What happens when A1C is too high?

A1C is a blood test that determines the body’s average blood sugar level over the past two to three months. A1C is also known as hemoglobin A1C, HbA1c, glycated hemoglobin, or glycated hemoglobin test. In the body, a protein called hemoglobin transports oxygen and nutrients throughout the body. It can absorb glucose along the way, which binds to hemoglobin and becomes glycated hemoglobin. The higher the glucose level in the blood, the more glucose is attached to the hemoglobin. The A1C test measures the amount of hemoglobin with glucose attached.

The test is often used to diagnose prediabetes and diabetes, as well as to monitor treatment plans for people with diabetes. Experts have identified healthy, prediabetic, and type 2 diabetes ranges for A1C, and knowing your A1C levels can help you adjust your treatment and lifestyle.

A1C scope and what it means

The A1C result is expressed as a percentage, which reflects the percentage of glucose and hemoglobin bound together. For example, the A1C level of 5 out of 100 HbA1c would be 5%.

The A1C ranges for normal, prediabetic, and diabetic are as follows:

  • Normal: less than 5.7%
  • Prediabetes: 5.7% to 6.4%
  • Diabetes: 6.5% or higher

The higher your A1C, the higher your blood sugar level. If your A1C falls within the prediabetes range, you should consult with your healthcare provider to determine the best way to prevent type 2 diabetes, as prediabetes is a known risk factor for type 2 diabetes. In general, in the pre-diabetic range, the higher the A1C, the greater the risk of developing diabetes.

The A1C test should not be used to diagnose type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes.

What happens when A1C is too high

High A1C levels should not be ignored. Studies have shown a direct correlation between high A1C and severe diabetes complications. An A1C level above 7% means someone is at increased risk of developing diabetes complications, which should prompt people to ensure they have a plan in place to manage their blood sugar levels and reduce this risk. If these strategies are in place, an increase in A1C may indicate that they need to be adjusted.

Several factors can erroneously increase or decrease your A1C results, including:

  • Kidney failure, liver disease, or severe anemia
  • African, Mediterranean or Southeast Asian ancestry
  • certain blood disorders (such as sickle cell anemia or thalassemia)
  • certain medicines, including opioids and some HIV medicines
  • blood loss or transfusion
  • early or late pregnancy

Without better management, high blood sugar can lead to serious complications such as heart disease, stroke, vision loss, nerve damage, kidney disease, and gum disease. Short-term problems to watch out for include hypoglycemia and hyperglycemia.

Key elements for managing and preventing diabetes complications

heart attack and stroke

People with diabetes have high blood sugar, which over time can damage the blood vessels and nerves that control the heart, leading to heart disease. It has been found that people with diabetes tend to develop heart disease at a younger age than people without diabetes. Also, the longer you have diabetes, the greater your chances of developing heart disease.

The most common type of heart disease is coronary artery disease, which is caused by the buildup of plaque on the walls of the coronary arteries, the blood vessels that supply the heart with oxygen and blood. Plaque consists of cholesterol deposits that narrow the inside of arteries and reduce blood flow. This process is called atherosclerosis or arteriosclerosis. Reduced blood flow to the heart can lead to a heart attack.

Reduced blood flow to the brain can also lead to a stroke. People with diabetes have a particularly high risk of stroke and a higher mortality rate.

People with diabetes are also more likely to have other conditions that increase the risk of heart disease, including:

  • High blood pressure: This increases the force of blood through the arteries and can damage the walls of the arteries.
  • Too much low-density lipoprotein (LDL) cholesterol: Also known as bad cholesterol, this can cause plaque to form on the walls of damaged arteries.
  • High triglycerides: This combined with low HDL cholesterol or high LDL cholesterol is thought to contribute to arteriosclerosis.

People with diabetes are also more likely to develop heart failure, which is when your heart doesn’t pump blood well.

What causes plaque in your arteries?


Diabetes can also cause damage to your eyes, which can lead to vision loss and vision loss. Eye problems that can affect people with diabetes are called diabetic eye disease and include diabetic retinopathy, diabetic macular edema (fluid retention in the retina), cataracts, and glaucoma. However, people with diabetes can take steps to prevent diabetic eye disease by taking care of their diabetes.

If your blood sugar stays high over time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin in prediabetes. Damaged blood vessels may leak fluid and cause swelling. New, fragile blood vessels may also begin to grow. These blood vessels can seep into the middle of the eye, cause scarring, or cause dangerously high pressure inside your eye.

Diabetic retinopathy is the most common cause of vision loss in people with diabetes. Early detection and treatment of diabetic retinopathy can reduce the risk of blindness by 95%.

When damage to your eye first appears, there are usually no warning signs. A comprehensive dilated eye exam can help your healthcare provider detect and treat eye problems early—before severe vision loss.

Adults with type 1 diabetes should have a dilated eye exam within five years of diagnosis and annually thereafter. For adults with type 2 diabetes, they should have an eye exam immediately after diagnosis and annual dilated eye exams thereafter. However, after one or more normal eye exams, every one to two years may be considered.

