Table of ContentsView AllTable of ContentsHow A1C Measures Blood SugarA1C RangesA1C Levels in People with DiabetesHigh A1C LevelsSymptomsComplicationsHow to Lower A1C LevelsPreparing for an A1C

Table of ContentsView All

View All

Table of Contents

How A1C Measures Blood Sugar

A1C Ranges

A1C Levels in People with Diabetes

High A1C Levels

Symptoms

Complications

How to Lower A1C Levels

Preparing for an A1C

When your A1C is too high, you are at greater risk of diabetes complications such as kidney disease, cardiovascular conditions, and nerve damage.

In those without diabetes, A1C levels should stay below 5.7%. Dangerous levels of A1C are 9.05% and higher. An A1C above 9% increases the risk of long-term diabetes complications like blindness, nerve damage, and kidney failure.Under 7% is considered good diabetes control.

Verywell / Ellen Lindner

The A1C Blood Test - Illustration by Ellen Lindner

An A1C test is also known asglycated hemoglobin,glycohemoglobin, or HbA1c. It measures the amount of glucose in your blood. More specifically, it checkshemoglobin, an iron-rich protein that transports oxygen and nutrients throughout the body.

Glucose (a sugar the body uses for energy) binds to hemoglobin, creating glycated hemoglobin compounds. The higher your blood glucose level, the more glucose attaches to the hemoglobin. Hemoglobin cells last about 90 days, so the A1C provides an overall picture of your blood sugar control for the previous three months.

For people without diabetes, A1C tests are recommended every three years in adults over the age of 45 and anyone with a high risk of diabetes. Risk factors include a family history of diabetes, a BMI above 25, high blood pressure, a history of heart disease, and a lack of physical activity.

For people with diabetes, regular A1C monitoring can catch aspike in blood sugar levelsearly. An increase should prompt your healthcare provider to reevaluate your treatment plan. This may include reviewing your medications, diet, and how often you test your blood sugar.

What Is a High A1C?

A1C results show the percent of glucose and hemoglobin bound together in your bloodstream. For example, a 5% A1C indicates five out of every 100 hemoglobins are glycated. The higher your A1C, the greater the risk of developing complications. A dangerously high A1C is considered 9.05% or higher.

The A1C ranges for normal,prediabetes, anddiabetesare as follows:

Talk to your healthcare provider if your A1C is in the prediabetic range. Prediabetes is a risk factor for type 2 diabetes.A diet change, increased activity, and moderate weight loss may help improve blood sugar control to prevent diabetes.

For people with diabetes, an A1C under 7% is typically considered good control. Research shows an A1C above 9% significantly increases the risk ofdiabetic complications.For adults with diabetes, the target A1C range is typically between 7% and 8%. This depends on your age and other health factors.

A1C levels correspond to the following average blood sugar levels:

What Is a Dangerously High A1C Level?

If your A1C is above your target range, talk to your healthcare provider about steps you can take to lower your blood sugar.

How Do You Feel When Your A1C Is Too High?

A high A1C means your blood sugar has been elevated for several months. So, symptoms of a high A1C are similar to those of high blood sugar. Symptoms can include:

Hyperglycemiacan become a medical emergency. When blood sugar levels become too high, you can develop a complication called diabetic ketoacidosis (DKA). This happens when your body runs out of insulin, which is used to help sugar move into your cells for energy.

Symptoms of DKA include:

If you have a test to show your ketone levels at home, seek care if it shows that your ketones are moderate to high. If you do not have a test to check ketones at home and are experiencingsymptoms of DKA, seek medical care.

Complications of High A1C Levels

Studies show high A1C levels increase the risk of severe diabetes complications.Blood vessel damage can start at A1C levels above 7%. The risk of complications significantly increases at A1Cs above 9%. When your A1C is too high, you are at a greater risk of:

Heart Disease and Stroke

People with diabetes are at an increased risk ofheart disease. Chronic high blood sugar levels can damage nerves and blood vessels that control the heart.

