My HbA1c is high — what should I do?
An HbA1c in the prediabetic or diabetic range warrants a fasting glucose, fasting insulin, lipid panel, and a metabolic review. Lifestyle interventions are first-line. Pharmacologic options (metformin, GLP-1 receptor agonists) are provider-reviewed when warranted.
Full answer
HbA1c reflects average glycemia over ~90 days. Values in the prediabetic (5.7–6.4%) or diabetic (≥6.5%) range trigger a fasting glucose, fasting insulin, HOMA-IR, full lipid panel, and weight/waist review. First-line management is nutrition (carbohydrate quality and quantity), resistance and aerobic training, sleep, and weight optimization. Pharmacologic options — metformin, GLP-1 receptor agonists, SGLT2 inhibitors — are provider-reviewed when lifestyle alone is insufficient or when cardiometabolic risk is elevated. The metabolic pathway integrates these decisions with the broader biomarker baseline.
Educational. Not a substitute for individualized provider review.
- Methodology — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03