Quick answer: For many non-pregnant adults with type 2 diabetes, the American Diabetes Association’s general A1C target is below 7%. That number is a starting point, not a pass-or-fail grade. Reported ADA guidance describes a looser goal, such as below 8%, for people with a history of severe low blood sugar, limited life expectancy, advanced complications, or many other health conditions, and tighter goals for some people when they can be reached safely. For older adults, the ADA’s health-status table gives roughly 7.0 to 7.5% for people who are healthy, below 8.0% for people with several chronic illnesses or some loss of function, and advises against relying on A1C for people in very poor health. Age alone does not set the number. Your health, your medicines, and your risk of low blood sugar do. Ask your clinician what your own target is and why.
Why there is no single A1C goal “by age”
If you search for A1C goals by age, you will find charts that line up decades of life against A1C numbers: a stricter target in your forties, a looser one in your seventies. Those charts are tidy, and they are not how the guidelines are built. The American Diabetes Association (ADA) Standards of Care frame the A1C goal around the person, not the birthday. The ADA’s older-adult table sorts people by health status, such as healthy, complex or intermediate health, and very complex or poor health, and gives a different A1C goal to each group. A healthy 80-year-old and a 55-year-old with advanced kidney disease can end up with the same goal, or the older person can end up with the tighter one.
That matters because a chart that says “age 70: below 8%” can lead a healthy, active 70-year-old to settle for a looser goal than the ADA table suggests, and can lead a person with frequent low blood sugar to chase a number that is putting them at risk. This guide explains how the reported targets are built, what drives a goal up or down, how A1C converts to an average glucose, why the number can mislead, and how to talk with your clinician about yours. It is general education. I am not a physician, and your own target should come from your care team.
A word on sources. The ADA publishes its Standards of Care every year, and the full text was not reachable from the tools I used to prepare this page. What follows comes from several secondary and summary pages that quote different editions of the Standards. I name the edition and the page each time, and I flag anything that I could not confirm. Where a source gave a number for one year and a newer source might have changed it, treat the number as a guide and check the current Standards with your clinician.
The general adult goal: below 7%, with conditions
The number most people have heard is 7%. A US Pharmacist article from November 2023, summarizing the 2023 ADA Standards, lists the A1C goal for many non-pregnant adults as below 7.0% (53 mmol/mol). A 2023 Diatribe summary of the same Standards adds the condition that gets dropped in casual retellings: below 7% for most non-pregnant adults “without significant hypoglycemia.” A 2026 summary from 2 Minute Medicine, which paraphrases the 2026 Standards, again puts the goal at below 7% with a continuous glucose monitor time in range above 70%, and says individual goals are set by age, health, and function. The National Kidney Foundation, in a page on kidney and diabetes lab values, likewise says the goal for most adults with diabetes is an A1C of 7% or lower. So across a three-year span of sources the headline number has stayed in the same place.
Two parts of that sentence are easy to skip. The first is “many” or “most.” The ADA does not say every adult should aim for 7%. The second is “without significant hypoglycemia.” A goal that can only be reached by repeated low blood sugar is not a goal the guidelines ask for. That is the pivot for everything that follows: the number is a means to a lower risk of long-term complications, and the cost of chasing it is judged against the risk of harm in the short term.
The reported goals, by situation
The table below gathers the A1C goals that appeared in the sources I could read. It is organized by situation because that is how the guidelines are organized. The “Source” column names the edition or page, since the wording differs slightly between them. None of these is a personal target. They are the ranges clinicians start from.