Common causes of vision loss

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nerve damage

Nerve damage caused by diabetes is called diabetic neuropathy. High blood sugar can damage your nerves, which may stop sending messages to different parts of your body. Nerve damage can cause problems ranging from mild numbness to pain. Half of people with diabetes have nerve damage.

There are several types of neuropathy:

  • Peripheral nerve damage: This type of injury affects your hands, feet, legs, and arms, and it is the most common type of nerve damage in people with diabetes. It usually starts in the feet – usually in both feet at the same time.
  • Autonomic nerve damage: This can affect your heart, bladder, stomach, intestines, sex organs or eyes.
  • Proximal nerve damage: This affects the nerves in the thigh, buttocks, buttocks, or legs. It can also affect the stomach and chest area.
  • Focal nerve damage: This affects a single nerve, most commonly in your hands, head, trunk, or legs.

People with diabetes should look for symptoms of nerve damage by identifying new symptoms related to pain, numbness or incontinence or new problems with bowel control. As with other complications, getting your blood sugar as close to your target range as possible is the best way to help prevent or delay nerve damage.

kidney disease

People with diabetes can also develop diabetic nephropathy. About one-third of adults with diabetes have kidney disease. High blood sugar can damage the blood vessels in the kidneys. They also don’t work properly when this happens. Many people with diabetes also develop high blood pressure, which can also damage the kidneys.

Watch out for these nutrients if you have diabetes-related kidney disease

gum disease

Diabetes doesn’t just cause high blood sugar levels. People with diabetes also have sugar in their saliva, which comes into contact with the mouth. As a result, their teeth and gums are exposed to more sugar, which contributes to the growth of bacteria and plaque that can irritate the gums and lead to gum disease.

In addition to gum disease, your jaw and tongue, as well as other oral tissues, can also be affected. The most common gum disease and other oral problems in people with diabetes include:

  • Gingivitis (unhealthy or inflamed gums)
  • periodontitis
  • Thrush (oral yeast infection)
  • xerostomia (dry mouth)
  • Oral burns

Some of the first signs of gum disease are swollen, tender, or bleeding gums. Sometimes you may not have any signs of gum disease. You may not know you have it until it is seriously damaged. Your best defense is to see your dentist twice a year for cleanings and checkups.

Encourage healthy dental hygiene with brushing diagram

Lower A1C

While diabetes complications are serious, there are ways to control blood sugar to lower A1C levels and prevent them. With the help of a medical professional, a treatment plan that includes medications and lifestyle changes will help lower your levels and avoid complications.

Healthy Eating and Meal Tracking

Your diet has a big impact on how your body produces and uses blood sugar. To maintain healthy blood sugar levels and therefore lower A1C, healthy eating and meal tracking can help. Meal tracking helps you plan healthy choices ahead and review factors that can lead to elevated blood sugar.

Some healthy snacks that lower A1C include:

  • berry
  • nut
  • Egg
  • yogurt
  • Apple

Reduce A1C with smart breakfast choices

Stress reduction techniques

Managing stress in general is critical to staying healthy and can especially help people with diabetes.

Studies have shown that acute stress increases glucose production and interferes with glucose utilization. This means that better control of stress can have a positive effect on blood sugar levels.

Some stress relief techniques include:

  • yoga
  • Journal
  • meditation
  • talk therapy

stay active

Exercise can help people with diabetes in a variety of ways, including weight loss and stress relief, but it also directly affects blood sugar levels. When you exercise, your muscles need and use sugar, which lowers the levels in your blood. Research shows that long-term regular physical activity has a positive effect on blood sugar control and body composition in people with type 2 diabetes. It also promoted cardiovascular health in these patients.

The more exercise, the greater the reduction in A1C. Most people with diabetes should get at least 150 minutes of moderate-intensity exercise per week.

Medication and Periodic Monitoring

A1C is an important tool for managing diabetes, but it cannot replace routine blood glucose testing at home. Blood sugar goes up and down during the day and night, which is not captured by your A1C. Two people may have the same A1C, one with steady blood sugar levels and the other with fluctuating blood sugar levels.

If you reach your A1C goal but have symptoms of high or low, check your blood sugar more frequently at different times of the day. Track and share results with your healthcare provider so you can make changes to your treatment plan and medications if needed.

10 Steps to Using a Blood Glucose Meter

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The A1C blood test is just one of many tools for checking and monitoring blood sugar. A1C is your average blood sugar level over a 90-day period, so if your blood sugar isn’t controlled, your healthcare provider may recommend checking your blood sugar levels between A1C tests. Regularly tracking your blood sugar can help you identify factors that affect your blood sugar levels and adjust your management plan. Managing diabetes is the best way to combat the various complications this condition can cause. Discuss problems and new symptoms with your healthcare provider to make sure your treatment plan meets your needs.