Why is my A1C 6.7% when fasting blood sugar is under 105?

by Sajjad Malik







Question


Hi Doctor,


Please guide me that my daily fasting sugar level always comes less than 105. But after getting A1C my result comes 6.7%.


Kindly advice what it means. I was quite satisfied that I was under control.


Please also note that I am not taking any medicine. I only use your tips of Natural remedies.


Thanks.


—Sajjad Malik





Quick Answer


An A1C of 6.7% is in the diabetes range. If you have not previously been diagnosed, the result should be repeated promptly with an NGSP-certified laboratory method or confirmed with another accepted laboratory test.


Fasting readings below 105 mg/dL do not prove that glucose is normal throughout the day. You may have after-meal spikes, the home meter may be missing higher periods, or the A1C may be affected by anemia, altered red-cell survival, kidney disease, or a hemoglobin variant.


Do not rely only on natural remedies or change treatment from one result. Arrange a clinical review, repeat laboratory testing, and check after-meal glucose patterns.




Answer by Dr. Albana Greca, MD, MMedSc



Hello Sajjad,


Fasting glucose measures one moment after an overnight fast. A1C reflects glucose exposure across the day and night over roughly two to three months.



What Does A1C of 6.7% Mean?



  • Normal: below 5.7%

  • Prediabetes: 5.7–6.4%

  • Diabetes: 6.5% or higher when appropriately confirmed


An A1C of 6.7% corresponds to an estimated average glucose near 146 mg/dL and is not normal.


If diabetes is already diagnosed, 6.7% may be near a common treatment goal, but a treatment target is not the same as normal.




Why “Below 7%” Does Not Mean Normal


A target near 7% balances benefit, treatment burden, and hypoglycemia risk in many people with diabetes; it does not define normal glucose.




Can Diabetes Be Present With Fasting Glucose Below 105?


Yes. A1C, fasting plasma glucose, and the oral glucose tolerance test measure different aspects of glucose metabolism.


If repeat A1C remains at least 6.5%, diabetes can be confirmed even when fasting plasma glucose is below 126, provided the assay is reliable.


Our diabetes blood-test guide compares the diagnostic tests.



Why Might Fasting Readings Look Better Than A1C?



  • After-meal spikes: breakfast, lunch, or dinner glucose may rise substantially while fasting remains near normal.

  • Limited testing: one morning reading misses most of the day.

  • Meter variation: home meters are less precise than laboratory testing.

  • Testing technique: strips, sample size, temperature, and meter condition affect readings.

  • Recent improvement: A1C may still reflect earlier higher weeks.

  • A1C interference: red-cell or hemoglobin conditions may falsely increase or decrease the result.


Check our after-meal glucose guide for meal-related patterns.



Could the A1C Be Falsely High?


Possibly. A1C depends on glucose exposure and red-cell lifespan. It may be misleading with:



  • Iron-deficiency anemia

  • Some hemoglobin variants or assay interference

  • Kidney or liver disease

  • Recent changes in anemia treatment

  • Other conditions affecting red-cell turnover


Hemoglobin variants are more common with South Asian, Southeast Asian, African, and Mediterranean ancestry. Effects depend on the assay.


Blood loss, hemolysis, transfusion, or shortened red-cell survival may make A1C falsely low. Discordance should be investigated.



What Tests Should Be Done Next?



  1. Repeat laboratory A1C using an NGSP-certified method.

  2. Obtain laboratory fasting plasma glucose.

  3. Check two-hour after-meal glucose for several days if advised.

  4. Consider a 75-gram oral glucose tolerance test if uncertain.

  5. Review blood count, iron, kidney, and liver tests when indicated.

  6. Ask which A1C method was used if a hemoglobin variant is suspected.


If discordance persists, consider CGM, fructosamine, or glycated albumin. See our A1C guide.



How Should Home Glucose Be Checked?


Wash and dry your hands, use unexpired strips, and compare the meter with a laboratory glucose when possible. A short profile may include:



  • Fasting

  • Before a meal

  • About two hours after the start of the meal

  • At bedtime


This pattern is more informative than checking only fasting glucose.



Are Natural Remedies Enough?


No herb, tea, spice, or supplement has proved able to replace appropriate diabetes treatment. Some products interact with medicine or contain undeclared ingredients.


Meals, activity, sleep, weight management, and avoiding tobacco matter, but medication may still be needed. See our herbs safety guide.




Do Not Delay Medical Review


Arrange prompt follow-up rather than continuing natural remedies alone. Seek earlier care for increased thirst, frequent urination, unexplained weight loss, blurry vision, recurrent infections, or persistently high glucose.


Urgent care is needed for very high glucose with vomiting, abdominal pain, deep breathing, dehydration, confusion, or marked drowsiness.




Does A1C of 6.7% Automatically Require Medicine?


Not from an online answer alone. Confirm the diagnosis and investigate the mismatch. Treatment should consider age, weight, kidney function, cardiovascular risk, symptoms, and preferences.


An individualized goal does not make a new diabetes-range result normal. The clinician should decide whether medication is needed.



Remember: A1C 6.7% is in the diabetes range, not normal. Fasting readings below 105 may miss after-meal highs, and A1C can be affected by blood conditions. Repeat laboratory A1C and fasting glucose, review after-meal readings, and do not rely only on natural remedies.




Written by: Dr. Albana Greca, MD, MMedSc, Family Physician

Medically reviewed by: Dr. Ruden Cakoni, MD, Endocrinologist

Last medically reviewed: August 5, 2026


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Safety note: A diabetes-range A1C requires confirmation and clinical review; do not change treatment from a home-meter pattern alone.



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