| Situation | Reported A1C goal | Where it comes from |
|---|---|---|
| Many non-pregnant adults | Below 7.0% (53 mmol/mol) | US Pharmacist, Nov 2023, citing the 2023 ADA Standards; 2 Minute Medicine summary of the 2026 Standards; Diatribe 2023 |
| Short-duration diabetes, few other conditions, long life expectancy, if safely reachable | Closer to non-diabetic, below 6.5%, without significant hypoglycemia | 2014 ADA executive summary, as quoted on the NGSP page. An older edition, so confirm the current wording |
| History of severe hypoglycemia, limited life expectancy, advanced complications, many conditions, or long-standing hard-to-control diabetes | A less stringent goal, such as below 8% | HCPLive, citing the ADA recommendations for glycemic goals; Diatribe 2023 |
| Older adults in good health | Below 7.0 to 7.5% (53 to 58 mmol/mol) | ADA 2024 Standards, Section 13, Table 13.2 (Diabetes Care 2024;47 Suppl 1) |
| Older adults with complex or intermediate health | Below 8.0% (64 mmol/mol) | Same table |
| Older adults in very complex or poor health | Avoid reliance on A1C; avoid low blood sugar and symptomatic high blood sugar | Same table |
| Children and teens with diabetes | A general target of 7% or less, individualized | DiabetesEd.net page (published 2021, modified 2026), which does not name the Standards edition |
| Before elective surgery | A1C below 8%, or a 14-day glucose management indicator below 8%, or time in range above 50% | 2 Minute Medicine summary of the 2026 Standards |
Pregnancy goals are tighter than these and are set with an obstetric and diabetes team. I did not find a pregnancy A1C number on a page I could read, so I do not give one. Check the current ADA Standards or ask your care team.
Read the table for what it says about the structure, not just the numbers. The same adult could sit in different rows at different points in life. A person in their fifties with newly found type 2 diabetes and no complications is plausibly in the “below 7%, or lower if safe” group. The same person at 78, after a stroke, with chronic kidney disease and a fall in the last year, is in a different row, and a different goal is not a failure of treatment. It is the ADA’s own approach.
What pushes the goal looser
HCPLive, quoting the ADA’s recommendations for glycemic goals, lists the groups for whom a less stringent goal such as below 8% may be appropriate. The page was published in 2014 and modified in 2023, so it reflects the ADA’s long-standing framing. The groups are people with a history of severe hypoglycemia, people with limited life expectancy, people with advanced microvascular or macrovascular complications, people with extensive coexisting conditions, and people with long-standing diabetes in whom the general goal has been hard to reach despite diabetes self-management education, appropriate glucose monitoring, and effective doses of several glucose-lowering drugs, including insulin.
The common thread is risk. Lowering A1C usually lowers the risk of long-term complications over years. But pushing it down can require medicines that raise the chance of low blood sugar, and low blood sugar carries immediate dangers, such as falls and confusion. The ADA’s older-adult table is explicit about this logic. In the “healthy” row it says that acute illness raises the risk of dosing errors and hypoglycemia, and for each row it lists when to simplify or de-intensify treatment, for example when there is severe or recurrent hypoglycemia on insulin or on high-risk non-insulin agents, wide glucose swings, or a long list of medicines. De-intensifying means lowering a dose or stopping a treatment, and it is a decision for the prescriber, not something to try on your own.
What pushes the goal tighter
The 2014 ADA executive summary, quoted on the National Glycohemoglobin Standardization Program page, says that for people with short-duration diabetes, little other illness, and a long life expectancy, a goal “as close to non-diabetic levels (below 6.5 percent) as possible without significant hypoglycemia” is suggested. That wording is from an older edition, and I could not confirm that the current Standards phrase it the same way. I include it because people ask why their neighbor’s target is 6.5% and theirs is 7%, and the likely answer is that the guidelines describe a range of goals, with a lower number reserved for people who can reach it safely and are likely to benefit over many years.
Two practical points. First, a tighter goal is not a better grade. It is a different tradeoff that only makes sense when low blood sugar is unlikely. Second, if a lower number comes from lifestyle changes alone, many of the risks that justify a looser goal, such as hypoglycemia from sulfonylureas or insulin, are not in play. That is a conversation to have with a clinician who knows which medicines you take.
The older-adult table, in plain language
The ADA’s 2024 Standards, Section 13, Table 13.2 (published in Diabetes Care, December 2023) sets goals by health status. Here is how it reads, in my words, with the original numbers.
