All About Your A1C

What is A1C and should you get tested?

What has your blood sugar been up to lately? If you’re at risk for prediabetes or type 2 diabetes, or if you’re managing diabetes, an A1C test can answer that question.

The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood glucose (sugar) levels over the past 3 months. A1C tests are often used to diagnose prediabetes and diabetes. They’re also the main test to help you and your health care team manage your diabetes. Because higher A1C levels are linked to diabetes complications, reaching and maintaining your individual A1C goal is crucial.

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

When Should You Get an A1C Test?

Get a baseline A1C test if you’re an adult who’s 45 or older – or if you’re under 45, overweight, and have one or more of the following risk factors for prediabetes or type 2 diabetes:

• A parent, brother, or sister with Type 2 diabetes

• You are physically active less than 3 times a week

• History of gestational diabetes

• You are African American, Hispanic or Latino, American Indian, or Alaska Native

Prepare for Your A1C Test

The A1C test is done in a doctor’s office or a lab using a sample of blood from a finger stick or from your arm.

You don’t need to do anything special to prepare for your A1C test; however, ask your doctor if other tests will be done at the same time and if you need to prepare for them.

Your A1C Results

For Diagnosing Prediabetes or Diabetes

• Normal: Below 5.7%

• Prediabetes: 5.7% to 6.4%

• Diabetes: 6.5% or above

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 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

For Managing Diabetes

Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your blood sugar meter:

A1C testing is a valuable ally in the fight against diabetes. Knowing your results lets you and your health care team work together to manage this chronic condition.

After Your A1C Test

If your result is normal but you’re over 45, have risk factors, or have ever had gestational diabetes, repeat the A1C test every 3 years.

If your result shows you have prediabetes, talk to your doctor about steps now to improve your health and lower your risk for type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.

If you don’t have symptoms but your result shows you have prediabetes or diabetes, get a second test on a different day to confirm the result.

Symptoms to watch for:

• Frequent urination, often at night

• Losing weight without trying

• Increased thirst

• Increased hunger

• Blurry vision

• Numb or tingling hands or feet

• Fatigue

• Very dry skin

• Sores that heal slowly

• Having more infections than usual

If your test shows you have diabetes, ask your doctor to refer you to diabetes self-management education and support services so you can have the best start in managing your diabetes.

If you have diabetes, get an A1C test at least twice a year. Test more often if your medicine changes or you have other health conditions. Talk to your doctor about what’s right for you.

Lifestyle Tips

Stay active. Current guidelines recommend that adults get a minimum of 150 minutes of moderate physical exercise each week. If you use insulin or have other conditions, talk to your doctor about a suitable exercise plan. Housework, gardening, and other routine activities can also keep you moving.

Monitor your blood glucose. This is crucial to ensure you meet your targets and make any necessary changes.

Follow your treatment plan. This includes the use of medications and lifestyle therapies.

Manage your weight. Consider working with a health care professional to set realistic and achievable weight loss goals.

Track your progress. This is useful for self-motivation, monitoring changes, and identifying which strategies work for you.

Enlist support. Lifestyle changes are often easier to adopt if other people can encourage and monitor your progress.

By Jenny L. Workman