Diabetics also tend to develop heart disease younger than those without diabetes.The longer you have diabetes, the more likely it is you also have heart disease.

Plaque—cholesterol, fat, and cellular waste—builds up in a process known asatherosclerosis. This decreases blood flow to the heart, which can cause aheart attack.

Decreased blood flow to the brain can also cause astroke. Diabetes is linked to an increased risk of stroke and higher rates of mortality from stroke.

Diabetes also increases your risk of other heart disease risk factors. These include:

In addition, diabetes increases the risk ofheart failure, which means your heart can’t pump blood very well.

Blindness

High blood sugar can cause eye damage, leading to poor vision andvision loss.Common eye diseases in diabetes include:

Damaged blood vessels may leak fluid and cause swelling. New blood vessels that form may be weak. These blood vessels can bleed into the middle part of the eye, cause scarring, or dangerously increase pressure inside your eye.

Diabetic eye changes are often without symptoms at first. Eye damage can begin during the prediabetes stage and typically progresses slowly.

A full, dilatedeye examhelps find and treat eye problems early—before too much vision loss occurs.

Adults with type 1 diabetesshould get a dilated eye exam within five years of diagnosis and every year after that.

Adults with type 2 diabetesshould get an eye exam soon after diagnosis and a dilated eye exam every year. If you maintain good glucose control, you may only need a diabetic eye exam every other year.

Warning: Rapid A1C Drop May Worsen EyesResearch shows lowering your A1C too rapidly can also cause vision problems. Known as a paradoxical response, some people experience a worsening of diabetic retinopathy after quickly lowering a high A1C.

Warning: Rapid A1C Drop May Worsen Eyes

Research shows lowering your A1C too rapidly can also cause vision problems. Known as a paradoxical response, some people experience a worsening of diabetic retinopathy after quickly lowering a high A1C.

Nerve Damage

Nerve damage can cause problems ranging from mild numbness to severe pain. Half of all people with diabetes have nerve damage.

Common types of neuropathy in people with diabetes include:

Symptoms of nerve damage include:

Maintaining a lower A1C is the best way to prevent or delay diabetic nerve damage.

Kidney Disease

High A1C levels increase the risk ofdiabetic kidney disease. One in three adults with diabetes has diabeticnephropathy(kidney disease).

Like with the eyes, heart, and nerves, high blood glucose damages blood vessels in the kidneys. When that happens, the kidneys are less able to filter out waste products and extra fluid.

Diabetic nephropathy typically does not have any early symptoms. As the condition worsens, it can cause:

Many people with diabetes also develop high blood pressure, which can also damage the kidneys.

Gum Disease

High blood glucose also increases the sugar content in your saliva. This exposes the mouth, teeth, and gums to more sugar, germs, and plaque. This can irritate gums, causinggum disease.

In addition to gum disease, your jaw, tongue, and other mouth tissue can be affected. The most common gum disease and other mouth problems that people with diabetes have include:

Some of the first signs of gum disease are swollen, tender, or bleeding gums. You may not have any overt signs of gum disease until serious damage has occurred. The best defense is to brush your teeth twice a day and visit your dentist twice a year.

How to Lower High A1C Levels

Managing blood sugar to keep your A1C in your target range can prevent diabetic complications. If your A1C is high, develop a plan with your healthcare team. Strategies tolower your blood sugarprimarily include:

There is no way to lower your A1C quickly. Remember that the A1C measures your blood sugar over time, generally over the last three months. So, lowering it is a gradual process and can take several months.

At-Home Blood Sugar Monitoring

A1C is an important tool for managing diabetes but doesn’t replace at-home blood sugar monitoring. Research shows a direct link between more frequent blood sugar testing and a lower A1C.

At-home monitoring can be done with either aglucometeror a continuous glucose monitoring system (CGMS).

Talk to your healthcare provider about how often you should test your blood sugar. In addition, keeping a blood sugar log can provide valuable information to you and your health team. This can help determine what (if any) changes to make to your treatment plan.