| Health status | A1C goal | What the table says to consider |
|---|---|---|
| Healthy: few chronic illnesses, intact thinking and daily function | Below 7.0 to 7.5% | These people usually manage complex tasks well when stable. During acute illness, the risk of dosing errors and low blood sugar rises. Simplify or de-intensify for severe or recurrent hypoglycemia, wide swings, or declining thinking or function after illness. |
| Complex or intermediate: several chronic illnesses, two or more instrumental daily-living impairments, or mild to moderate cognitive impairment | Below 8.0% | Other conditions can impair self-management and avoiding low blood sugar. Long-acting formulations can reduce pill burden. Simplify for severe hypoglycemia on insulin, difficulty managing a complex regimen, or a major social change such as losing a caregiver. |
| Very complex or poor health: long-term care, end-stage illness, moderate to severe cognitive impairment, or two or more daily-living impairments | Avoid reliance on A1C; avoid low blood sugar and symptomatic high blood sugar | Tight control offers no clear benefit here. Keeping thinking and function matters most. |
| End of life | Avoid low blood sugar and symptomatic high blood sugar | The focus is comfort and avoiding painful or burdensome treatment, including injections and finger sticks when they cause distress. |
Source: ADA Standards of Care in Diabetes 2024, Section 13, Table 13.2, as read from the PMC copy of the table. The table also lists a short-term rehabilitation row with a glucose goal of 100 to 200 mg/dL and “avoid reliance on A1C.” I read the table but not the full chapter.
Notice what is missing: ages. The table does not say “70 to 79” or “over 80.” It describes the person’s health and function. That is the single best argument against reading an A1C-by-age chart literally. If you or a parent is older, ask which row applies and why, and whether the current edition of the Standards changes the numbers.
Illustrative profiles, not recommendations
To make the structure concrete, here are three made-up people and where each might fall in the framework. These are invented examples to show the reasoning. They are not medical advice, and no real person is described.
- A 48-year-old with type 2 diabetes found at a routine physical, no complications, managing with food, walking, and one medicine that rarely causes low blood sugar. The general goal below 7% is the usual starting point, and a clinician might discuss whether a lower number is reasonable because the chance of low blood sugar is small.
- A 66-year-old with type 2 diabetes for 15 years, on insulin, with early kidney disease and one severe low blood sugar episode last year. The history of severe hypoglycemia is one of the reasons the ADA gives for a less stringent goal such as below 8%, and the team may simplify the regimen.
- An 82-year-old living at home, independent, with few health problems, who walks daily and takes a medicine that does not usually cause low blood sugar. That person may fit the “healthy” row, with a goal near 7.0 to 7.5%. Age alone does not move them to the looser row.
The point is not to match yourself to a profile. It is to see why the first question to ask is “what is my health status and what is my risk of low blood sugar?” and not “what is the number for my age?”
Turning A1C into an average glucose
A1C is reported as a percentage, which is hard to feel. The estimated average glucose (eAG) translates it into the units on a glucose meter. The formula comes from the A1C-Derived Average Glucose (ADAG) study, published in 2008: eAG in mg/dL equals 28.7 times A1C minus 46.7. An MDedge page that describes it, and a research summary on Metabolicum, say the study enrolled 507 people analyzed (268 with type 1 diabetes, 159 with type 2, and 80 without diabetes), measured A1C monthly for three months, and compared it to continuous glucose monitor readings for 48 hours each month and frequent finger sticks. The Metabolicum summary reports a correlation of r = 0.92. I computed the table below directly from the formula.
| A1C | eAG (mg/dL) | eAG (mmol/L) |
|---|---|---|
| 5.0% | 97 mg/dL | 5.4 mmol/L |
| 6.0% | 126 mg/dL | 7.0 mmol/L |
| 6.5% | 140 mg/dL | 7.8 mmol/L |
| 7.0% | 154 mg/dL | 8.6 mmol/L |
| 7.5% | 169 mg/dL | 9.4 mmol/L |
| 8.0% | 183 mg/dL | 10.2 mmol/L |
| 8.5% | 197 mg/dL | 11.0 mmol/L |
| 9.0% | 212 mg/dL | 11.8 mmol/L |
| 10.0% | 240 mg/dL | 13.4 mmol/L |
Computed from eAG = 28.7 × A1C − 46.7. The mmol/L column divides by 18. The ADAG authors, as summarized on the Metabolicum page, describe individual variation of about ±15 mg/dL at any A1C, so your real average can differ from the table.
