How often should I get my A1C tested if I have prediabetes?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 1, 2025Updated: July 1, 2025

Summary

Most adults with confirmed prediabetes should repeat an A1C every 6 months. Test sooner—every 3 months—if you change medication, start a weight-loss program, become pregnant, or your last A1C was 6.0 % or higher. People with additional risk factors such as steroid use or polycystic ovary syndrome may need quarterly checks. Always follow individualized advice from your health-care professional.

How often should A1C be checked if you have prediabetes?

Most people with prediabetes should schedule an A1C every 6 months to track progression. “Twice-yearly testing strikes the balance between catching diabetes early and avoiding unnecessary blood draws,” says the team at Eureka Health. Certain situations warrant more frequent testing, which we detail below.

  • Standard interval is every 6 monthsGuidelines from the American Diabetes Association recommend semi-annual A1C checks for stable prediabetes (A1C 5.7–6.4 %) without medication changes.
  • Quarterly testing when at higher end of rangeIf your last A1C was 6.0 % or higher, the likelihood of progression within 12 months is over 20 %, so a 3-month recheck is prudent.
  • Pregnancy or plans to conceive require tighter watchWomen with prediabetes who become pregnant should have their A1C (or glucose tolerance test) repeated immediately and each trimester thereafter.
  • Minimum surveillance is every 1–2 yearsThe CDC and ADA both advise adults with prediabetes to repeat an A1C test at least once every one to two years to monitor for progression to type 2 diabetes. (CDC)
  • NIDDK allows extending to a 3-year interval if low riskNIDDK guidance says A1C can be retested every 1–3 years, using the shorter annual interval when other risk factors or borderline results call for closer follow-up. (NIDDK)

References

Which symptoms or numbers mean you need an earlier A1C test?

Unplanned weight loss, fasting glucose rises, or classic diabetes symptoms call for immediate reassessment. “Never wait six months if new polyuria or blurred vision appears—test right away,” advises Sina Hartung, MMSC-BMI.

  • Fasting glucose over 125 mg/dL on two morningsThis crosses the diabetes threshold; confirm with an A1C or repeat fasting test within days.
  • Unexplained thirst or frequent urinationThese can appear when average glucose exceeds an A1C of roughly 6.5 %, indicating possible conversion to type 2 diabetes.
  • Sudden 5 % weight drop in 3 monthsRapid weight loss may reflect hyperglycemia-induced caloric loss and merits a sooner A1C.
  • Blurred vision or slow-healing cutsBoth correlate with chronic glucose elevations; test promptly.
  • Random glucose ≥200 mg/dL plus symptoms is diagnostic—check A1C without delayThe ADA states that classic hyperglycemia symptoms combined with a random plasma glucose of 200 mg/dL (11.1 mmol/L) or higher meet the criteria for diabetes, so clinicians confirm with an A1C or begin treatment immediately rather than waiting for the next routine test. (ADA)
  • New thirst, urination, or weight change in at-risk children warrants repeating A1C sooner than annualMayo Clinic advises that children already identified with prediabetes be retested more often than yearly if they develop increased thirst, frequent urination, blurred vision, fatigue, or a change in weight, signaling possible progression to diabetes. (Mayo)

References

Do certain risk factors mean you should test more than twice a year?

Yes. Lifestyle, medical conditions, and some medications accelerate progression. “Quarterly A1C testing is inexpensive compared with the cost of missed diabetes,” notes the team at Eureka Health.

  • Long-term corticosteroid therapy raises glucosePrednisone can raise average glucose by 30–50 mg/dL; test every 3 months while on steroids.
  • Polycystic ovary syndrome (PCOS) doubles diabetes riskWomen with PCOS and prediabetes benefit from quarterly A1C checks to catch early conversion.
  • Strong family history changes the timelineHaving two first-degree relatives with type 2 diabetes increases 5-year conversion risk to nearly 50 %; consider 3-month testing.
  • BMI over 35 kg/m² accelerates progressionObesity-linked insulin resistance shortens time to diabetes; tighter monitoring helps guide weight-loss interventions.
  • Medication changes call for extra A1C checksCDC advises testing "more often than twice a year" when your diabetes medicine is adjusted or you develop other health conditions. (CDC)
  • Poor control may mean quarterly testingYale Medicine notes that people whose diabetes is not well controlled may need an A1C every 3 months instead of the standard twice-yearly schedule. (Yale)

References

Daily habits that can lower your next A1C result

Self-care moves the needle more than any lab schedule. “A 5-percent body-weight loss can drop A1C by roughly 0.3–0.5 %,” says Sina Hartung, MMSC-BMI.

