From the Guidelines
To lower an HbA1C of 5.8, focus on lifestyle modifications rather than medications since this level is considered prediabetic but not yet diabetic. The most recent and highest quality study, 1, recommends performing aerobic and resistance exercise regularly, with aerobic activity bouts ideally lasting at least 10 min, and aiming for 30 min/day or more most days of the week. Daily exercise, or at least not allowing more than 2 days to elapse between exercise sessions, is recommended to decrease insulin resistance.
Some key lifestyle modifications include:
- Aim to lose 5-7% of your body weight through a combination of dietary changes and increased physical activity
- Adopt a balanced diet rich in vegetables, lean proteins, and whole grains while limiting refined carbohydrates, sugary foods, and processed items
- Portion control is essential—consider using smaller plates and measuring servings
- Regular strength training twice weekly can also improve insulin sensitivity
- Monitor your blood glucose periodically to track progress
- Ensure adequate sleep (7-9 hours nightly)
- Manage stress through techniques like meditation or yoga
These lifestyle changes work by improving insulin sensitivity, reducing glucose production by the liver, and enhancing muscle uptake of glucose. An HbA1C of 5.8 indicates average blood glucose of about 120 mg/dL, and these interventions can effectively bring it below 5.7, potentially preventing progression to type 2 diabetes. Additionally, a study by 1 found that a wide range of physical activity, including leisure time activities, can significantly reduce HbA1c.
It's also important to note that the American Diabetes Association recommends individualized HbA1c targets, taking into account factors such as life expectancy, disease duration, and presence of microvascular or macrovascular complications, as stated in 1. However, for a prediabetic individual with an HbA1C of 5.8, lifestyle modifications are the primary recommendation.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Methods to Lower HbA1C
To lower HbA1C levels at 5.8, several methods can be employed, including:
- Exercise training and physical activity advice, as shown in studies 2, 3, 4
- Increasing moderate to vigorous physical activity (MVPA) time, as found in study 5
- Reducing sedentary time, although this was not significantly associated with changes in HbA1c in study 5
- Supervised aerobic exercise, with a dose-dependent effect on HbA1c reduction, as demonstrated in study 4
Types of Exercise
Different types of exercise have been shown to be effective in reducing HbA1c levels, including:
- High-intensity interval training (HIIT), which was found to be the most effective treatment for HbA1c reduction in study 2
- Combined training (CT), which was associated with a significant reduction in HbA1c levels in study 2
- Aerobic training (AT), which was shown to be effective in reducing HbA1c levels in studies 2, 3, 4
- Resistance training (RT), which was associated with a significant reduction in HbA1c levels in study 2
- Physical activity advice, which was found to be effective in reducing HbA1c levels when combined with dietary advice in study 3
Duration and Intensity of Exercise
The duration and intensity of exercise have also been shown to be important factors in reducing HbA1c levels, with:
- Longer durations of exercise (more than 150 minutes per week) being associated with greater reductions in HbA1c levels in study 3
- Moderate to vigorous-intensity aerobic exercise being associated with significant reductions in HbA1c levels in study 4
- Every 30 minutes per week of moderate to vigorous aerobic exercise being associated with a significant reduction in HbA1c levels in study 4