Worked example, with made-up numbers. Suppose a lab reports an A1C of 7.4%. The formula gives 28.7 × 7.4 − 46.7 = 165.7 mg/dL. If a continuous glucose monitor worn for two weeks shows a mean glucose of 150 mg/dL, the gap is about 16 mg/dL, roughly the size of the ±15 mg/dL individual variation the ADAG authors described, so nothing here is alarming on its own. A bigger or repeated gap is worth raising with your clinician, because the NIDDK recommends comparing A1C with home glucose or CGM data and checking the accuracy of the results when they disagree. Use the site’s A1C and average glucose calculator to try your own numbers, or read how to calculate average glucose from A1C for the arithmetic.
Two anchors are worth memorizing from the table. An A1C of 7.0% corresponds to an eAG of about 154 mg/dL, and 8.0% corresponds to about 183 mg/dL. Said plainly, moving the goal from below 7% to below 8% means accepting an average glucose roughly 29 mg/dL higher, in exchange for less risk of low blood sugar and a simpler regimen. That is the tradeoff behind a looser goal.
Other targets that sit beside A1C
A1C is a three-month average, and it hides the shape of your days. The ADA also lists targets for individual readings and for continuous glucose monitor data. According to the US Pharmacist summary of the 2023 Standards and a Diatribe summary of the same Standards, many non-pregnant adults aim for a before-meal (preprandial) capillary glucose of 80 to 130 mg/dL and a peak after-meal (postprandial) glucose below 180 mg/dL, measured one to two hours after the start of the meal. Our normal blood sugar chart goes deeper on those ranges.
For continuous glucose monitor users, the international consensus on time in range, led by Battelino and presented at the ADA Scientific Sessions in June 2019 and described in an American Journal of Managed Care report, sets these targets. I computed the daily minutes myself from the percentages.
| Measure | Most adults | Older or high-risk adults |
|---|---|---|
| Time in range, 70 to 180 mg/dL | More than 70% of the day (about 16 h 48 min) | More than 50% (about 12 h 00 min) |
| Time below 70 mg/dL | Less than 4% (about 58 min) | Less than 1% (about 14 min) |
| Time below 54 mg/dL | Less than 1% (about 14 min) | No separate target given in the source I read |
| Time above 180 mg/dL | Less than 25% (about 6 h 00 min) | Less than 50% (about 12 h 00 min) |
| Time above 250 mg/dL | Less than 5% (about 1 h 12 min) | Less than 10% (about 2 h 24 min) |
Source: AJMC report of the 2019 international consensus (Battelino et al., Diabetes Care 2019). The 2 Minute Medicine summary of the 2026 Standards repeats the time in range above 70% target for most non-pregnant adults. Check the current ADA Standards for updated wording.
These are the metrics the how to read your CGM data guide walks through. A CGM time-in-range goal can give an older person a more useful target than A1C, because it can show how much time is spent low. The 2 Minute Medicine summary of the 2026 Standards recommends continuous glucose monitoring for older adults on insulin. If you do not use a monitor, the CGM vs A1C guide explains what each one measures.
When A1C can mislead you
A1C reflects the sugar attached to hemoglobin in red blood cells, so it depends on both your glucose and how long your red cells live. A National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) page by Randie Little, PhD, published February 12, 2020, says red cell lifespan can change in certain conditions, including certain anemias, sickle cell disease and hemoglobin C disease, significant kidney disease, and liver failure. The same page says hemoglobin variants, such as sickle cell trait, affect some A1C lab methods but not all, that about 7% of people worldwide carry some heterozygous variant, and that many do not know they have one. The National Glycohemoglobin Standardization Program keeps a list of which methods are affected by which variants.
The NIDDK page also says point-of-care A1C devices should not be used for diagnosis, and that the ADA does not recommend them for diagnosis, and it advises comparing A1C with home glucose or CGM averages. If they do not match, one of the tests may be inaccurate. Some other sources mention recent blood loss, blood transfusion, and pregnancy as causes of unreliable A1C. I did not find those on a page I could read, so I list them as things to ask your clinician about, not as established points on this page.
What to do with that: if your A1C and your daily readings tell different stories, say so. A fructosamine test or a CGM-based glucose management indicator might help, but whether either fits your case is a clinical decision. The NIDDK page I read did not describe fructosamine, so I am not recommending a replacement test here.
