direction, too. Research has shown that people who successfully extended their sleep beyond six hours experienced measurable improvements: lower fasting insulin resistance, better insulin secretion, and improved function of the cells that produce insulin. If you’re doing everything right with diet and exercise but still seeing stubborn A1c numbers, poor sleep could be the missing piece. Aim for seven to eight hours consistently, and address issues like snoring or frequent nighttime waking, which could signal sleep apnea (a condition closely linked to insulin resistance).
Consider a Continuous Glucose Monitor
A continuous glucose monitor (CGM) is a small sensor worn on your arm or abdomen that tracks your blood sugar in real time. You can see exactly how specific foods, activities, and stressors affect your levels throughout the day. This immediate feedback loop helps you make smarter choices, and it works: a meta-analysis of 14 randomized controlled trials found that CGM users lowered their A1c by about 0.3 percentage points compared to people using traditional finger-stick testing alone.
That might sound modest, but a 0.3% drop on top of dietary and exercise changes adds up. CGMs are particularly useful in the early weeks of behavior change, when you’re learning which meals spike your sugar and which don’t. Some people are surprised to find that foods they assumed were safe (like certain fruits or “whole grain” breads) cause larger spikes than expected, while other meals they avoided are perfectly fine.
Medications That Help
When lifestyle changes alone aren’t enough, medication can make a significant difference. The newer class of injectable medications called GLP-1 receptor agonists has become especially prominent. These drugs work by mimicking a hormone that signals your pancreas to release insulin after meals, slows stomach emptying, and reduces appetite. Long-acting versions lower A1c by about 1 percentage point on average, with some people seeing even larger reductions.
Metformin remains a widely used first-line option and typically lowers A1c by 1 to 1.5 points. Your doctor will choose a medication based on your current A1c, other health conditions, and how you respond to initial treatment. Medication works best alongside the dietary and activity changes described above, not as a replacement for them.
What a Realistic Timeline Looks Like
Because the A1c test averages your blood sugar over roughly three months, you won’t see the full impact of your changes until your next lab draw. But more recent blood sugar levels are weighted slightly more heavily in the test, so improvements you make in the final few weeks before your appointment do count.
For most people, a realistic goal is lowering A1c by 0.5 to 1.5 percentage points over three to six months, depending on where you start and how many changes you implement at once. Someone starting at 9% who combines a low-carb diet with daily exercise and medication could see a drop to the 7% range within that window. Someone at 6.8% trying to get below 6.5% with diet alone may need a bit more patience.
The changes that tend to produce the fastest visible results are carbohydrate reduction and consistent post-meal movement. These directly affect the blood sugar spikes that drive your average upward. Sleep and stress management work more gradually but sustain your progress over time. Stack these strategies together rather than relying on any single one, and your next A1c test will reflect the effort.