A good A1C score for someone without diabetes is below 5.7%. If you have diabetes, the general target is below 7%, though your ideal number depends on your age, health, and whether you’re pregnant. The A1C test measures your average blood sugar over the past two to three months, expressed as a percentage. The higher that percentage, the higher your blood sugar has been running.
A1C Ranges: Normal, Prediabetes, and Diabetes
Three clear cutoffs define where your A1C falls:
- Normal: below 5.7%
- Prediabetes: 5.7% to 6.4%
- Diabetes: 6.5% or above
A result in the prediabetes range means your blood sugar is elevated but not yet high enough for a diabetes diagnosis. It’s a signal that your body is starting to have trouble processing glucose efficiently. A single test isn’t enough to diagnose diabetes on its own. Any result at or above 6.5% needs to be confirmed with a second test, unless you already have obvious symptoms like frequent urination, extreme thirst, or unexplained weight loss.
What A1C Means in Everyday Blood Sugar Terms
A1C percentages can feel abstract, so it helps to translate them into estimated average glucose, the kind of number you’d see on a blood sugar meter. An A1C of 7% corresponds to an average blood sugar of roughly 154 mg/dL. At 5.7%, your average runs around 117 mg/dL. At 6.5%, it’s approximately 140 mg/dL.
The relationship is roughly linear: each 1% increase in A1C adds about 28 to 30 mg/dL to your estimated average. So an A1C of 8% translates to an average around 183 mg/dL. These aren’t perfect conversions because the test reflects a weighted average over two to three months, with more recent weeks influencing the number more heavily. But they give you a practical way to understand what your A1C actually means day to day.
Targets for Adults With Diabetes
The American Diabetes Association sets the goal for most nonpregnant adults with diabetes at below 7%. That target balances meaningful protection against complications (nerve damage, kidney disease, eye problems) with a realistic risk of blood sugar dropping too low. The higher your A1C climbs above 7%, the greater your risk of developing those long-term complications.
That said, the ADA is explicit that there’s no one-size-fits-all number. Your doctor may set a more ambitious target, like below 6.5%, if you’re younger, newly diagnosed, and managing well without episodes of low blood sugar. Or the target may be loosened if tight control would do more harm than good.
Adjusted Goals for Older Adults
For older adults, the right A1C target depends less on age itself and more on functional status and life expectancy. Someone who is active and independent generally aims for the same below-7% target as younger adults. But as independence decreases or chronic conditions accumulate, the goal shifts upward because the risks of low blood sugar (falls, confusion, hospitalization) start to outweigh the long-term benefits of tight control.
Diabetes Canada’s clinical guidelines lay out a useful framework. For older adults who are functionally dependent, a target up to 8% is reasonable. For those who are frail or living with dementia, targets may be relaxed to 8.5%. For someone at the end of life, routine A1C testing isn’t recommended at all. The priority shifts entirely to avoiding symptoms: no dangerously high blood sugar, no dangerously low blood sugar.
The type of medication matters too. If someone takes a drug that carries a higher risk of causing low blood sugar, the target is set higher to build in a safety margin.
Targets During Pregnancy
Pregnancy calls for tighter A1C control than usual. Before conception, the goal is an A1C below 6.5% to reduce the risk of birth defects, preeclampsia, and other complications. During the second and third trimesters, an A1C below 6% is ideal because it’s associated with the lowest rates of oversized babies, preterm delivery, and preeclampsia.
If hitting below 6% would cause frequent episodes of low blood sugar, the target can be relaxed to below 7%. Pregnancy also affects the test itself: red blood cells turn over faster during pregnancy, which naturally pulls A1C readings lower. For that reason, A1C is treated as a secondary measure during pregnancy, with daily glucose monitoring taking the lead.
When A1C Results Can Be Misleading
The A1C test works by measuring how much glucose has attached to your red blood cells. Anything that changes those blood cells or how long they survive can throw the result off. Several conditions can produce a falsely high or falsely low reading:
- Severe anemia or iron deficiency
- Sickle cell disease or thalassemia (these alter the structure of hemoglobin itself)
- Kidney failure or liver disease
- Recent blood loss or blood transfusions
- Certain medications, including opioids and some HIV drugs
- Pregnancy, particularly early or late stages
If any of these apply to you, your doctor may rely on alternative tests, like fructosamine or a glucose tolerance test, to get an accurate picture of your blood sugar control.
How Often to Get Tested
If you don’t have diabetes and your results have been normal, your doctor will typically include an A1C check as part of routine screening, especially if you have risk factors like a family history of diabetes or a BMI above 25. For people with diabetes who are meeting their treatment goals on a stable plan, testing twice a year is standard. If your medication or treatment has recently changed, or your A1C isn’t at target, testing every three months gives a faster feedback loop to see whether adjustments are working.
Because the test reflects a two-to-three-month average, checking more frequently than every three months won’t give you meaningfully new information. The result needs time to reflect real changes in your blood sugar patterns.