How often A1C is checked
The NGSP page quoting the ADA’s “Clinical Use” guidance, and the 2023 US Pharmacist summary, both say that people who are meeting treatment goals with stable glycemic control are tested at least two times a year, and people whose therapy has changed or who are not meeting goals are tested quarterly, which means about every three months, and as needed. A1C reflects roughly the last two to three months, which is why the schedule is spaced around a quarter of a year. Our how often to check A1C guide covers the rhythm in more detail.
What to do in each situation
If you have prediabetes
A goal for diabetes does not apply, because prediabetes is a risk category and not a diagnosis of diabetes. The National Kidney Foundation lab values page and a Johns Hopkins diabetes guide table list an A1C of 5.7 to 6.4% as the prediabetes range and 6.5% or higher as the diabetes range. Read what does an A1C of 5.7 mean and the complete A1C and glucose guide. Questions for your clinician usually center on how often to retest and what to change in food, movement, and sleep.
If you have type 2 diabetes and take no glucose-lowering medicine
The general goal of below 7% is a reasonable starting point to discuss. Because that group generally avoids medicines that cause low blood sugar, one of the main reasons for a looser goal is less likely to apply, and whether a lower goal fits is something to talk about with your clinician. For food and movement, see the diabetes food guide, diets compared, and what the evidence says about lowering A1C without medication.
If you are an older adult, or caring for one
Ask which row of the ADA health-status table applies and why. Bring a short list of falls, low-sugar episodes, trouble with pills or injections, and what the person can still do independently. The goal is to fit treatment to the person, and a looser number can reflect safety. If low blood sugar is a worry, ask whether a continuous monitor could help.
If you take insulin or a sulfonylurea
The ADA older-adult table lists severe or recurrent hypoglycemia on insulin and on “high-risk non-insulin agents” as reasons to simplify or de-intensify treatment. I did not see the table name which drugs are in that group, and I am not dosing anything here. Do not change a dose or stop a medicine because of a number in this article. If your A1C is lower than your goal and you notice shakiness, sweating, or confusion, contact your care team promptly about low blood sugar. If you do not know which of your medicines can cause lows, ask your pharmacist.
How to talk with your clinician about your target
You do not have to memorize guidelines to have a good conversation. Come with three things: your last few A1C results with dates, anything that has changed in your health, and any low blood sugar episodes, including mild ones. Ask what your target is, who set it, and when it would be revisited. If your target is below 7% and you are older or have complications, ask whether it is still the right number. If your target is looser and you feel well, ask what would make a tighter one reasonable. Targets are meant to be re-evaluated, and the US Pharmacist summary of the 2023 Standards says so in as many words: targets should be individualized and re-evaluated.
Twelve questions to bring
- What is my A1C target, and what is it based on?
- Which row of the ADA older-adult health-status table, if any, fits me?
- Do any of my medicines raise my risk of low blood sugar?
- How often should my A1C be checked, given my current numbers?
- Could anything about my blood, kidneys, or liver make my A1C less reliable?
- If my A1C and my home readings disagree, what should we do?
- Would a continuous glucose monitor be useful for me, and what time-in-range target would fit?
- What counts as a low for me, and what should I do when I have one?
- Under what circumstances would you want to loosen my goal, or tighten it?
- What is my target for blood pressure and cholesterol, and are they tied to my A1C goal?
- Is there a simpler way to treat my diabetes that gets the same result?
- When should we revisit all of this?
Common mistakes
- Treating 7% as a pass mark. It is a general starting point. A looser goal can be the right one for you.
- Using an age chart as a rule. The ADA’s older-adult table sorts by health status, not by decade.
- Ignoring lows. A low A1C that comes with frequent low blood sugar is not a good outcome.
- Comparing A1C with a neighbor’s. Different health, medicines, and risk justify different targets.
- Trusting the number when it conflicts with your readings. Some blood conditions distort it. Ask about it.
- Changing medicine on your own. Doses and de-intensifying are decisions for your prescriber.
