If you have diabetes or are at risk for developing it, your doctor might recommend a hemoglobin A1C test. This important blood test helps assess how well your blood sugar has been managed over time. Also known as the HbA1C test or glycated hemoglobin test, it measures your average blood sugar levels over the last three months. But what exactly does this test show, and who should get it?
Mark Bridenstine, MD, an endocrinologist at Banner Health in Loveland, CO, offers insights on the purpose of the A1C test and why monitoring your A1C levels can be an essential part of managing your health.
Who needs an A1C test for diabetes and blood sugar monitoring?
Your doctor may recommend an A1C test if you:
- Are at higher risk of developing diabetes or have prediabetes
- Could be diagnosed with diabetes, particularly type 2 diabetes
- Have diabetes and need to monitor how well your blood sugar is controlled
The A1C test is not just for those with diabetes but also for people at risk of developing it. It’s a valuable tool to diagnose prediabetes, which can be a precursor to type 2 diabetes. Early diagnosis helps prevent complications and improves long-term health outcomes.
How does the A1C test work?
The A1C test is a simple blood test, often done in a lab. You can also perform it with a finger-stick blood sample in some cases. This test measures the percentage of glycated hemoglobin, or hemoglobin that has glucose (sugar) attached to it. When sugar enters your bloodstream, it binds to hemoglobin, a protein in red blood cells that carries oxygen. The more glucose in your blood, the higher the percentage of glycated hemoglobin.
Understanding your A1C test results: Diagnosing diabetes and prediabetes
An A1C result reflects your average blood sugar levels over the past three months. This time frame corresponds to the average lifespan of a red blood cell, which is around 90 days. Unlike a regular blood glucose test, which shows your current blood sugar level at a specific moment, the A1C provides a long-term picture.
For example, if your A1C result is 7.0%, it means that 7% of your hemoglobin molecules are coated with sugar. According to the American Diabetes Association (ADA), an A1C level of 6.5 or higher on two separate tests confirms a diagnosis of diabetes.
The ADA interprets A1C results as follows:
- A1C below 5.7%: Normal, no diabetes
- A1C between 5.7% and 6.4%: Prediabetes, indicating an increased risk of developing diabetes
- A1C of 6.5 or higher: Indicates diabetes. To confirm the diagnosis, this result needs to be seen on two separate tests.
It’s important to remember that a single A1C test may not be the only factor in determining a diabetes diagnosis. Doctors may also consider other factors like fasting blood sugar levels, glucose tolerance tests and your overall health.
Ideal A1C levels
For most people with diabetes, the target A1C level is typically 7.0% or less. However, the ideal range for each person may vary depending on several factors, including:
- Age
- How long you’ve had diabetes (duration)
- Risk of diabetes complications
- Overall health
- Other existing medical conditions
- Your risk of hypoglycemia (low blood sugar)
- Your ability to manage your diabetes with medication
Your health care provider will help determine what A1C level is best for you based on these considerations.
Managing your A1C and understanding the risks
Keeping your A1C levels within a healthy range is important for preventing diabetes complications. A well-controlled A1C helps reduce your risk of damage to your eyes, kidneys, nerves and heart. However, high A1C levels mean your diabetes is not well controlled, which can increase your risk for these health issues.
There are several ways to manage your A1C levels effectively:
- Dietary changes: Limiting processed foods, avoiding sugary drinks and eating smaller portions of high-calorie or high-carbohydrate foods can help. Focus on a balanced diet with plenty of whole grains, vegetables, and lean proteins.
- Exercise: Regular physical activity is key to managing blood sugar. Even short bouts of exercise, like a 10-minute walk after meals, can help lower A1C. Find activities you enjoy to make exercise a sustainable part of your routine.
- Medications: In some cases, lifestyle changes alone may not be enough to control your A1C. If needed, your doctor can recommend diabetes medications to help keep your blood sugar in check.
If your A1C levels remain high, you may need to be screened for potential complications, such as kidney damage, nerve damage, or heart disease. According to the American Diabetes Association, diabetes is the seventh-leading cause of death in the United States. It’s also a contributing factor to other leading causes of death, such as heart disease and stroke.
Why A1C monitoring matters
Whether you're at risk for developing diabetes or already have it, keeping your A1C levels in check is essential for preventing or minimizing the impact of diabetes complications. Early diagnosis through A1C testing can help you take steps to lower your risk of developing full-blown diabetes or mitigate the health effects if you're already diagnosed.
Regular monitoring and follow-up tests allow both you and your doctor to evaluate how well your current treatment plan is working and whether adjustments need to be made. Maintaining an A1C below 6.5 or higher can help prevent long-term complications and improve your overall quality of life.
Got more questions? Whether you're trying to diagnose prediabetes or manage type 2 diabetes, your doctor can help determine how often you should have an A1C test. If you're looking to get tested or need further guidance, you can find expert care at Banner Health. To evaluate your risk for diabetes, take our free diabetes risk assessment.
Other useful articles:
- Blood Sugar and How to Keep It Balanced
- Making Healthier Choices: A Guide to Quitting Soda
- The Skinny on Dietary Fats: The Best and Worst for Your Health
Content in this article was updated on October 17, 2024.
