For most adults with type 2 diabetes, a good A1c is below 7%. That translates to an estimated average blood sugar of about 154 mg/dL over the previous two to three months. But “good” isn’t the same number for everyone. Depending on your age, health history, and risk of low blood sugar episodes, your ideal target could be anywhere from 6.5% to 8%.
What the Major Guidelines Recommend
The American Diabetes Association (ADA) recommends an A1c below 7% for the general adult population with type 2 diabetes. The American Association of Clinical Endocrinologists (AACE) sets a slightly tighter goal of 6.5% or lower for most people. Both organizations stress that targets should be individualized, meaning your doctor may adjust the number up or down based on your specific situation.
These aren’t arbitrary thresholds. The landmark UKPDS study, which followed thousands of people with type 2 diabetes, found that every 1% drop in A1c was associated with a 37% reduction in the risk of microvascular complications like eye disease, kidney damage, and nerve problems. The benefits for heart attack and stroke were smaller but still meaningful: a 14% and 12% risk reduction per 1% drop, respectively.
What Your A1c Actually Tells You
A1c measures the percentage of your red blood cells that have glucose attached to them. Because red blood cells live about three months, the test captures a rolling average of your blood sugar rather than a single snapshot. Here’s what common A1c levels look like in everyday blood sugar terms:
- A1c 6%: average blood sugar around 126 mg/dL
- A1c 7%: average blood sugar around 154 mg/dL
- A1c 8%: average blood sugar around 183 mg/dL
- A1c 9%: average blood sugar around 212 mg/dL
- A1c 10%: average blood sugar around 240 mg/dL
These are averages with wide ranges. An A1c of 7% could reflect someone whose blood sugar stays relatively steady in the 120s to 180s, or someone who swings between 80 and 250 throughout the day. The number alone doesn’t tell you how stable your blood sugar is, which is one reason doctors sometimes look at additional measures like continuous glucose monitor data.
When a Tighter Target Makes Sense
If you’re relatively young, were recently diagnosed, and aren’t on medications that cause low blood sugar, aiming for an A1c of 6.5% or even closer to normal (below 5.7%) can be worthwhile. The earlier in the course of diabetes you bring your A1c down, the more you reduce the cumulative damage that high blood sugar does to small blood vessels in your eyes, kidneys, and nerves. People who can reach these tighter targets through lifestyle changes alone, or with medications that don’t cause hypoglycemia, get the benefits without much downside risk.
When a Higher Target Is Safer
Pushing A1c too low isn’t always better. Intensive glucose control increases the risk of hypoglycemia by several-fold, and low blood sugar episodes trigger a surge of stress hormones that raise heart rate and blood pressure. For someone with existing heart disease or reduced cardiac reserve, those swings can lead to serious cardiovascular events.
A less aggressive target of below 8% is generally more appropriate if you have a long history of diabetes (decades rather than years), have experienced severe or frequent low blood sugar episodes, live with advanced heart or kidney disease, or are dealing with significant frailty. The logic is straightforward: the risk of complications from aggressive treatment outweighs the long-term benefit of tighter control, especially if life expectancy means you may not live long enough to see that benefit materialize.
A1c Targets for Older Adults
Age alone doesn’t dictate your target, but overall health status does. The ADA’s 2025 guidelines break older adults into three categories:
- Healthy older adults (few other chronic conditions, sharp cognition, fully independent): below 7% to 7.5%
- Complex health (multiple chronic conditions, mild to moderate cognitive decline, or difficulty with daily activities): below 8%
- Very complex or poor health (end-stage chronic illness, moderate to severe cognitive impairment, or significant functional limitations): no fixed A1c target. The focus shifts entirely to avoiding dangerously low or symptomatically high blood sugar day to day.
For healthy older adults, there’s no inherent need to loosen control just because of a birthday. The shift happens when the burden of treatment, whether that’s medication side effects, complicated dosing schedules, or the real danger of falls from hypoglycemia, starts to outweigh the long-term payoff.
How Often to Check Your A1c
If your blood sugar is stable and you’re meeting your target, testing twice a year is sufficient. If you’ve recently changed medications, adjusted your diet significantly, or your numbers have been inconsistent, testing every three months gives you and your doctor a faster feedback loop. The test reflects about three months of blood sugar history, so checking more frequently than that rarely adds useful information.
Beyond A1c: Time in Range
If you use a continuous glucose monitor, you may have heard of “time in range,” which measures the percentage of the day your blood sugar stays between 70 and 180 mg/dL. Spending about 70% of the day in that range corresponds roughly to an A1c of 7%, while 50% time in range lines up with an A1c around 8%. Each additional 10% of time spent in range (about 2.4 extra hours per day) corresponds to roughly a 0.6% drop in A1c.
Time in range captures something A1c misses: variability. Two people with identical A1c values can have very different daily blood sugar patterns, and the one with wider swings may face higher risks. If you have access to continuous glucose data, it’s a useful complement to your A1c results, not a replacement for them.