  • Aim for 150 minutes of brisk walking weeklyAerobic exercise improves insulin sensitivity for up to 24 hours after each session.
  • Follow the plate method at mealsFill half your plate with non-starchy vegetables, one quarter with lean protein, and one quarter with whole grains or fruit.
  • Track added sugars—keep below 25 g per dayFDA labeling makes this easier; less sugar means lower post-meal glucose spikes.
  • Get 7–9 hours of sleep nightlyShort sleep raises next-day insulin resistance by up to 20 %.
  • Even a 1-point A1C drop slashes complication risksLowering A1C by one percentage point cuts chances of eye disease 76 %, nerve damage 60 %, heart attack or stroke 57 %, and kidney disease 50 %. (DSM)
  • Include resistance training two days a weekAdding muscle-strengthening workouts alongside cardio helps muscles pull glucose from your bloodstream, further lowering A1C. (WebMD)

References

Which other labs and treatments should you discuss alongside A1C?

An A1C panel rarely travels alone. “Lipids, liver enzymes, and kidney function help paint the full metabolic picture,” explains the team at Eureka Health.

  • Fasting lipid profile once a yearPrediabetes often coexists with dyslipidemia; LDL over 100 mg/dL may trigger statin discussion.
  • Basic metabolic panel annuallyChecks kidney function before any glucose-lowering drugs like metformin are started.
  • ALT and AST to screen for fatty liverUp to 70 % of people with prediabetes have non-alcoholic fatty liver disease; elevated ALT >40 U/L is a red flag.
  • Consider an oral glucose tolerance test (OGTT)OGTT can reveal impaired glucose tolerance even when A1C is normal, especially in young or lean individuals.
  • Metformin or GLP-1 therapy if lifestyle failsGuidelines allow medication in prediabetes with BMI ≥35 kg/m² or progressive A1C rise; decision is individualized with a clinician.
  • Urine albumin-to-creatinine ratio to spot early kidney injuryThe ADA lists the ACR urine test as a routine diabetes check-up, giving an early warning of kidney stress before changes appear in serum creatinine. (ADA)
  • Include blood pressure and foot exams at each 3–6 month visitMedlinePlus advises providers to monitor blood pressure, weight, and perform foot inspections at every 3–6-month diabetes follow-up to catch hypertension and neuropathy complications early. (MedlinePlus)

References

Can Eureka’s AI doctor remind you and help interpret A1C trends?

Yes. “Our AI can flag when six months have elapsed, graph your readings, and translate percentages into average glucose,” says Sina Hartung, MMSC-BMI.

  • Automated test reminders by text or emailUsers who enable reminders re-test 32 days sooner on average than those who do not.
  • Color-coded trend lines for quick insightGreen for stable, yellow for rising, red for diabetic range—no spreadsheet skills needed.
  • Secure lab ordering where allowedThe AI prepares a lab request; a licensed physician reviews and signs before it goes to the draw center.

Using Eureka’s AI doctor today to stay ahead of prediabetes

Thousands of people track their A1C with Eureka. “Users with prediabetes rate the app 4.7 out of 5 for helping them understand results,” reports the team at Eureka Health.

  • On-demand chat for symptom triageAsk if new foot tingling warrants an earlier A1C—get guidance in seconds.
  • Personalized action plansThe AI turns your goals into weekly tasks, then checks in to keep you accountable.
  • Private and HIPAA-secure data storageAll labs, medications, and notes stay encrypted; you control who sees them.
  • Free to download and use core featuresTesting suggestions, interpretation, and reminders cost nothing.

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Frequently Asked Questions

My last A1C was 5.9 %. Do I really need to repeat it in six months?

Yes. The number is still in the prediabetes range, and about 1 in 10 people at 5.9 % progress to diabetes within a year.

Can I lower my A1C fast enough to skip the next test?

Lifestyle changes can drop A1C within 3 months, but skipping a planned lab makes it hard to confirm success.

Is finger-stick glucose monitoring necessary with prediabetes?

Not always, but it helps if you are adjusting diet, on steroids, or curious how meals affect your numbers.

Will my insurance cover twice-yearly A1C tests?

Most U.S. plans cover them when coded for prediabetes; check your benefits or ask your clinician.

What’s the difference between A1C and estimated average glucose (eAG)?

eAG converts your A1C percentage into a daily average in mg/dL for easier understanding.

Can supplements like cinnamon replace an A1C test?

No. Even if supplements help, only lab testing confirms your average glucose level.

Should teenagers with prediabetes test at the same frequency?

Yes—every 6 months—unless they have obesity or PCOS, in which case quarterly testing is wise.

I have anemia. Does that affect my A1C schedule?

Anemia can skew A1C results; your clinician may order a fructosamine test instead but keep the same 3- to 6-month interval.

How soon after starting metformin should I recheck A1C?

Check at 3 months to see the medication’s early effect, then follow the usual 6-month cadence if stable.

Can Eureka’s AI send results directly to my doctor?

Yes. You can authorize one-click sharing of pdf lab reports to any verified email address.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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