Healthy Eating and Meal Tracking

Diet has a huge impact on blood sugar. Carbohydrates like bread, rice, potatoes, and sweets raise blood sugar. During digestion, the body breaks carbohydrates down into glucose.

One way to find out how certain foods affect your blood sugar is to test two hours after eating. Keeping a food journal along with blood sugar logs helps identify high blood sugar patterns. This can help you learn to manage your glucose levels better and lower your A1C.

Talk to your healthcare team if you are unsure what you should eat to manage your blood sugar. A dietitian or certified diabetes educator can help you learn how tobalance mealsfor lower blood sugar.

Stress Relief Techniques

Managing stress is crucial to staying healthy in general and can particularly help people with diabetes.

Some stress relief techniques include:

Exercise

When you exercise, your muscles use glucose for energy, lowering glucose levels in the blood. Studies show that long-term regular physical activity has a positive impact on A1C levels. Exercise also helps spur weight loss, reduce stress, and improve cardiovascular health.

The more exercise, the greater the A1C reduction. Most people with diabetes should aim for at least 150 minutes of moderate-intensity exercise weekly.

Look Out For LowsPeople who take insulin or other medications that lower blood sugar should monitor their blood sugar more closely during and after exercise to prevent hypoglycemia.

Look Out For Lows

People who take insulin or other medications that lower blood sugar should monitor their blood sugar more closely during and after exercise to prevent hypoglycemia.

Medication

If your A1C is high, your provider may prescribe new medications or adjust current medication dosing if lifestyle changes don’t work.

Type 1 diabetes requiresinsulin. Your endocrinologist may make adjustments to your basal and bolus rates. Bring up-to-date glucose logs and food journals to your appointment. This data can help your doctor or diabetes nurse determine the correct insulin-to-carb ratio and basal rates. If that doesn’t bring your A1C down, other medications can be added to help improve control.

Prescription medication for type 2 diabetes works in a few different ways. Some help your body make more insulin, and others help your body use the insulin it makes. Some people with type 2 diabetes use insulin to manage their blood sugar.

Remember to take your medication as prescribed and check with your healthcare team for any questions.

It is normal to feel nervous about a blood test, such as the A1C. Here are some considerations before your next appointment.

Fasting:You do not need to fast for an A1C test. However, you may need to fast for other tests ordered along with an A1C, such as fasting glucose and cholesterol tests. So check with your healthcare provider beforehand if you need to fast before any labwork.

Several factors can falsely increase or decrease your A1C result, including:

If you believe you might be pregnant, started a new medication, or had a change in your health history, be sure to let your healthcare provider know.

Summary

The A1C test measures the average blood glucose level over three months. It is used to diagnose and monitor diabetes treatment.

A high A1C level increases your risk of diabetic complications. Over time, high blood sugars cause cardiac disease, diabetic retinopathy, kidney failure, neuropathy, and gum disease.

For people with diabetes, getting regular bloodwork can catch a high A1C early. At-home blood glucose monitoring, a low-carbohydrate diet, and exercise can help lower your A1C. If lifestyle changes do not help, your doctor may prescribe medications or change your doses. Talk to your healthcare team about any issues or questions you have.

