The hemoglobin A1C test is the closest thing to a diabetes scorecard you can find. Whether someone has had diabetes mellitus for years or if they have just been diagnosed, they have probably heard about this test. Unlike blood sugar meters people use at home, the A1C measures an average blood sugar level over the past several months by analyzing how many of a patient’s hemoglobin cells have glucose attached to them. The test results keep track of how well a person is managing his or her diabetes. Show
What does A1C stand for?Hemoglobin A1C (HbA1C), commonly called A1C, stands for glycosylated hemoglobin. An A1C test (sometimes called the HbA1C test or glycohemoglobin test) provides information on how well-controlled a person’s diabetes is. “It does this by measuring the percentage of red blood cell hemoglobin protein that has sugar stuck to it and provides a three-month average of your blood glucose levels,” explains Marie Bellantoni, MD, a board-certified endocrinologist at the Center for Endocrinology at Mercy Medical in Baltimore. The higher blood sugar levels are, the more glucose attaches to hemoglobin. The results provide patients and their healthcare providers with information on how well their treatment, diet, and medication is working and whether adjustments are necessary. RELATED: Diabetes medications and treatments A1C testThere are a few reasons a doctor might suggest an A1C test:
The A1C blood test is not for diagnosing Type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Do you have to fast for an A1C blood test?Unlike the fasting plasma glucose (FPG) and the OGTT tests, there is no need to fast before having the A1C test. If A1C test results indicate a person has or might have diabetes, a healthcare provider might suggest one of these tests to confirm the results. Another test, the random plasma glucose test, which does not require fasting, can also be used. If the results are borderline or if the results of the different tests do not match, a doctor might suggest repeating the test in several weeks or months. How accurate are A1C tests?A1C levels rise well before the clinical onset of diabetes, making early diagnosis possible according to the 2017 Standards of Medical Care in Diabetes by the American Diabetes Association (ADA). Sometimes, however, in the early stages of diabetes, blood sugar levels are not high enough to show up as problematic. Testing environments, such as temperature in the lab, equipment used, and handling of samples, can affect the results; however, this is more common in the fasting plasma glucose and the OGTT than in the A1C. Strict quality controls and advancements in testing have made the A1C test more precise than in the past, according to the NIDDK. Doctors should be aware of laboratories that use an NGSP-certified method of testing for A1C levels. The NIDDK warns that blood samples taken at home or analyzed in a healthcare provider’s office should not be used for diagnosis. There are some health conditions and situations that might skew the results of the test. These include:
Also, the test can be unreliable for people of African, Mediterranean, or Southeast Asian descent, people with a family member with sickle cell anemia, and those with thalassemia. For those who fall into these groups, a healthcare provider might suggest a different test or a specialized A1C. How often is A1C tested?To keep A1C levels in check, patients should have the test repeated regularly. “If the A1C is less than 5.7, indicating you don’t have diabetes, you should have it checked every three years,” according to Robert Williams, MD, a family doctor and geriatrician in Lakewood, Colorado, and a medical advisor for eMediHealth. “If it is between 5.7 and 6.4, indicating you are at risk of developing diabetes, you should have it rechecked every one to two years. If you have a confirmed diabetes diagnosis, and your blood sugar is well-controlled, you should have an A1C test every six months. If you already have diabetes and your medications change, or your blood sugar is not well-controlled, you should have an A1C test every three months.” Normal A1C levelsThere are some general guidelines for interpreting A1C results. However, there are also exceptions, according to the ADA. The general guidelines are:
For reference, normal A1C levels for people without diabetes is 4% to 5.6%. What is a good A1C level?Levels between 5.7 and 6.4 are considered prediabetes. For most people with diabetes, the general A1C goal is to have a level between 6.0 and 6.9. While it might sound like the ideal A1C target is under 6.0, for those with diabetes, this level can indicate low blood sugar levels, which can be just as dangerous as high blood sugar levels. If A1C results fall between 7.0 and 8.9, a doctor might suggest lifestyle changes or medications to help lower the levels to what is considered controlled. However, for some people, these levels might be appropriate, such as:
What is a dangerous level of A1C?When levels rise to 9.0, the risk of kidney and eye damage and neuropathy increases. Some people who are newly diagnosed could have levels over 9.0. Lifestyle changes and possibly medication can lower levels quickly. For someone who has long-standing diabetes, levels rise above 9.0 could signal the need for a change in their treatment plan. Some labs estimate average blood glucose (eAG), which corresponds to home glucose meter readings (mg/dL), allowing patients to understand the results better. Why is my A1C high?As blood sugar level rises, so do A1C levels. “A high A1C indicates that blood sugar control is not optimal. This in itself is not an emergency, but it gives your healthcare provider a picture of how blood glucose has, or has not, been controlled,” says Dr. Williams. Poor diabetes control or a need for medication adjustments might cause higher A1C. Diet changes, daily exercise, or medication adjustments might quickly lower A1C. Because Type 2 diabetes is a progressive disease, adjustments to one’s treatment might be a part of the process of controlling diabetes. Poor diabetes control does not always mean a patient is doing something wrong. But there are other reasons why levels might be high. As previously mentioned, other health conditions can cause skewed results. These include kidney disease, anemia, liver disease, asplenia, blood loss, hypothyroidism, uremia, and sickle cell anemia. Other factors that might lead to a high A1C level include increased age, pregnancy, and gestational diabetes. Can you have high A1C and not be diabetic?According to one 2009 study, 3.8% of people without a history of diabetes have an elevated A1C level (over 6.0). This group is more likely to have other risk factors for Type 2 diabetes and cardiovascular disease. Researchers found that the following groups were more likely to have an elevated A1C without having a diagnosis of diabetes:
A high A1C result might signal that there is a problem. “Even a modest increase in your blood sugar, above normal levels, can increase your risk of heart disease, even when you don’t have full-blown diabetes,” says Dr. Bellatoni. A physician can review test results and talk to patients about risk factors and lifestyle changes to improve blood sugar levels. How to lower your A1C levels“It’s important to get your hemoglobin A1C levels as close to normal as possible,” says Dr. Bellatoni, “Decreasing your hemoglobin A1C decreases your risk of having complications from diabetes. Even if you cannot get your A1C back to the normal range, any improvement lowers your risk of diabetes complications.” Diabetes tracking and treatment
Diet changes
Lifestyle changes
Psychological adjustments
Remember, A1C tests measure blood sugar levels over three months. Lifestyle and diet changes take several months before making a meaningful impact. What is a normal A1C for a 60 year old woman?A normal A1C level is below 5.7%. Normal eAG is below 117 mg/dL or 6.5 mmol/L. If someone's A1C levels are higher than normal, they may have diabetes or prediabetes. Their doctor might order a repeat test to confirm this.
What is a normal A1C levels chart?What's a Normal Hemoglobin A1c Test? For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have prediabetes and a higher chance of getting diabetes. Levels of 6.5% or higher mean you have diabetes.
How can I get my A1C down quickly?7 Ways to Improve Your A1C. Exercise. Physical activity helps your body use insulin more efficiently, so it can better process the glucose in your blood. ... . Eat Right. ... . Take Medications as Prescribed. ... . Manage Your Stress. ... . Stick to a Schedule. ... . Drink in Moderation. ... . Monitor Your Numbers.. |