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Ways to Lower Hemoglobin A1c (HbA1c)

Written by Biljana Novkovic, PhD | Last updated:
Puya Yazdi
Medically reviewed by
Puya Yazdi, MD | Written by Biljana Novkovic, PhD | Last updated:

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Hemoglobin blood test
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Blood sugar changes measured by HbA1C levels are directly associated with inflammation in the body. Inflammation is the main player in the diseases we all want to avoid- heart disease, dementia, diabetes and many more. In this post, you will learn about lifestyle, diet, and supplement strategies that can improve your levels.

However, remember that the most important thing is to work with your doctor to find out what’s causing your high HbA1c levels and to treat any underlying conditions.

Discuss the strategies listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!

Lifestyle to Lower Hemoglobin A1c (HbA1C)

1) Lose Weight

One of the best things you can do to decrease your blood glucose and HbA1c it to lose weight if you are overweight [1, 2].

This will enable your cells and tissues to use and respond to glucose more efficiently [3, 4]!

2) Exercise

There are a plethora of studies showing exercise helps lower HbA1c in both healthy people and those who have diabetes. Studies, in general, suggest that engaging in moderate to vigorous exercise for at least 30 minutes on more than 3 days per week is most beneficial [5, 6, 7].

Aerobic exercise, resistance training, and both combined were each associated with declines in HbA1c levels in several studies with type 2 diabetics [8, 9, 10].

One study of 2.7k people found that physical activity was more beneficial in shorter bouts of ≥10min with higher intensity [11].

A systematic review of 47 trials with over 8.5 diabetics showed that exercising for more than 150 minutes per week reduced HbA1c more than 2 times as efficiently compared to 150 minutes or less of exercise per week [9].

3) Quit Smoking

Studies show that smoking increases HbA1c levels [12, 13].

In a meta-analysis of over 35 men and women without diabetes, HbA1c was 0.1% higher in current smokers and 0.03% higher in ex-smokers, compared with those who never smoked [12].

Smoking is also associated with unsatisfactory blood sugar levels in diabetics. Both type 1 and type 2 diabetes patients who smoked had higher HbA1c values than non-smokers [14].

Among 2.3k women with gestational diabetes, HbA1c was higher than expected in women who smoked at the beginning of the pregnancy [13].

4) Get More Sleep

Sleep duration and the number of sleep segments are associated with HbA1c in type 2 diabetes patients. A one-hour longer sleep duration was associated with a 0.174% (1.4 mmol/mol) decrease in HbA1c in a study of 118 diabetics. Moreover, those who napped had lower HbA1c [15].

In 210 type 2 diabetics, later bedtime on weekends was significantly associated with poorer glycemic control [16].

In another study, in 2.5k type 2 diabetics, sleep compensation during weekends (sleep duration of about 1h more during weekends compared to weekdays) had a beneficial effect on HbA1c [17].

A meta-analysis of 22 studies has found that adults with type 1 diabetes who reported sleeping >6 hours had lower HbA1c levels than those sleeping ≤6 hours. Similarly, those reporting good sleep quality had lower HbA1c than those with poor sleep quality [18].

Another meta-analysis of 15 studies showed that both short (<5h) and long (>9h) sleep durations were associated with an increased HbA1c in type 2 diabetes patients. So was poor sleep quality [19].

In 80 people with type 1 diabetes, social jetlag, a small but recurrent circadian misalignment between biological and social time, was associated with higher HbA1c [20].

5) De-Stress

Stress impacts many aspects of your body, including your blood sugar and HbA1c. Studies suggest we shouldn’t neglect our emotional health and should instead find healthy ways to avoid or cope with stress [21, 22, 23, 24, 25, 26, 27].

Mood difficulties are common among patients with diabetes and have been linked to poor blood glucose control and increased diabetes complications [25, 26]. In one study of 100 diabetics, lower HbA1c levels were significantly associated with less affect intensity and with higher emotional intelligence [24].

