Everything about your A1C (2024)

What has your blood sugar been doing lately? Get an A1C test to determine your average values. It is important to know whether you are at risk for prediabetes or type 2 diabetes, or whether you have diabetes under control.

The A1C test – also called the hemoglobin A1C or HbA1c test – is a simple blood test that measures your average blood sugar level over the past 3 months. It is one of the most commonly used tests to make a diagnosisprediabetesIndiabetes mellitus,and is also the most important test to help you and your healthcare provider manage your diabetes. Higher A1C levels are associated with diabetes complications, so it is very important to reach and maintain your individual A1C goal if you have diabetes.

What does the A1C test measure?

When sugar enters the bloodstream, it binds to hemoglobin, a protein in your red blood cells. Everyone has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that contain sugar-coated hemoglobin.

Who should get an A1C test and when?

To testfor diabetes or prediabetes:
Get a baseline A1C test if you are an adult over 45 years old - or if you are under 45 years old, overweight and have one or morerisk factorsfor prediabetes or type 2 diabetes:

• If your result is normal, but you are over 45 years old, have risk factors, or have ever had gestational diabetes, you should repeat the A1C test every 3 years.
• If your result shows that you have prediabetes, talk to your doctor about taking steps to improve your health and reduce your risk of type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.
• If you haven'tsymptomsbut your result shows that you have prediabetes or diabetes, you should take another test on another day to confirm the result.
• If your examination shows that you have diabetes, ask your doctor for a referralinformation and support for diabetes self-managementso you can get the best start in managing your diabetes.

Controldiabetes:
If you have diabetes, get an A1C test at least twice a year, more often if your medications change or if you have other health problems. Discuss with your doctor how often is best for you.

How to Prepare for Your A1C Test

The test is performed in a doctor's office or laboratory using a blood sample from a finger prick or from your arm. You don't need to do anything special to prepare for your A1C test. However, ask your doctor whether other tests will be performed at the same time and whether you should prepare for them.

Your A1C result

Diagnose van prediabetes of diabetes

A normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the prediabetes range of 5.7% to 6.4%, the higher your A1C, the greater your risk of developing type 2 diabetes.

Manage diabetes
Your A1C result may also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you are used to seeing on your blood glucose meter:

What can affect your A1C result?

Several factors can falsely increase or decrease your A1C result, including:

• Kidney failure, liver disease, or severe anemia.
• A less common type of hemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anemia or thalassemia) may have.
• Certain medications, including opioids and some HIV medications.
• Blood loss or blood transfusions.
• Early or late pregnancy.

Tell your doctor if any of these apply to you and ask if you need further tests to find out.

Your A1C goal

The goal for most people with diabetes is 7% or less. However, your personal goal will depend on many things, such as your age and any other medical conditions. Work with your doctor to determine your own individual A1C goal.

Younger people have more years of diabetes ahead of them, so their goals may be lower to reduce the risk of complications unless they often suffer from hypoglycemia (low blood sugar or "the low"). People who are older, have had serious falls, or have other serious health problems may have a higher goal.

A1C: Just part of the toolbox

A1C is an important tool in managing diabetes, but it does not replace regular home blood glucose testing. Blood sugar levels go up and down day and night, which is not captured by your A1C. Two people can have the same A1C, one with stable blood sugar levels and the other with high and low fluctuations.

If you're reaching your A1C goal but have symptoms of high or low levels, check your blood sugar more often and at different times of the day. Keep track of the results and share them with your doctor so you can make changes to your treatment plan if necessary.

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