25 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.American Diabetes Association Professional Practice Committee.2. Diagnosis and classification of diabetes:Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S20-S42. doi:10.2337/dc24-S002Li Q, Yang LZ.Hemoglobin a1c level higher than 9. 05% causes a significant impairment of erythrocyte deformability in diabetes mellitus.Acta Endocrinol (Buchar). 2018;14(1):66-75.National Institute of Diabetes and Digestive and Kidney Disease.The A1C test & diabetes.Nathan DM; DCCT/EDIC Research Group.The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview.Diabetes Care. 2014;37(1):9-16. doi:10.2337/dc13-2112Centers for Disease Control and Prevention.Testing for diabetes and prediabetes: A1C.MedlinePlus.Hyperglycemia.Huang ES, Liu JY, Moffet HH, John PM, Karter AJ.Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study.Diabetes Care. 2011;34(6):1329-36. doi:10.2337/dc10-2377National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, heart disease, and stroke.Centers for Disease Control and Prevention.Your heart and diabetes.Tun NN, Arunagirinathan G, Munshi SK, Pappachan JM.Diabetes mellitus and stroke: A clinical update.World J Diabetes. 2017;8(6):235-248. doi:10.4239/wjd.v8.i6.235National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.American Diabetes Association Professional Practice Committee.12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S231-S243. doi:10.2337/dc24-S012Bain SC, Klufas MA, Ho A, Matthews DR.Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review.Diabetes Obes Metab. 2019;21(3):454–66. doi:10.1111/dom.13538Centers for Disease Control and Prevention.Diabetes: Nerve damage.National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.American Diabetes Association Professional Practice Committee.11. Chronic kidney disease and risk management: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S219-S230. doi:10.2337/dc24-S011National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, gum disease, & other dental problems.National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.Helgeson VS, Honcharuk E, Becker D, Escobar O, Siminerio L.A focus on blood glucose monitoring: relation to glycemic control and determinants of frequency.Pediatr Diabetes. 2011;12(1):25-30. doi:10.1111/j.1399-5448.2010.00663.xWright EE Jr, Kerr MSD, Reyes IJ, Nabutovsky Y, Miller E.Use of Flash Continuous Glucose Monitoring is associated with A1C reduction in people with type 2 diabetes treated with basal insulin or noninsulin therapy.Diabetes Spectr. 2021;34(2):184-189. doi:10.2337/ds20-0069Hilliard ME, Yi-Frazier JP, Hessler D, Butler AM, Anderson BJ, Jaser S.Stress and A1c among people with diabetes across the lifespan.Curr Diab Rep. 2016;16(8):67. doi:10.1007/s11892-016-0761-3American Diabetes Association.Blood sugar and exercise.American Diabetes Association Professional Practice Committee.5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes-2024[published correction appears in Diabetes Care. 2024 Apr 1;47(4):761-762].Diabetes Care. 2024;47(Suppl 1):S77-S110. doi:10.2337/dc24-S005Penttilä I, Penttilä K, Holm P, et al.Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus.World J Methodol. 2016;6(2):133–42. doi:10.5662/wjm.v6.i2.133

25 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.American Diabetes Association Professional Practice Committee.2. Diagnosis and classification of diabetes:Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S20-S42. doi:10.2337/dc24-S002Li Q, Yang LZ.Hemoglobin a1c level higher than 9. 05% causes a significant impairment of erythrocyte deformability in diabetes mellitus.Acta Endocrinol (Buchar). 2018;14(1):66-75.National Institute of Diabetes and Digestive and Kidney Disease.The A1C test & diabetes.Nathan DM; DCCT/EDIC Research Group.The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview.Diabetes Care. 2014;37(1):9-16. doi:10.2337/dc13-2112Centers for Disease Control and Prevention.Testing for diabetes and prediabetes: A1C.MedlinePlus.Hyperglycemia.Huang ES, Liu JY, Moffet HH, John PM, Karter AJ.Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study.Diabetes Care. 2011;34(6):1329-36. doi:10.2337/dc10-2377National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, heart disease, and stroke.Centers for Disease Control and Prevention.Your heart and diabetes.Tun NN, Arunagirinathan G, Munshi SK, Pappachan JM.Diabetes mellitus and stroke: A clinical update.World J Diabetes. 2017;8(6):235-248. doi:10.4239/wjd.v8.i6.235National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.American Diabetes Association Professional Practice Committee.12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S231-S243. doi:10.2337/dc24-S012Bain SC, Klufas MA, Ho A, Matthews DR.Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review.Diabetes Obes Metab. 2019;21(3):454–66. doi:10.1111/dom.13538Centers for Disease Control and Prevention.Diabetes: Nerve damage.National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.American Diabetes Association Professional Practice Committee.11. Chronic kidney disease and risk management: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S219-S230. doi:10.2337/dc24-S011National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, gum disease, & other dental problems.National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.Helgeson VS, Honcharuk E, Becker D, Escobar O, Siminerio L.A focus on blood glucose monitoring: relation to glycemic control and determinants of frequency.Pediatr Diabetes. 2011;12(1):25-30. doi:10.1111/j.1399-5448.2010.00663.xWright EE Jr, Kerr MSD, Reyes IJ, Nabutovsky Y, Miller E.Use of Flash Continuous Glucose Monitoring is associated with A1C reduction in people with type 2 diabetes treated with basal insulin or noninsulin therapy.Diabetes Spectr. 2021;34(2):184-189. doi:10.2337/ds20-0069Hilliard ME, Yi-Frazier JP, Hessler D, Butler AM, Anderson BJ, Jaser S.Stress and A1c among people with diabetes across the lifespan.Curr Diab Rep. 2016;16(8):67. doi:10.1007/s11892-016-0761-3American Diabetes Association.Blood sugar and exercise.American Diabetes Association Professional Practice Committee.5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes-2024[published correction appears in Diabetes Care. 2024 Apr 1;47(4):761-762].Diabetes Care. 2024;47(Suppl 1):S77-S110. doi:10.2337/dc24-S005Penttilä I, Penttilä K, Holm P, et al.Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus.World J Methodol. 2016;6(2):133–42. doi:10.5662/wjm.v6.i2.133

