Can athletes have increased A1C levels?
Yes, athletes can have increased A1C levels. Generally, athletes tend to have increased A1C levels compared to non-active people [1]. The same relationship is present in both groups when they have diabetes mellitus. Professional sportsmen affected by the disease have an increased A1C reading compared to diabetics with a sedentary lifestyle [2].
However, being an athlete does not mean you have to have an increased A1C. The results of this blood test depend on factors like the type of sport you do, diet, and metabolism [2, 1].
What is are normal A1C levels?
The A1C test, also known as the HbA1c or glycated hemoglobin, measures the average glucose level over about 2 to 3 months. It is often used to diagnose and monitor diabetes.
A normal level of A1C is below 5.7% [3]. Read our other blog, to find out what A1c levels of 5.5 mean.
What can cause increased A1C in athletes?
One of the primary causes of increased A1C levels in anyone is prediabetes or diabetes. Particularly in situations when these conditions are not diagnosed and managed, the glycation of the blood in athletes can be increased [4].
The levels of A1C in active people also depend on the type of exercise they do. Aerobic and anaerobic exercises have different metabolic responses during and after the activity. In addition to the type, the intensity of physical activity [1] and athletic competition stress also affect the A1C.
What is prediabetes?
Prediabetes is a condition characterized by increased blood glucose levels. However, they are typically not high enough to be called diabetes. Prediabetes often occurs as a precursor of diabetes type 2 [7, 8, 9, 10].
Nevertheless, it is a complex condition. It has many phenotypes with different risks of progression to diabetes [11].
In laboratory values, prediabetes can be defined as impaired fasting glucose of 100-125 mg/dL or impaired glucose tolerance. Intolerance can be diagnosed by a glucose test two hours after eating. It can usually be considered when the results of this test are in a range of 140-199 mg/dL. In terms of A1C, the diagnostic range of prediabetes is 5.7-6.4% [7, 12].
Having prediabetes increases the risk of many other health conditions. The apparent disease that can occur with prediabetes is diabetes mellitus type 2. However, people with prediabetes also have an increased risk of strokes, heart diseases, early retinopathy, macrovascular diseases, and nephropathy [13, 14].
Prediabetes is often linked to metabolic disorders such as dyslipidemia, obesity, and insulin resistance [9].
The wide range of associated diseases and the increased risk for dangerous conditions show that prediabetes is not benign and demands medical attention. Early identification and intervention are key in the management and prevention of complications. The good news is that it can be effectively treated. In the beginning, doctors often prescribe lifestyle modifications [7, 10, 13].
Check your glucose levels regularly, especially when you know someone in your family has diabetes.
Is increased A1C in athletes equal to prediabetes?
Generally, higher A1C levels are considered prediabetes or even diabetes. However, athletes belong to a special group where the situation is more complex. Sport professionals can have a higher result in A1C than normal people, but it does not mean that they have prediabetes [15, 1].
Athletes engaged in highly intensive sports can have higher levels of A1C. Extreme physical activity like cycling appears to directly contribute to a higher level of glycated glucose [1].
A diabetic specialist with experience in sports should diagnose prediabetes in athletes. With his expertise, the doctor will individually assess all the parameters, including A1C levels, the sport type practiced, and diet.
Can athletes get diabetes?
Yes, sadly, diabetes can affect anyone, including athletes [16].
Professionals can get all types of diabetes, like the most common type 2 and less prevalent type 1. However, even when an athlete has diabetes, their performance and safety are not affected as long as the condition is well managed. The number of people with diabetes in competitive sports is increasing [17, 16]. It shows that you can live your dream despite having this metabolic disease.
Practicing professional sports with diabetes demands more discipline. Diabetic athletes must pay attention to their insulin levels, sugar intake, and exercise effects. Wrong or no disease management can lead to dangerous low or high glycaemic states [4, 18].
How can athletes lower their A1C?
One of the most critical factors influencing A1C is diet. High sugar consumption can lead to increased glucose readings. Balancing the diet with a focus on carbohydrates can stabilize and lower blood glucose levels [19].
Regular exercise is often not a problem for athletes. However, simple cardio exercise, like a one-third-hour walk done regularly, can contribute to a lowering in A1C [20]. Whether an athlete should do that depends on the types of exercise they typically do during their training.
For professional athletes who suffer from diabetes, insulin management can be necessary to effectively lower glucose levels. The doses should be adjusted to the exercise type and routine to prevent a too-low sugar state [21].