Hemoglobin A1c 9.8 %: Is That High?

Written by

Ernestas K.

Clinical research writer specializing in human health, biology, and preventive medicine.

Reviewed against ADA, CDC, NIH, WHO, Mayo Clinic guidelines · Last reviewed March 17, 2026

Is Hemoglobin A1c 9.8 % Low, Normal, or High?

HbA1c 9.8% is considered high and indicates that blood sugar has been poorly controlled over the past two to three months. The American Diabetes Association defines diabetes as HbA1c of 6.5 percent or above, and at 9.8% your average blood sugar has been significantly elevated. This result needs medical attention, but the important thing to know is that HbA1c can be brought down with the right combination of treatment and lifestyle changes.

Hidden Risk of Hemoglobin A1c 9.8 %

An HbA1c of 9.8% often does not cause dramatic symptoms day to day, which makes it easy to underestimate how much damage elevated blood sugar is doing over time. High glucose works quietly, and complications develop gradually before becoming obvious. The ADA stresses that bringing HbA1c closer to target significantly reduces the risk of long-term complications.

• Every 1 percent reduction in HbA1c reduces the risk of microvascular complications (eye, kidney, nerve damage) by approximately 37 percent according to the landmark UKPDS study
• Persistent high blood sugar damages small blood vessels in the eyes, potentially leading to diabetic retinopathy, the leading cause of vision loss in working-age adults
• Nerve damage (neuropathy) that starts as tingling or numbness in the feet affects about half of all people with diabetes and worsens with prolonged elevated glucose
• Kidney disease risk increases significantly when HbA1c stays above target. The National Kidney Foundation reports that diabetes is the leading cause of kidney failure
• Heart disease and stroke risk are two to four times higher with diabetes, and poor glucose control amplifies this risk further

What Does a Hemoglobin A1c Level of 9.8 % Mean?

HbA1c measures how much glucose has bonded to the hemoglobin in your red blood cells over the past two to three months. Since red blood cells live about 90 to 120 days, this test captures a rolling average rather than a single moment.

At 9.8%, your estimated average blood sugar has been roughly 183 mg/dL. To put that in context, the ADA target for most adults with diabetes is an HbA1c below 7.0 percent, which corresponds to an average blood sugar around 154 mg/dL. Your reading is about one full percentage point above that target.

What this tells you is that your body is not managing glucose effectively enough with your current treatment plan. Either you are producing too little insulin, your cells are highly resistant to the insulin being produced, or both. In type 2 diabetes, insulin resistance is usually the primary driver, often worsened by excess weight, inactivity, and dietary patterns. In type 1 diabetes, the issue is insufficient insulin production.

An HbA1c of 9.8% means that glucose has been spending too much time circulating in your blood at elevated levels. Over months and years, this excess glucose damages blood vessels and nerves throughout the body. The relationship between HbA1c and complications is well established: the higher and longer blood sugar stays elevated, the greater the risk.

Lifestyle Changes for Hemoglobin A1c 9.8 %

Lifestyle changes are essential for bringing HbA1c down from 9.8%, and they work alongside medication rather than replacing it. Exercise directly lowers blood sugar by moving glucose from the bloodstream into working muscles, and this effect persists for hours after the workout ends.

The ADA recommends at least 150 minutes of moderate aerobic exercise per week. Walking, cycling, swimming, or any activity that raises your heart rate counts. Start where you are. If you are currently inactive, begin with 10-minute walks after meals and build gradually. Post-meal walking is particularly effective because it blunts the blood sugar spike that follows eating.

Weight management has a major impact on insulin resistance. Losing 5 to 10 percent of your body weight can meaningfully improve how your cells respond to insulin and lower HbA1c by 0.5 to 1.0 percentage points. For someone weighing 200 pounds, that is 10 to 20 pounds.

Strength training is valuable because muscle tissue actively absorbs glucose. Building muscle through resistance exercise gives your body more capacity to clear glucose from the blood. Two to three sessions per week complement aerobic exercise.

If you smoke, quitting is critical. Smoking increases insulin resistance, raises blood sugar, and accelerates every vascular complication that diabetes can cause. Sleep and stress management also matter. Poor sleep impairs insulin sensitivity, and chronic stress raises cortisol, which pushes blood sugar higher.

Diet Changes for Hemoglobin A1c 9.8 %

Diet is a cornerstone of managing HbA1c at 9.8%. What and how much you eat directly determines how much glucose enters your bloodstream and how hard your body has to work to manage it. The ADA recommends individualized eating plans that focus on reducing processed carbohydrates and added sugars while ensuring adequate nutrition.