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.American Diabetes Association Professional Practice Committee.2. Diagnosis and classification of diabetes:Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S20-S42. doi:10.2337/dc24-S002Li Q, Yang LZ.Hemoglobin a1c level higher than 9. 05% causes a significant impairment of erythrocyte deformability in diabetes mellitus.Acta Endocrinol (Buchar). 2018;14(1):66-75.National Institute of Diabetes and Digestive and Kidney Disease.The A1C test & diabetes.Nathan DM; DCCT/EDIC Research Group.The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview.Diabetes Care. 2014;37(1):9-16. doi:10.2337/dc13-2112Centers for Disease Control and Prevention.Testing for diabetes and prediabetes: A1C.MedlinePlus.Hyperglycemia.Huang ES, Liu JY, Moffet HH, John PM, Karter AJ.Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study.Diabetes Care. 2011;34(6):1329-36. doi:10.2337/dc10-2377National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, heart disease, and stroke.Centers for Disease Control and Prevention.Your heart and diabetes.Tun NN, Arunagirinathan G, Munshi SK, Pappachan JM.Diabetes mellitus and stroke: A clinical update.World J Diabetes. 2017;8(6):235-248. doi:10.4239/wjd.v8.i6.235National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.American Diabetes Association Professional Practice Committee.12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S231-S243. doi:10.2337/dc24-S012Bain SC, Klufas MA, Ho A, Matthews DR.Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review.Diabetes Obes Metab. 2019;21(3):454–66. doi:10.1111/dom.13538Centers for Disease Control and Prevention.Diabetes: Nerve damage.National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.American Diabetes Association Professional Practice Committee.11. Chronic kidney disease and risk management: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S219-S230. doi:10.2337/dc24-S011National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, gum disease, & other dental problems.National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.Helgeson VS, Honcharuk E, Becker D, Escobar O, Siminerio L.A focus on blood glucose monitoring: relation to glycemic control and determinants of frequency.Pediatr Diabetes. 2011;12(1):25-30. doi:10.1111/j.1399-5448.2010.00663.xWright EE Jr, Kerr MSD, Reyes IJ, Nabutovsky Y, Miller E.Use of Flash Continuous Glucose Monitoring is associated with A1C reduction in people with type 2 diabetes treated with basal insulin or noninsulin therapy.Diabetes Spectr. 2021;34(2):184-189. doi:10.2337/ds20-0069Hilliard ME, Yi-Frazier JP, Hessler D, Butler AM, Anderson BJ, Jaser S.Stress and A1c among people with diabetes across the lifespan.Curr Diab Rep. 2016;16(8):67. doi:10.1007/s11892-016-0761-3American Diabetes Association.Blood sugar and exercise.American Diabetes Association Professional Practice Committee.5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes-2024[published correction appears in Diabetes Care. 2024 Apr 1;47(4):761-762].Diabetes Care. 2024;47(Suppl 1):S77-S110. doi:10.2337/dc24-S005Penttilä I, Penttilä K, Holm P, et al.Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus.World J Methodol. 2016;6(2):133–42. doi:10.5662/wjm.v6.i2.133

National Institute of Diabetes and Digestive and Kidney Diseases.The A1C test & diabetes.