Studies indicate there is an association between behavior problems (internalizing, externalizing) and HbA1c levels in youth with type 1 diabetes. Increased problematic behaviors in youth with type 1 diabetes have been associated with elevated HbA1c and mediated by low self-confidence and diabetes mismanagement [27].

A study of 312 type 2 diabetics has shown that lower life satisfaction was associated with higher HbA1c [23].

In a study of 938 non-diabetic people, weight discrimination has been associated with higher HbA1c in obese people, in addition to the effects of obesity on HbA1c itself. The study suggests that psychological and social factors can increase vulnerability to diabetes in nondiabetic obese people [22].

Higher socioeconomic status or high levels of parental education were found to be associated with lower HbA1c in children and adolescents with type 1 diabetes [28].

Caucasian, higher socioeconomic status, two-parent household, more frequent self-monitoring of blood glucose and low insulin requirements were associated with lower HbA1c concentration one year after the onset of type 1 diabetes in children [29]. These factors probably translate into HbA1c levels through increased diet quality, less stress, and more exercise.

Evidence is in favor of mind-body wellness techniques for emotional regulation and mindfulness-based cognitive therapy. Mindful self-compassion training significantly reduced depression, diabetes distress, and HbA1c in a randomized controlled trial [25].

6) Oral Hygiene

Improve your oral hygiene. It may come as a surprise, but studies suggest that proper and regular tooth brushing may help decrease your blood glucose and HbA1c levels. Also, address any existing periodontal (gum) issues such as inflammation, as these can increase HbA1c [30, 31, 32, 33, 34, 35].

7) Avoid Air Pollution

Long (1-year) and intermediate (3 months) term exposure to higher levels of air pollution was associated with increases in HbA1c [36, 37, 38, 39].

Air pollution was associated with higher HbA1c levels in 9.1k newly diagnosed type 2 diabetes patients [40].

Air pollution may result in increased low-level chronic inflammation in the body that, in turn, can have an adverse effect on blood sugar control.

8) Get More Sun

Getting more sun increases Vitamin D levels.

An association was found between higher HbA1c levels and lower Vitamin D in 160 pregnant women [41].

Vitamin D administration decreased HbA1c levels in a study of 65 children and adolescents with type 1 diabetes [42].

Enhanced vitamin D supplementation also improved HbA1c in a study of type 2 diabetes overweight and obese patients [43].

However, other studies in healthy subjects found no correlation between vitamin D and HbA1c [44, 45].

Dietary Changes that May Lower Hemoglobin A1c (HbA1C)

1) Avoid Sugar and Processed Carbs

Avoid sugary foods and processed carbs [46, 47]. They cause spikes in blood sugar levels.

A loose restriction of carbohydrate intake in a study of 133 type 2 diabetes patients improved HbA1c levels significantly during the 2-year follow-up period [48].

A low carbohydrate diet reduced HbA1c and BMI in a study of 66 Japanese patients with poorly controlled type 2 diabetes [49].

When an energy-restricted, protein-rich meal was used to replace certain meals in15 obese type 2 diabetes patients, over a period of 12 weeks, HbA1c decreased from 8.8% to 8.1%. Participants who continued with the practice further reduced their HbA1c [50].

2) Increase Fruits, Vegetables, and Fiber

Increase your fiber intake. Fruits and vegetables are generally rich in fiber, and studies show they can help keep your blood sugar levels under control. Beans, chickpeas, broccoli, berries, pears, avocado, and nuts are all great fiber sources [51, 52, 53, 54].

Higher total fiber intake was associated with lower HbA1c in a study of over 2k people with type 1 diabetes [53].

Similarly, HbA1c levels were lower in both people with and without type 2 diabetes when they consumed more fiber. Increasing fiber intake may be an effective approach to improve blood sugar levels in type 2 diabetic patients [51, 52].

Oats are a great source of fiber and can help decrease HbA1c and fasting glucose. The intake of oats and beta-glucan extracted from oats tends to lower HbA1c. Higher consumption of whole oats and oat bran, but not oat or barley beta-glucan extracts, were associated with lower HbA1c, fasting glucose and fasting insulin, in a meta-analysis of 18 studies [55].

