Quick Guide

The A1C test diagnoses type 1 and type 2 diabetes and monitors blood sugar management for those with diabetes. Your A1C test result indicates your average blood sugar level over the past two to three months by measuring the percentage of hemoglobin proteins coated with sugar in your blood. Higher A1C levels indicate poorer blood sugar control and an increased risk of diabetes complications.

Other Names

HbA1c test

Glycated hemoglobin

Glycosylated hemoglobin

Hemoglobin A1C

Why A1C is done

The results of an HbA1C test assist your doctor or healthcare provider in:

• Identifying prediabetes, which increases the risk of developing diabetes and cardiovascular disease.
• Confirming type 1 and type 2 diabetes. For a diabetes diagnosis, your doctor will likely examine the results of two blood tests on different days—either two A1C tests or the A1C test combined with another test, such as a fasting or random blood sugar test.
• Monitoring your diabetes treatment plan. The initial A1C test result establishes your baseline A1C level, and subsequent tests are regularly performed to track your diabetes treatment plan.

Frequency of test needed

The frequency of HbA1C tests depends on factors such as the type of diabetes, your treatment plan, adherence to treatment goals, and your doctor’s clinical judgment. For instance:

• Once a year if you have prediabetes.
• Twice a year if you don’t use insulin and consistently maintain your blood sugar level within the target range.
• Four times a year if you take insulin or struggle to keep your blood sugar level within the target range.
• More frequent HbA1C tests may be necessary if there are changes to your diabetes treatment plan or if you start a new diabetes medication.

When would you need an A1C test?

If you’re not diagnosed with diabetes, a healthcare provider might prescribe an HbA1C test if you exhibit symptoms of the condition, such as:

• Intense thirst (polydipsia).
• Increased urination (peeing).
• Blurry vision.
• Fatigue or constant tiredness.

Additionally, you might undergo an HbA1C test to screen for Type 2 diabetes if you’re at risk. Risk factors encompass:

• Family history of Type 2 diabetes.
• Personal history of gestational diabetes.
• Obesity.
• Lack of physical activity or exercise.
• Being over the age of 35.

Test requirements

You don’t need to fast before getting an A1C test.

What do your A1c results mean

The HbA1C test reports results as a percentage, with a higher percentage corresponding to higher average blood sugar levels. The interpretation for diagnosis is as follows:

• Below 5.7% is considered normal.
• 5.7% to 6.4% is diagnosed as prediabetes.
• 6.5% or higher on two separate tests indicates diabetes.
• For many adults managing diabetes, a common treatment target is an A1C level of less than 7%. Some individuals may have lower or higher targets based on their specific needs.

Maintaining a target of less than 7% is linked to a reduced risk of diabetes-related complications. If your A1C level exceeds your target, your doctor may recommend adjustments to your diabetes 

Note

Receiving an HbA1C result that’s higher than expected can be stressful. It’s essential to understand that an elevated A1C for the first time doesn’t automatically mean you have diabetes. Various factors can lead to inaccurate results, and your healthcare provider will guide you on whether further tests are necessary. Don’t hesitate to ask your provider any questions; they are there to assist you.

For those with diabetes, it’s crucial to recognize that the HbA1C is a temporary average of blood sugar levels. Remember that there are steps you can take to modify your A1C level. If managing diabetes feels overwhelming, discuss it with your healthcare provider. Together, you can develop a plan to work towards your management and HbA1C goals.

References:

1. (2022). Retrieved from https://www.mayoclinic.org/tests-procedures/a1c-test/about/pac-20384643 
2. (N.d.). Retrieved from https://www.mayocliniclabs.com/test-catalog/overview/82080 
3. professional, C. C. medical. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diagnostics/9731-a1c