A good A1C for most adults with type 1 diabetes is below 7%, which translates to an estimated average blood sugar of about 154 mg/dL. That’s the benchmark the American Diabetes Association sets for non-pregnant adults. But “good” isn’t one number for everyone. Your ideal target depends on your age, whether you’re pregnant or planning to be, your risk of low blood sugar episodes, and the technology you use to manage your insulin.
The Standard Target: Below 7%
For most adults with type 1 diabetes, keeping your A1C under 7% significantly lowers the risk of long-term complications. The landmark Diabetes Control and Complications Trial, which specifically studied people with type 1, found that tighter blood sugar control led to a 63% reduction in eye disease progression, a 54% reduction in serious kidney damage, and a 60% reduction in nerve damage over five years. Those are dramatic numbers, and they’re the reason 7% remains the standard goal decades later.
What’s especially striking is the dose-response relationship: for every 10% proportional drop in A1C, the risk of eye disease progression fell by about 40%. That means even getting from 8.5% down to 7.5% matters, even if you haven’t hit the 7% mark yet. Progress counts.
Targets for Children and Teens
Kids and adolescents with type 1 diabetes have their own guidelines, and they’ve gotten more ambitious in recent years. The International Society for Pediatric and Adolescent Diabetes updated its recommendations in 2024, now suggesting an A1C of 6.5% or lower for young people who use advanced technology like continuous glucose monitors paired with automated insulin delivery systems. For those without access to that technology, the target remains 7% or lower.
These tighter goals reflect how much easier it’s become for families to manage blood sugar with newer devices. An automated insulin pump that adjusts delivery based on real-time glucose readings can prevent the sharp highs and lows that make tight control so difficult to achieve manually.
Pregnancy and Preconception Goals
If you’re planning a pregnancy or currently pregnant, the targets are considerably tighter. Before conception, the goal is an A1C below 7% and as close to 6% as possible, without triggering frequent low blood sugar. During pregnancy itself, the target drops to below 6%. High blood sugar in pregnancy raises the risk of complications for both mother and baby, which is why these numbers are more aggressive than the standard adult goal.
Reaching an A1C near 6% requires close monitoring and frequent insulin adjustments. Most providers will recommend checking blood sugar many times daily or using a continuous glucose monitor throughout pregnancy.
When a Higher Target Makes Sense
Not everyone should push for the lowest possible A1C. A target between 7% and 8.5% may be safer and more appropriate if you experience repeated episodes of severe low blood sugar, have developed hypoglycemia unawareness (where you no longer feel symptoms of a low), are elderly and managing other health conditions, or have cognitive impairment that makes intensive management difficult.
Severe hypoglycemia can cause seizures, loss of consciousness, and dangerous falls. For someone who frequently drops low without warning, the risks of an aggressive A1C target can outweigh the benefits. The goal shifts from preventing complications 20 years out to preventing a dangerous episode today.
A1C and Time in Range
If you wear a continuous glucose monitor, you probably also track time in range, the percentage of the day your blood sugar stays between 70 and 180 mg/dL. These two metrics tell complementary stories. Spending about 70% of the day in range corresponds to an A1C of roughly 7%. Dropping to 50% time in range pushes A1C closer to 8%.
Time in range can actually be more useful day to day than A1C alone. Two people can have the same A1C of 7%, but one stays steady between 90 and 160 while the other swings wildly from 50 to 300. Their complication risk isn’t the same. Time in range captures that variability in a way A1C cannot, which is why many diabetes specialists now treat both numbers as important.
When Your A1C Might Be Misleading
A1C measures how much sugar has attached to your red blood cells over the past two to three months. Anything that changes how long your red blood cells live can skew the result. Iron deficiency anemia, vitamin B12 deficiency, and folate deficiency all extend red blood cell lifespan, which artificially raises your A1C. On the other hand, conditions that destroy red blood cells faster, like hemolytic anemia or significant blood loss, can make your A1C appear falsely low.
Certain hemoglobin variants, most commonly hemoglobin S (associated with sickle cell trait) and hemoglobin C, can push results in either direction depending on the lab method used. If your A1C consistently doesn’t match what your glucose readings suggest, one of these factors could be the reason. In those cases, your provider may rely more heavily on continuous glucose monitor data or a different blood test called fructosamine to gauge your control.
What “Good” Really Means for You
The best A1C is one that balances long-term protection against complications with safety from low blood sugar in daily life. For most adults, that’s below 7%. For children on modern technology, it may be 6.5% or lower. During pregnancy, it’s below 6%. And for people dealing with severe lows or other health challenges, anywhere in the 7% to 8.5% range can be a perfectly reasonable and responsible goal. The number that keeps you safe, functional, and healthy over time is the right one.