A study showed in over 3k people showed that in nondiabetics, for every extra 80 g vegetable portion consumed, HbA1c reduced by 0.01% [46].

3) Mediterranean Diet

A Mediterranean diet includes many healthy components, such as fruits, vegetables, nuts, legumes, whole grains, and fish. There is lots of research showing that this type of diet has beneficial effects on diabetes and lowers HbA1c [56, 57, 58, 59, 60].

The essential nutrients and health-promoting properties of the diet, including high fibers, high magnesium, high antioxidant flavonoids, and high monounsaturated fatty acids (MUFA) are all powerful ways to decrease inflammation in the body [57].

In a meta-analysis of 9 studies with 1178 diabetics, a Mediterranean diet improved blood sugar control, body weight, and heart disease risk factors.

In a study of 27 diabetics, compared with the usual diet, a traditional Cretan Mediterranean diet lowered HbA1c from 7.1% to 6.8% [58].

In a study with over 200 overweight middle-aged men and women with newly diagnosed type 2 diabetes, a low-carbohydrate Mediterranean diet resulted in a greater reduction of HbA1c levels, a higher rate of diabetes remission, and delayed need for diabetes medication compared with a low-fat diet [59].

A meta-analysis of 8 studies found that the Mediterranean diet reduced HbA1c significantly compared to the usual diet, but so did the Paleo diet [60].

4) Paleo Diet

Several initial studies suggest that a paleo diet, consisting of lean meat, fruits, vegetables, and nuts, can also help improve blood sugar and HbA1c levels [61, 62, 60].

5) Drink More Water

A study showed that 1 cup of plain water per day was associated with a -0.04% lower HbA1c in men. Men had a 22% reduced odds of having HbA1c≥5.5% for each cup per day of plain water. There was no such association in women, however [63].

6) Moderate Alcohol Consumption

Studies suggest that moderate alcohol consumption (1 serving per day) can reduce HbA1c in both non-diabetics and diabetics [64, 65].

In Japanese women, HbA1c levels were lower in occasional, regular light and regular heavy drinkers than in nondrinkers. HbA1c was further significantly lower in regular light and heavy drinkers than in occasional drinkers [66].

Higher alcohol consumption was associated with lower HbA1c in diabetes patients [65].

Higher alcohol intake was associated with lower HbA1c levels in Korean adults [67].

However, it’s very important to remember that alcohol consumption is associated with other health issues and diseases so always talk with your physician about the optimal amount of alcohol you should be taking.

7) Probiotic Yogurt

Multistrain probiotics and probiotic yogurt decrease HbA1c in several studies of people with type 2 diabetes [68, 69, 70, 71].

A probiotic strain, L. fermentum reduced HbA1c in a study of 45 volunteers with borderline-high values [72].

Some studies, however, failed to find improvement associated with probiotics [73, 74].

8) Dark Chocolate

Among type 1 diabetes patients, those who consumed dark chocolate (25 g/day 2 – 5 times/week) showed a significantly lower HbA1c than both patients who consumed the same amount of milk chocolate or neither dark nor milk chocolate [75].

In another study of 7.8k people, those who ate up to 2 – 6 servings (28.5 g) of dark chocolate per week had a 34% lower risk of being diagnosed with diabetes [76].

Supplements that May Lower Hemoglobin A1c (HbA1C)

Talk to your doctor about the following foods and supplements. Initial studies suggest they may help decrease blood sugar levels and HbA1c:

See also:

HbA1c Part 1: All About HbA1c and 33 Reasons to Maintain Healthy HbA1c Levels

About the Author

Biljana Novkovic

Biljana Novkovic

PhD
Biljana received her PhD from Hokkaido University.
Before joining SelfHacked, she was a research scientist with extensive field and laboratory experience. She spent 4 years reviewing the scientific literature on supplements, lab tests and other areas of health sciences. She is passionate about releasing the most accurate science and health information available on topics, and she's meticulous when writing and reviewing articles to make sure the science is sound. She believes that SelfHacked has the best science that is also layperson-friendly on the web.

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