A good A1C for most people with type 1 diabetes is below 7%, which translates to an estimated average blood sugar of about 154 mg/dL. That’s the target recommended by the American Diabetes Association for nonpregnant adults, and hitting it significantly lowers the risk of long-term complications. But “good” isn’t one-size-fits-all. Your ideal number depends on your age, whether you’re pregnant or planning to be, how often you experience dangerous lows, and your overall health.
The Standard Target: Below 7%
The ADA’s 2025 Standards of Care recommends an A1C below 7% for most nonpregnant adults with diabetes, including type 1. This threshold comes largely from the landmark DCCT trial, which followed people with type 1 diabetes and found that virtually all of the reduction in eye, kidney, and nerve damage could be explained by lowering average A1C levels. Getting below 7% early in the course of the disease has the strongest protective effect.
Going even lower can be beneficial. The ADA notes that an A1C below 7% is acceptable and potentially advantageous if you can reach it safely, meaning without frequent or severe low blood sugar episodes. Some people with type 1 diabetes maintain an A1C in the 6.0% to 6.5% range with the help of continuous glucose monitors and insulin pumps, but this requires careful management and isn’t realistic or safe for everyone.
What Your A1C Means in Daily Numbers
A1C reflects your average blood sugar over roughly two to three months, but it helps to understand what that looks like day to day. Here’s how common A1C levels translate to estimated average glucose:
- 6.0%: approximately 126 mg/dL
- 6.5%: approximately 140 mg/dL
- 7.0%: approximately 154 mg/dL
- 7.5%: approximately 169 mg/dL
- 8.0%: approximately 183 mg/dL
If you use a continuous glucose monitor, you may also track “time in range,” which measures the percentage of time your blood sugar stays between 70 and 180 mg/dL. An A1C of 7% corresponds to roughly 64% time in range. An A1C of 6.5% corresponds to about 70% time in range, which is the commonly recommended CGM target. These two metrics complement each other: A1C captures the big picture, while time in range reveals how stable your blood sugar is throughout the day.
Targets for Children and Teens
The International Society for Pediatric and Adolescent Diabetes (ISPAD) also recommends an A1C below 7% for children of all ages with type 1 diabetes. This is a shift from earlier guidelines that allowed higher targets for younger kids out of concern for dangerous lows. With modern insulin pumps and continuous glucose monitors, children younger than 7 who have access to quality diabetes care can often achieve an A1C of 6.5% or lower without a high risk of hypoglycemia. The UK’s NICE guidelines go a step further, encouraging a target of 6.5% or below for pediatric patients when it can be reached safely.
Targets During Pregnancy
If you have type 1 diabetes and are pregnant or planning to become pregnant, the target drops. The ADA recommends an A1C below 6.5% before conception and as close to normal as safely possible throughout pregnancy. Higher A1C levels during early pregnancy are linked to increased risk of birth defects, preeclampsia, premature delivery, and high birth weight. Because A1C naturally trends slightly lower during pregnancy due to changes in red blood cell turnover, your care team will likely rely on frequent blood sugar checks or CGM data alongside A1C results.
When a Higher A1C Is the Right Goal
A lower A1C is not always better. The main tradeoff is hypoglycemia: the more aggressively you push blood sugar down, the more likely you are to experience dangerous lows. For some people, a slightly higher target is safer and more appropriate.
Older adults with multiple chronic conditions or a high treatment burden typically do well with a target below 8%. For those who are frail, have limited life expectancy, or are at high risk for falls, guidelines suggest a target of 7.5% to 8.5%. The International Diabetes Federation recommends 7% to 8% for people who are functionally dependent or living with dementia. In these situations, avoiding hypoglycemia and maintaining quality of life takes priority over preventing complications that develop over decades.
Your target may also be adjusted upward if you have a history of severe hypoglycemia (episodes requiring someone else’s help), if you have hypoglycemia unawareness (you no longer feel the warning signs of a low), or if you live or work in situations where a sudden low could be dangerous.
Why A1C Matters for Complications
The connection between A1C and long-term complications in type 1 diabetes is well established. Analysis of the DCCT trial data showed that 96% of the difference in retinopathy progression between the intensive treatment group and the conventional group was explained by differences in A1C alone. The same held true for kidney disease and nerve damage. While blood sugar variability, like frequent spikes and crashes, may play a small additional role, the average level captured by A1C is overwhelmingly what drives complication risk.
This doesn’t mean every fraction of a percentage point matters equally. The risk reduction from moving from 9% to 8% is larger than the reduction from 7% to 6.5%. If your current A1C is well above target, even a modest improvement provides meaningful protection. Perfection isn’t the goal. Consistent progress is.