Get an A1C test to find out your average blood sugar levels. It is very important to know if you’re at risk for prediabetes or type 2 diabetes, or if you have been diagnosed as having type 2 diabetes, to know that your condition is well managed.
The A1C test, which is also known as the hemoglobin A1C or HbA1c test, is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the commonly used tests to diagnose prediabetes and diabetes, and is also used to help you and your health care team manage your diabetes. Higher A1C levels can lead to diabetes complications, so reaching and maintaining your A1C goal is imperative if you have diabetes.
What Does the A1C Test Measure?
When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.
Who Should Get an A1C Test, and When?
Testing for diabetes or prediabetes:
All adults over 45 should get a baseline A1C, as well as those under 45 who are overweight and have one or more risk factors for prediabetes or type 2 diabetes:
- If you are over 45 and your test results come back normal, but you have risk factors or have had gestational diabetes, you should retest every 3 years.
- If your result shows you have prediabetes, talk to your doctor about what steps to take to improve your health and lower your risk to develop type 2 diabetes. Retest as recommended by your doctor, usually every 1 to 2 years.
- If you are symptom free but your result shows you have prediabetes or diabetes, test for a second time to confirm results.
- If your test shows you have diabetes, talk to your doctor about diabetes management plan to keep you healthy. You may wish to speak to a dietician about changing your diet to keep your blood sugar at appropriate levels.
If you have diabetes, get an A1C test at a minimum twice a year, more often if your medicine changes or if you have other health conditions. Your doctor would know best how often is right for you.
How to Prepare for Your A1C Test
The test is done in a doctor’s office or a lab using a sample of blood from a finger stick or from your arm. Nothing special is needed to be done to prepare for your A1C test.
Your A1C Result
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 reading of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. In the prediabetic range, the higher your A1C, the greater risk you have to develop type 2 diabetes.
Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you would see on your blood sugar meter:
What Can Affect Your A1C Result?
Get your A1C tested in addition to regular blood sugar self-testing if you have diabetes.
Several factors can give a false increase or decrease to your A1C result, including:
- Kidney failure, liver disease, or severe anemia.
- A less common type of hemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anemia or thalassemia) may have.
- Certain medicines, including opioids and some HIV medications.
- Blood loss or blood transfusions.
- Early or late pregnancy.
If any of these factors apply to you, speak to your doctor to see if additional testing is needed.
Your A1C Goal
The goal for most people with diabetes is 7% or below. However, there are many factors that can affect your personal goal including your age and other medical conditions. You and your doctor together should set your own individual A1C goal.
Younger people that will live with diabetes for many years may have a lower A1C goal so as to reduce the risk of complications, unless they often have hypoglycemia (low blood sugar). Older people that have severe lows, or have other serious health complications may have a higher A1C goal.
Remember, A1C is one of the important tools for managing diabetes, it doesn’t replace blood sugar testing at home. Blood sugar fluctuates throughout the day and night, which isn’t shown by your A1C. Two people can have the exact same A1C, but one can have steady blood sugar and one can swing between highs and lows.
If you’re reaching your A1C goal but having the high and low swings, check your blood sugar more often and at different times throughout the day. Keep track and share the results with your doctor.