What Does an A1C of 5.7 Mean? A Simple Guide for Adults Over 65

In this article: 

• A1C is a measure of long-term blood sugar control. It reflects your average blood sugar over the past two to three months, not just a single moment in time.
• An A1C of 5.7% falls in the prediabetes range, which runs from 5.7% to 6.4%. It’s blood sugar that’s higher than normal, but below the 6.5% threshold for a diabetes diagnosis.
• Older adults are at higher risk for increased blood sugar due to factors like age-related muscle loss and increased insulin resistance.
• Research suggests lifestyle changes may significantly lower the risk of progressing to type 2 diabetes. The CDC's Diabetes Prevention Program found a 71% risk reduction in adults over 60 who had goals of losing weight and increasing physical activity. 
• Medicare covers a structured diabetes prevention program (DPP) at no cost for eligible members. Adults with an A1C between 5.7% and 6.4% may qualify for the Medicare Diabetes Prevention Program (MDPP) in 2026.
• Lark MDPP is available in an app for eligible Medicare recipients. Lark is available 24/7 for help with healthy lifestyle changes and support. 

It’s normal to wonder what it means when you get a lab test result showing an A1C of 5.7%. It’s possible that your result is showing above the normal range. Your doctor may mention the word, “prediabetes,” or say something about, “high blood sugar.” 

What does it mean? Are you on the path to diabetes? 

The good news is that when A1C is 5.7, there’s a lot you can do to manage blood sugar. If you’re in Medicare, you may be eligible for a program designed to help prevent or delay the onset of type 2 diabetes. 

For adults over 65, learning that you have an A1C of 5.7 can be startling - but it can also be an opportunity to take charge of your health before a diagnosis of diabetes. Here’s what you should know about what your A1C means, what the research says about managing blood sugar and lowering risk for diabetes, and what the Medicare Diabetes Prevention Program is. 

What Exactly Is A1C?

An A1C test is a long-term measure of your blood sugar. It measures how much sugar, or glucose, has been sticking to your red blood cells over the past 2-3 months. Because red blood cells live about 90 days, the test gives your doctor a kind of "moving average" of your blood sugar. A fasting or random blood sugar test measures your blood sugar level at one point in time, but an A1C test gives a better picture of how your blood sugar has been behaving over time.

Think of it like a weather average. The weather can be hot for one day, but that doesn’t mean it’s been a hot summer. However, if the average temperature has been high for 2-3 months, that might be something you notice as unusual!

Here is how the numbers break down, according to the CDC:

• Below 5.7% — Normal range
• 5.7% to 6.4% — Prediabetes range
• 6.5% and above — Diabetes range

If your A1C is between 5.7% and 6.4%, you are in the range of prediabetes. Blood sugar is higher than normal, but not as high as if you had diabetes. Having an A1C in the prediabetes range is an early sign from your body that is worth paying attention to. 

If A1C Is 5.7%, What Does That Mean for Seniors?

A1C goals are individualized, according to the American Diabetes Association. A 5.7% may be a strong call to action or simply something to monitor. You and your doctor can decide whether to treat your A1C, how to treat it, and what your goal A1C is. If you’re active and generally healthy, your healthcare provider is more likely to encourage you to address your blood sugar levels proactively. 

You’re not likely to have symptoms if you have an A1C of 5.7%. In fact, more than 80 million American adults have prediabetes, and most of them don’t know it. That’s why catching your A1C when it’s still in the prediabetes range can be lifesaving information. 

‍

If you are over age 65 and you have an A1C of 5.7-6.4%, you may be eligible to participate in a Medicare Diabetes Prevention Program (MDPP). It’s a year-long program that focuses on making small changes to your lifestyle to lose extra weight and achieve physical activity recommendations. 

Research Suggests Lifestyle Changes Can Lower Blood Sugar

The Diabetes Prevention Program (DPP) is based on a big research study. Participants joined a year-long lifestyle change program with two simple goals. 

Losing 5–7% of body weight if overweight (for a 200-pound adult, that is roughly 10–14 pounds)

Getting about 150 minutes of moderate activity per week — broken into whatever chunks work for you

Adults over age 60 who made modest lifestyle changes to achieve these goals reduced their risk of developing type 2 diabetes by 71%! That is compared to 58% in younger adults. 

Lifestyle Choices That May Support Healthier Blood Sugar

How did these results happen? The DPP doesn’t include extreme diets or training for marathons. Instead, the emphasis is on small changes that you can make consistently. 

Eating patterns

There is no single "diabetes diet." Consistent, balanced eating patterns tend to matter more than any one food rule. Here are examples. 

• Swapping soda for water regularly
• Roasting or baking foods instead of frying foods
• Choosing foods that are high in fiber, like beans, whole grains, nuts, fruit, and vegetables
• Having whole, unprocessed foods more often than fast food or other processed foods

Movement and Physical Activity

Small, consistent activity tends to outperform occasional intense exercise for blood sugar management in older adults. Here are examples. 

• Adding a 10-minute walk in the morning or evening
• Exercising such as doing walking, swimming, chair exercises, or light resistance training 
• Breaking up sitting time by standing up and moving for 1-2 minutes per hour

Sleep and stress

Poor sleep and chronic stress are both associated with higher blood sugar levels in the research literature though the relationship is complex, as Harvard Health explains.

• Getting adequate sleep can help normalize hunger levels
• Managing stress can help normalize stress hormones and metabolism

These are not prescriptions. They are areas where research suggests some benefit. Talk to your doctor or care team before making significant changes.

What Medicare Covers for Prediabetes Support - Are You Eligible?

If you are on Medicare and your A1C is between 5.7% and 6.4%, you may qualify for a benefit most people have never heard of.

The Medicare Diabetes Prevention Program (MDPP) is a structured, year-long coaching program specifically designed for people in the prediabetes range. It is based on the CDC-recognized DPP described above, but it is designed for adults over age 65.

This program is now available in an online format at no cost to eligible Medicare beneficiaries. It is a once-in-a-lifetime benefit, meaning it is worth checking your eligibility sooner rather than later.

Like the regular DPP, the MDPP focuses on modest lifestyle changes that have been shown to prevent or delay the onset of type 2 diabetes by over 50%. Goals in the MDPP are to lose 5-10% of your body weight if you are overweight and to achieve recommendations for physical activity. The program focuses on building sustainable habits that can last for a long time. It does not require you to overhaul your life overnight.

The Bottom Line

An A1C of 5.7 is not a crisis. It is a signal that your body is sending you. 

For adults over 65, this number comes with an important opportunity. Research suggests this is a moment when modest, sustainable changes may meaningfully lower the risk of progressing to type 2 diabetes. Plus, older adults may respond especially well to those changes.

If you're in Medicare, you may be eligible to join Lark MDPP at no cost to you.

See If You Qualify at No Cost to You

Lark's Medicare Diabetes Prevention Program offers personal health coaching delivered right to your phone - built around the same CDC-recognized program that showed a 71% risk reduction in adults over 60. There is no cost to eligible Medicare members. 

Lark can help you stay on track with your weight and health goals as you log, track, and chat. Your Lark coach is available 24/7 for encouragement, nutrition and physical activity coaching, and habit tracking. Lark can help you make healthy choices and establish habits that fit into your lifestyle so you can lose weight and keep it off with or without GLP-1 medications. 

Click here to see if you may be eligible to join Lark MDPP or another Lark program today!

‍