How to lower your A1C — what 43 years with T1D taught me

Let me say this up front: I am not a doctor. I'm a certified coach, and I've lived with diabetes for 43 years. So I can only speak to what I've done, what I've watched work, and what I've watched go sideways — for me and for the people I coach.

Not everyone should have the same A1C

This is the part that doesn't get said enough. Not everybody can — or should — have the same A1C. Some people's bodies are more comfortable at a lower number. Some, through choices over the years, have made themselves insulin resistant and run higher. "Normal" is anything under six. But for a diabetic, that same number can be dangerous.

If your A1C is low, that means your blood sugar on average is running too low. It means you're having more lows than you are normal or high ranges. And lows are not the win people think they are.

Lower isn't better. Right for your body is better.

My number isn't your number

For me, for instance — I can't be lower than six. When I am, it means I'm having way too many severe lows. The paramedics have been at my house. Other times I've had to correct it on my own. That's not a healthy A1C for me, even though on paper it looks great.

Everybody's A1C is different. It depends on what works best for you. If you're on the go all day, your A1C can't be too low — because then you're snacking constantly just to keep it up, and your targets have to be adjusted to match the life you actually live.

What that 90-day average really tells you

Your A1C is an average of your blood sugars over 90 days. So it's about where your ranges are. Are you low too much? Are you high too much? Or are you in that normal range, very steady, very little peaks — and you've been completely steady? Not everybody can be that steady.

What actually moves the number

Your A1C is a 90-day average — the quiet story your blood is telling about itself. You can't fix it on Friday before Monday's lab, and you can't ruin it with one meal. What moves it is the boring stuff, repeated:

• What you eat — and just as importantly, how much.
• When you eat — spacing matters as much as content.
• Movement after meals, even just a 10-minute walk.
• Sleep — because for blood sugar, it's medication.
• Catching the trend before it becomes a pattern.

It all works together. Food, portion, timing, movement, stress, sleep. Pull one lever and the others shift. That's why a generic "diabetic diet" doesn't lower an A1C — your life does.

How I coach this

When we work together, we start with where you are: your numbers, your schedule, your low patterns, your high patterns, the meals you actually eat. Then we find your real target — not the internet's target — and build from there.

After 43 years, I can tell you this much: the people who steady their A1C aren't the ones chasing perfect. They're the ones who get bored of starting over.