Type 2 Diabetes: 7 Ways to Finally Hit Your A1C Target

You’ve heard the “diet and exercise” lecture a thousand times, and you know you should lose weight to help ease your type 2 diabetes management. But it’s easier said than done: Comprehensive lifestyle adjustments can feel overwhelming and often lead only to frustration and relapse.

If you’re still struggling to hit your A1C goal, it may instead be time to make a few targeted but impactful changes. Specific, strategic shifts in your habits and treatment plan can stabilize your blood sugar and should be easier to work into your current lifestyle.

1. Go for a Short Walk After Every Meal

Moving your body immediately after mealtime can have a noticeable impact on your blood sugar.

“Aerobic exercise causes muscles to rapidly absorb the readily available circulating blood glucose for energy, and it also increases insulin sensitivity,” says Jennifer Chung, MD, a functional and lifestyle medicine physician specializing in cardiometabolic health in Richmond, Virginia.

“The general recommendation for most people with type 2 diabetes is a minimum of 30 minutes of dedicated walking per day,” says Carole Jakucs, CDCES, a certified diabetes care and education specialist based in Los Angeles. Jakucs adds that this movement goal can be broken down into 10-minute intervals three times per day, especially after eating, to help lower post-meal blood sugar.

2. Mind Your Carbohydrates

Not all carbohydrates are created equal.

“If you don’t know how many carbohydrates to limit [yourself to], the easiest thing to do is not count carbs but to make a commitment to only eat them in their minimally processed, whole form,” says Dr. Chung.

3. Test Your Blood Sugar More Frequently

“Real-time data like this can be a powerful tool in changing behavior — and in this situation, tweaking meals and timing of exercise to improve blood glucose levels,” says Chung.

4. Lift Weights

Strength training can be particularly helpful in improving blood sugar. Some evidence suggests that it’s more effective than aerobic exercise.

“Resistance training increases muscle mass, which means muscle cells become bigger,” says Chung. “Larger muscle cells have more insulin receptors and more insulin-independent glucose transporters that pull glucose into the muscle cells without the need for insulin.”

5. Review Your Medications

At your next checkup, it may be a good idea to go over your prescriptions with your doctor, one by one, to see if you’re taking anything that’s actually working against your diabetes management goals.

“If you’ve been prescribed medications in these categories but haven’t started taking them, speak with your physician candidly about your concerns, and discuss alternatives or a follow-up plan to monitor,” says Chung. If you’re already on these medications and can recall that the onset of weight gain and poor blood glucose control occurred around the same time you started taking them, it’s also important to share this information with your physician so you can discuss alternatives, she says.

6. Treat Sleep Apnea

“Untreated obstructive sleep apnea deprives the brain of oxygen at night, increasing stress hormones like cortisol and adrenaline, and decreasing insulin sensitivity, directly increasing blood glucose levels,” says Chung.

7. Meet With a Diabetes Educator

“In my practice as a primary care physician, I have found that patients who participate in frequent meetings with a health educator create and sustain meaningful changes,” says Chung. “The health educator, whether a dietitian, diabetes educator, or health coach, provides accountability and ‘coaching’ that encourages habit changes.”

Chung says these specialists often can offer longer meetings with patients than the 15- to 20-minute check-in you may expect from a primary care physician, in which engaging in a deeper discussion about health goals is difficult.

“We typically have more time allotted for our visits than physicians and other prescribers,” says Jakucs. “We review lifestyle, including eating habits, when and how you take your diabetes medications, how much sleep you get, your activity level, stressors, and more.”

The Takeaway

• To reach your A1C goals when you have type 2 diabetes, don’t just “exercise.” Incorporate strategic physical activity into your days, such as walking for 10 minutes immediately after meals and strength training to increase your insulin sensitivity.
• Consider prioritizing carb quality rather than carb quantity: Replace refined carbohydrates with high-fiber, whole-food sources of complex carbohydrates.
• Be proactive: Check your blood sugar more frequently, and collaborate with your doctor to ensure other medications or untreated conditions like sleep apnea aren't negatively impacting your blood sugar.
• For long-term success, work with a certified diabetes educator for personalized coaching, and advocate for yourself if your current therapies aren’t helping you meet your A1C targets.