The A1C test is very familiar to diabetics. It tests your average blood sugar over the last 2-3 months, which is extremely important to this population. For many, an A1C goal of 7% or less is their goal; however, you may be struggling to reach this, even though you have been following your diabetes plan very closely. Here are some reasons—some in your control, some not—as to why you’re unable to reach your goal:

Hormone changes

Menstruation, menopause, physical stress, and emotional stress all play a role in your A1C level. Talk to your doctor about how you can manage stress and, therefore, your A1C. A few strategies include exercising and yoga.

Related conditions to diabetes

There are some diabetes-related conditions that can raise your blood sugar, such as gum disease and chronic kidney disease. When you see a doctor regularly, you help prevent some complications, like heart disease, nerve damage, foot problems, and vision problems.

Untreated anemia

Anemia, or low iron levels in the body, can affect your A1C results. Talk with your doctor if your blood sugar is unusually high.

Natural changes in blood sugar

Just like your blood pressure changes throughout the day, so does your blood sugar. Factors like the amount of carbs you eat, your stress levels, your sleep quality, and time dedicated to physical activity can all affect your A1C results.

Progression of your diabetes

Diabetes is a progressive condition, meaning it gets worse with time. Eventually, your body may stop producing insulin altogether, and you will have to change your diabetes plan accordingly. That doesn’t mean that you can’t manage it effectively, though. Talk to your doctor if you think you need to adjust medication.