American Diabetes Association Professional Practice Committee.2. Diagnosis and classification of diabetes:Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S20-S42. doi:10.2337/dc24-S002

Li Q, Yang LZ.Hemoglobin a1c level higher than 9. 05% causes a significant impairment of erythrocyte deformability in diabetes mellitus.Acta Endocrinol (Buchar). 2018;14(1):66-75.

National Institute of Diabetes and Digestive and Kidney Disease.The A1C test & diabetes.

Nathan DM; DCCT/EDIC Research Group.The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview.Diabetes Care. 2014;37(1):9-16. doi:10.2337/dc13-2112

Centers for Disease Control and Prevention.Testing for diabetes and prediabetes: A1C.

MedlinePlus.Hyperglycemia.

Huang ES, Liu JY, Moffet HH, John PM, Karter AJ.Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study.Diabetes Care. 2011;34(6):1329-36. doi:10.2337/dc10-2377

National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, heart disease, and stroke.

Centers for Disease Control and Prevention.Your heart and diabetes.

Tun NN, Arunagirinathan G, Munshi SK, Pappachan JM.Diabetes mellitus and stroke: A clinical update.World J Diabetes. 2017;8(6):235-248. doi:10.4239/wjd.v8.i6.235

National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic eye disease.

American Diabetes Association Professional Practice Committee.12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S231-S243. doi:10.2337/dc24-S012

Bain SC, Klufas MA, Ho A, Matthews DR.Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review.Diabetes Obes Metab. 2019;21(3):454–66. doi:10.1111/dom.13538

Centers for Disease Control and Prevention.Diabetes: Nerve damage.

National Institute of Diabetes and Digestive and Kidney Diseases.Diabetic kidney disease.

American Diabetes Association Professional Practice Committee.11. Chronic kidney disease and risk management: Standards of Care in Diabetes-2024.Diabetes Care. 2024;47(Suppl 1):S219-S230. doi:10.2337/dc24-S011

National Institute of Diabetes and Digestive and Kidney Diseases.Diabetes, gum disease, & other dental problems.

Helgeson VS, Honcharuk E, Becker D, Escobar O, Siminerio L.A focus on blood glucose monitoring: relation to glycemic control and determinants of frequency.Pediatr Diabetes. 2011;12(1):25-30. doi:10.1111/j.1399-5448.2010.00663.x

Wright EE Jr, Kerr MSD, Reyes IJ, Nabutovsky Y, Miller E.Use of Flash Continuous Glucose Monitoring is associated with A1C reduction in people with type 2 diabetes treated with basal insulin or noninsulin therapy.Diabetes Spectr. 2021;34(2):184-189. doi:10.2337/ds20-0069

Hilliard ME, Yi-Frazier JP, Hessler D, Butler AM, Anderson BJ, Jaser S.Stress and A1c among people with diabetes across the lifespan.Curr Diab Rep. 2016;16(8):67. doi:10.1007/s11892-016-0761-3

American Diabetes Association.Blood sugar and exercise.

American Diabetes Association Professional Practice Committee.5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes-2024[published correction appears in Diabetes Care. 2024 Apr 1;47(4):761-762].Diabetes Care. 2024;47(Suppl 1):S77-S110. doi:10.2337/dc24-S005

Penttilä I, Penttilä K, Holm P, et al.Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus.World J Methodol. 2016;6(2):133–42. doi:10.5662/wjm.v6.i2.133

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