If you're concerned about blood sugar, your doctor may order a hemoglobin A1C test. This test measures average blood sugar over the past three months. It is primarily used as a test for people with diabetes. If your A1C level is elevated, you can improve it by following the same type of diets that people with diabetes follow to help with blood sugar management. These diets include carbohydrate counting, the diabetes exchange diet and a plan called Create Your Plate.
Hemoglobin A1C 101
The A1C measures the attachment of glucose to hemoglobin, which is the protein in your red blood cells that carries oxygen throughout your body. It is measured as a percentage, and the higher the percentage, the higher your blood sugar. A normal A1C is 5.7 percent or less. An A1C between 5.7 percent and 6.4 percent is a sign of prediabetes, a risk factor for the development of type-2 diabetes, and indicates that your average blood glucose, or eAG, is about 126 milligrams per deciliter. An A1C of 6.5 or more usually means you have diabetes, and your blood sugars are averaging more than 126 milligrams per deciliter.
Carbohydrate-containing foods, including starches and grains, fruits, milk and yogurt, have the most impact on blood sugar. Controlling the level of carbs you eat at each meal helps keep blood sugar under control. Carbohydrate counting is a diet system aimed at helping you control carb intake. On the diet, you eat a specified number of grams or servings of carbs at each meal. Your doctor or dietitian can help you determine carb amounts, but it generally ranges from 45 to 60 grams, or three to four servings of carbs, at each meal. A 15-gram serving of carbohydrate is equal to one slice of bread, 1/3 cup of rice or pasta, a 4-ounce piece of fruit, 1 cup of milk or 1/2 cup of peas. For health and balance, each meal should include a source of protein, healthy fat and a nonstarchy vegetable -- for example fatty fish or chicken cooked in olive oil and mixed greens or steamed broccoli.
The Exchange Diet
The diabetes exchange list is another meal-planning tool that helps control blood sugar to lower A1C levels. The exchange system groups foods together based on similarities in nutritional content, including carb, protein, fat and calories. This way foods within each group can be exchanged to help with meal planning. Food groups include starches, fruits, milk, meat and meat alternatives, vegetables and fat. When meal planning, you can exchange 3/4 cup of unsweetened cold cereal with 1/2 cup of cooked oatmeal at breakfast. Your diet plan allows you to have a set number of exchanges from each food group each day. As with carb counting, food exchanges should be evenly distributed among meals and snacks for better blood sugar control.
Create Your Plate
For some people, counting carbs and exchanges can make meal planning too complicated, especially if you're newly diagnosed with diabetes. The American Diabetes Association suggests a simpler meal planning technique to aid in blood sugar control and help improve A1C levels called Create Your Plate. This diet uses your dinner plate to help control carbs and calories. First, divide your plate in half, then divide one of the halves in half again to create three sections. Fill the largest section with nonstarchy vegetables, such as broccoli or green beans, one of the smaller sections with a healthy starch such as sweet potatoes or brown rice and the other smaller section with a lean protein such as salmon or tofu. Round out your meal with a small serving of fruit or a serving of milk or unsweetened yogurt.
- National Institute of Diabetes and Digestive and Kidney Disorders: The A1C Test and Diabetes
- American Diabetes Association: Carbohydrate Counting
- University of Arkansas Division of Agriculture: The Exchange List System for Diabetic Meal Planning
- American Diabetes Association: Create Your Plate
- Kids Health: Carbs and Blood Sugars