Myth versus fact
| Common belief | What the sources say |
|---|---|
| “Everyone with diabetes should have an A1C under 7%.” | The ADA general goal is below 7% for many non-pregnant adults, and reported guidance describes looser goals such as below 8% for people with hypoglycemia history, limited life expectancy, advanced complications, or many other conditions. |
| “My goal gets looser every decade.” | The ADA older-adult table sorts by health and function. A healthy older adult can have a goal near 7.0 to 7.5%. |
| “A lower A1C is always better.” | Goals are set without significant hypoglycemia. A number reached through repeated lows is not the aim. |
| “A1C is a perfect average.” | It estimates average glucose with individual variation of about ±15 mg/dL according to a secondary summary of the ADAG study, and can be distorted by some anemias, hemoglobin variants, kidney disease, and liver failure. |
| “A looser goal means my doctor gave up.” | In the ADA table, a looser goal is part of the plan to reduce harm and keep function. |
Frequently asked questions
What is a good A1C for someone with type 2 diabetes?
For many non-pregnant adults, the ADA general goal is below 7%. Reported guidance describes looser goals, such as below 8%, for some people, and tighter ones for some others if it can be done safely. Your own target should come from your clinician.
What is the A1C goal for people over 65 or over 70?
The ADA does not set one number by age. Its 2024 older-adult table gives below 7.0 to 7.5% for healthy older adults, below 8.0% for those with complex or intermediate health, and advises avoiding reliance on A1C for those in very poor health.
Is an A1C of 8% okay?
For some people, such as those with a history of severe low blood sugar or advanced complications, reported ADA guidance describes a goal below 8% as reasonable. For others it is above the general goal. Ask your clinician what your target is.
What average glucose does an A1C of 7% equal?
Using the ADAG formula, 28.7 × 7 − 46.7 is about 154 mg/dL, and individual variation of about ±15 mg/dL is described by a secondary summary of the study.
Can my A1C be wrong?
It can be affected by conditions that change red blood cell lifespan or by hemoglobin variants. The NIDDK lists certain anemias, sickle cell disease, hemoglobin C disease, significant kidney disease, and liver failure. Ask whether your lab method is affected if your numbers do not fit your readings.
How often should I get an A1C test?
Reported ADA guidance says at least two times a year when meeting goals with stable control, and quarterly when therapy has changed or goals are not being met.
Should I aim for an A1C below 6.5%?
An older ADA executive summary describes a goal closer to non-diabetic levels, below 6.5%, for people with short-duration diabetes and long life expectancy, if it can be reached without significant hypoglycemia. Whether it fits you is a conversation for your clinician.
Is time in range better than A1C?
They measure different things. A1C is a three-month average. Time in range shows how much of the day is spent between 70 and 180 mg/dL, and how much is spent low. Many people use both.
What is the A1C goal for children with diabetes?
A DiabetesEd.net page describes a general ADA target of 7% or less for pediatrics, individualized. Children and pregnancy have their own guidance, so ask the care team.
Does this article tell me what my A1C target should be?
No. It describes what published guidance reports. Your target depends on your health, medicines, and risk of low blood sugar, and is set with your clinician.
Sources
- US Pharmacist: Recommended glycemic targets and value of routine monitoring (Nov 29, 2023, citing the 2023 ADA Standards)
- ADA Standards of Care 2024, Section 13, Table 13.2 (older adults)
- Diatribe: Current targets for lipids, cholesterol, blood pressure, time in range, and A1C
- 2 Minute Medicine: ADA Standards of Care in Diabetes 2026 quick reference
- HCPLive: A1C target, when a less stringent goal may be appropriate
- NGSP: ADA clinical use of A1C
- AJMC: ADA issues time-in-range targets for CGM use (June 13, 2019)
- NIDDK: Interpreting A1C, diabetes and hemoglobin variants (Feb 12, 2020)
- MDedge: HbA1c expressed as estimated average glucose
- Metabolicum: Nathan 2008, the ADAG study
- DiabetesEd.net: pediatric glucose targets
- National Kidney Foundation: understanding your lab values
The ADA Standards of Care, PubMed, and the CDC were not reachable from the tools used to prepare this page, so the Standards are cited through summaries and tables. Individual targets should be confirmed with your care team.
About the author: Charles Kirkland is the founder of Metabolic Clarity Labs and author of The Journey Back. He is not a physician. This is general education, not a medically reviewed treatment plan.
Sources checked October 31, 2026. Discuss personal decisions with a qualified clinician. Do not start, stop, or change prescribed treatment based on this article.
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