What you should know about the A1c test

Proper diagnosis and management of diabetes is essential to avoiding serious complications such as kidney disease, glaucoma and heart disease. The A1c test is used by doctors to diagnosis Type 1 and Type 2 diabetes as well as gauge how well patients are managing their blood sugar levels.

What does A1c stand for?

A1c is a component of your blood's hemoglobin. It is also sometimes referred to as HbA1c, glycosylated or glycated hemoglobin. Hemoglobin is the part of the blood that carries oxygen to different parts of the body. When there is sugar in the blood stream, it links to part of the hemoglobin and creates A1c.

What does A1c have to do with diabetes?

While it is normal for all individuals to have some A1c in their hemoglobin, too much is an indication of excess blood sugar and, possibly, diabetes.

How is the A1c test different from self-monitoring blood glucose tests?

Blood glucose tests you do at home offer only a snapshot of your current blood sugar level. They do not provide any indication as to whether your blood glucose has been properly managed over a period of time. By measuring how much A1c is in your bloodstream, doctors can evaluate how well your blood sugar has been maintained for the past two to three months.

How is A1c measured?

The A1c test is a laboratory test. You'll need to have a sample of blood drawn which is then analyzed.

What do my A1c test results mean?

According to the National Institutes of Health, having an A1c level of less than six percent is considered normal. The institutes also offer the following guidelines for A1c test results:

  • Normal: Less than 5.7 percent
  • Pre-diabetes: 5.7 - 6.4 percent
  • Diabetes: Greater than 6.5 percent

In addition, the NIH says seven percent is a common goal for those with diabetes. Should your A1c levels consistently be higher than that, you may be at increased risk for complications. However, each case is unique, and your health care provider may set a different goal for you. Discussing your test results with your provider is important not only to understand how well your diabetes is being managed, but also to create a plan to reduce your blood sugar levels if needed.

When should I have the A1c test done?

If your doctor suspects you may have diabetes, an A1c test may be ordered to confirm the diagnosis. After you have been diagnosed, the American Diabetes Association recommends repeating the test at least twice a year to ensure your treatment plan is working effectively. In addition, you may have the A1c test done more frequently if your medication or treatment plan should change.

If I've recently had an A1c test, can I skip home testing?

No, the A1c test does not replace daily testing at home. Self-monitoring blood glucose tests are an important component of managing your diabetes and ensuring your glucose levels are at a safe level on a daily basis. Also, insulin cannot be adjusted based upon the A1c test so it is vital that diabetes patients check their blood sugar daily and keep an accurate log of the results.

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About Maryalene LaPonsie

Maryalene LaPonsie spent 13 years as a constituent case manager in the Michigan Legislature  helping individuals address concerns regarding Medicaid eligibility, medical insurance claims and government regulations. Today, she reports on a variety of issues including health insurance, health reform and affordable health care options. Maryalene holds a bachelor’s degree in political science from Western Michigan University.

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