• Reduce refined carbohydrates: white bread, white rice, pastries, chips, crackers, and sugary cereals cause rapid blood sugar spikes. Replace with whole grains, vegetables, and legumes
• Eliminate sugary beverages completely. Soda, juice, sweet tea, and flavored coffee are among the biggest contributors to high blood sugar and are often the easiest category to cut
• Fill half your plate with non-starchy vegetables at every meal: broccoli, spinach, peppers, tomatoes, green beans, cauliflower. These provide fiber and nutrients with minimal glucose impact
• Choose lean proteins: chicken, turkey, fish, eggs, tofu, and legumes. Protein has minimal effect on blood sugar and helps you feel full
• Include healthy fats from olive oil, avocados, nuts, and fatty fish to slow digestion and prevent post-meal spikes
• Practice carb awareness. You do not need to count every gram, but knowing which foods are high in carbohydrates and controlling portion sizes is the single most important dietary skill for managing diabetes
• Use the plate method: half vegetables, quarter lean protein, quarter complex carbs. Simple, effective, and sustainable at every meal

Hemoglobin A1c 9.8 % in Men, Women, Elderly, and Kids

An HbA1c of 9.8% is above target regardless of age or sex, but the approach to management may differ. In men, poorly controlled diabetes increases the risk of erectile dysfunction, which affects an estimated 50 percent of men with diabetes. Men with HbA1c at this level should also be closely monitored for cardiovascular risk, as men with diabetes have significantly elevated rates of heart attack and stroke.

For women, diabetes management is complicated by hormonal fluctuations. Menstrual cycles can cause blood sugar variability, and menopause brings additional insulin resistance. Women with diabetes who are planning pregnancy need to bring their HbA1c as close to normal as possible before conceiving, ideally below 6.5 percent, to reduce risks to both mother and baby.

In elderly adults, the HbA1c target is often relaxed. The American Geriatrics Society recognizes that tight glucose control in older adults can increase the risk of dangerous hypoglycemia, falls, and adverse medication effects. For an older person with multiple health conditions, a target of 7.5 to 8.0 percent may actually be appropriate. Your doctor will individualize the goal based on your overall health.

Type 2 diabetes in children and teenagers has increased dramatically. A young person with HbA1c of 9.8% needs aggressive management because they face decades of potential exposure to high glucose. The American Academy of Pediatrics recommends intensive lifestyle intervention and medication as needed, with an HbA1c target below 7.0 percent for most youth with diabetes.

Medicine Effects on Hemoglobin A1c 9.8 %

With HbA1c at 9.8%, medication is almost certainly part of your treatment plan, and your current regimen may need adjustment. The ADA recommends that most people with diabetes aim for an HbA1c below 7.0 percent, and reaching that target from 8.0 usually requires medication optimization alongside lifestyle changes.

• Metformin is typically the first-line medication. It reduces liver glucose output and improves insulin sensitivity. If you are already on metformin and your HbA1c is still 8.0, additional medication is likely needed
• SGLT2 inhibitors (empagliflozin, dapagliflozin) lower blood sugar by helping your kidneys remove excess glucose through urine. They also offer heart and kidney protective benefits
• GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide) lower blood sugar, reduce appetite, and promote weight loss. These are increasingly used as second-line therapy after metformin
• Sulfonylureas (glipizide, glimepiride) stimulate insulin production and are effective but carry a risk of hypoglycemia and weight gain
• Insulin may be necessary if oral medications and GLP-1 agonists do not bring HbA1c to target. Starting insulin is not a failure. It means your pancreas needs help
• Talk to your doctor about whether your current medications are doing enough. An HbA1c of 9.8 is a signal that something in the treatment plan should change

When to Retest Hemoglobin A1c 9.8 %

With HbA1c at 9.8%, you should expect to retest every three months until your numbers stabilize closer to target. This cadence allows your doctor to assess whether treatment changes are working and make adjustments quickly if needed.

If your medication or lifestyle plan was recently changed, give it a full three months before retesting. HbA1c reflects a two to three month average, so changes you make today will not fully show up in the results for about 12 weeks.

Your doctor may also recommend regular fasting glucose checks or post-meal glucose monitoring at home. A home glucose meter provides day-to-day data that complements the HbA1c trend. Many people find that daily monitoring makes them more aware of how food, exercise, and stress affect their numbers.

Continuous glucose monitors (CGMs), which provide real-time blood sugar readings throughout the day, are increasingly available and may be covered by insurance for people with HbA1c in this range. CGMs give the most detailed picture of glucose patterns and can help identify specific meals, times of day, or habits that drive blood sugar higher.

Hemoglobin A1c 9.8 % — Frequently Asked Questions

When to See a Doctor About Hemoglobin A1c 9.8 %

An HbA1c of 9.8% calls for a conversation with your doctor soon, ideally within the next week or two. This result indicates that your current approach to blood sugar management is not producing adequate control, and adjustments are needed. This could mean changing medications, adding a new medication, fine-tuning insulin doses, or developing a more structured diet and exercise plan.

Bring a list of your current medications, your typical eating habits, your exercise routine, and any home glucose readings you have. The more context your doctor has, the better they can tailor your plan. If you have been struggling with diet, medication adherence, or exercise, be honest about it. Your doctor needs accurate information to help effectively.

Ask about referrals to a diabetes educator or a certified diabetes care and education specialist (CDCES). These professionals provide practical, day-to-day guidance on meal planning, glucose monitoring, medication management, and problem-solving that complements your doctor's medical oversight.

Also ask about screening for diabetes complications if you have not been checked recently. At HbA1c 9.8%, your doctor should be monitoring your eyes (annual dilated eye exam), kidneys (urine albumin test), feet (neuropathy screening), and cardiovascular risk factors. Catching complications early is far better than discovering them late.