Diabetes is a life-long disease that should be carefully treated. While there is no cure for diabetes, it's possible to live a long, healthy life by making healthy lifestyle choices, taking any necessary medications, and working closely with your healthcare provider to find a personalized treatment plan that works best for you.
While there are many options to treat and manage your diabetes, the A1C test is one option that can help you keep your blood sugar levels under control long term.
If you're exhibiting symptoms of diabetes, are at risk of developing diabetes, or have already been diagnosed with diabetes, here's what you should know about how the A1C test could benefit you before scheduling an appointment with your healthcare provider.
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Diabetes is a serious condition that affects how your body produces or uses insulin. Insulin is a hormone that is created by your pancreas. It is used to help the glucose (sugar) found in your bloodstream from the foods you eat enter your cells and be turned into energy.
When your body stops making insulin or can't use the available insulin as it should, too much sugar builds up in your bloodstream. This can lead to symptoms such as feeling thirsty or tired in the short term. Over time, however, high blood sugar can lead to more serious health complications, including kidney disease, vascular and neurological issues, eye problems, and heart disease.
Likewise, not every diabetic's experience will be the same. They may exhibit many of the same symptoms, but the types of diabetes are often diagnosed and treated differently. Some key differences in the types of diabetes include:
Type 1 diabetes is an autoimmune disease that occurs in individuals whose immune system attacks the insulin-secreting cells in the pancreas, leading to low/lack of insulin production. It most commonly occurs in children, adolescents, and young adults. However, it can occur at any age.
Symptoms of type 1 diabetes can appear very suddenly and develop over a short period. They include:
Sores that heal slowly
Unintentional weight loss (more common in type 1)
Treatment for type 1 diabetes could include:
Eating a healthy diet
Maintaining a healthy weight
Taking medications, such as insulin — This is the principal treatment for type 1 diabetes, and often the person will be insulin-dependent for a lifetime.
Type 2 diabetes occurs in individuals whose bodies don't process insulin as they should, mainly due to insulin resistance. Unlike type 1 diabetes, symptoms of type 2 diabetes develop slowly over time, and initially, they could be very mild and could go unnoticed. Similar to type 1 diabetes, symptoms include:
Sores that heal slowly
Unintentional weight loss (less common in type 2)
Treatment for type 2 diabetes depends on your overall health, other medical conditions, and personal preferences. Treatment options could include:
Eating a healthy diet
Maintaining a healthy weight
Taking medications if necessary, such as medications to help with insulin resistance (metformin), or insulin
This type of diabetes only occurs during pregnancy. It usually exhibits no signs at all, which is why healthcare providers perform routine blood tests between the 24th and 28th week of pregnancy to check for it.
Gestational diabetes is most commonly treated by making lifestyle changes, such as eating a healthy diet and exercising regularly, although some individuals may have to take medications as well.
Gestational diabetes usually disappears on its own after delivery, although an increased risk of developing type 2 diabetes often exists in the years after.
The A1C test is used to give an indication of your average blood sugar levels over the past three months. A1C tests are used to diagnose prediabetes, type 1 diabetes, and type 2 diabetes. For individuals who have already been diagnosed with type 1 or type 2 diabetes, the A1C test can help monitor the condition by determining if your treatment plan is working.
The A1C test is sometimes referred to as the hemoglobin A1C test or the glycohemoglobin test. Hemoglobin is a part of your red blood cells responsible for bringing oxygen to the cells in your body. Glucose, or sugar, binds with hemoglobin to your red blood cells. The A1C test measures the percentage of hemoglobin in your red blood cells coated with glucose.
Therefore, the test is also known as hemoglobin A1C, glycated hemoglobin, and HbA1c.
Your healthcare provider will present your A1C levels in the form of a percentage. A higher percentage directly corresponds with how high and poorly controlled your blood glucose levels have been. The normal range for an A1C is considered anything lower than 5.7 percent.
Even if you're not experiencing signs of diabetes, it's a good idea to have a baseline A1C test performed if you're:
Over the age of 45
Are under 45 but are overweight and have one or more of the risk factors of type 2 diabetes, such as family history or having previously had gestational diabetes
Your healthcare provider will recommend how frequently you have an A1C test performed based on your conditions and circumstances. This could include:
One time a year, if you're diagnosed with prediabetes
Two times a year, if your blood sugar levels are within the target range and you don't take insulin
Four times a year, if you're having trouble managing your blood sugar levels and if you take insulin
While the A1C test is one of the most common tools used to diagnose diabetes, your healthcare provider could also use several other tests. These include:
This is the quickest and simplest blood test used to measure your blood sugar levels at a certain point when the blood sugar level isn’t elevated due to eating. Hence, the test requires fasting for 8 to 12 hours to be performed, preferably first thing in the morning.
This is a blood test that healthcare providers sometimes use to diagnose diabetes when you have symptoms, but they don't want to wait until after you have fasted as it measures the blood sugar level at any point in time.
The glucose challenge test and the oral glucose tolerance test (OGTT) are routine blood tests given to every pregnant woman between the 24th and 28th week of pregnancy to determine gestational diabetes.
While the A1C test cannot be used to diagnose gestational diabetes, your healthcare provider can have the test performed early in your pregnancy to see if you had undiagnosed diabetes before becoming pregnant.
Because the A1C test includes your blood sugar levels over the past three months, that time frame can include the time you weren't pregnant.
Additionally, the A1C test can be used after your baby is born to check for type 2 diabetes. Even if your blood sugar levels are within the normal range, it's important to check your A1C at least every three years after having gestational diabetes.
Just as your experience with diabetes will be different from others diagnosed with the same condition, your A1C results will likely be different from someone else's. Anything lower than 5.7 percent is considered within the normal range.
If your A1C is between 5.7 and 6.5 percent, your levels are within the prediabetes range. If your A1C is higher than 6.5 percent, you're within the diabetic range. The goal, then, for most adults with diabetes is to consistently maintain an A1C level of less than 7 percent.
Managing your blood sugar levels will also require checking your blood sugar at home with a blood sugar meter or another device. This device will display your blood sugar levels in milligrams of sugar per deciliter (mg/dL)
When you use a self-monitoring device, the result will reflect your blood sugar levels at the time that you take the test. Because of this, certain factors can impact your results, such as eating.
Checking your blood sugar levels at home can help you track your long-term blood sugar level goals and see if you are on track for meeting your A1C goals. A1C levels and their corresponding estimated average blood glucose (eAG) levels are as follows:
A1C: 6 percent, eAG: 126 mg/dL
A1C 7 percent, eAG 154 mg/dL
A1C 8 percent, eAG 183 mg/dL
A1C 9 percent, eAG 212 mg/dL
A1C 10 percent, eAG 240 mg/dL
A1C 11 percent, eAG 269 mg/dL
A1C 12 percent, eAG 298 mg/dL
The A1C test level that your healthcare provider sets for you will be based on your specific circumstances. If you're diagnosed with diabetes, your healthcare provider may set an A1C goal for you based on:
Other health conditions you may have
If you're pregnant
Your diabetes treatment plan
Complications you may be experiencing from diabetes
How long you've had diabetes
You can expect your healthcare provider to recommend maintaining an A1C below 6.5 percent if you:
Are young or have a longer life expectancy
Were recently diagnosed with diabetes
Are otherwise in good health
Are successfully managing your condition
Alternatively, your healthcare provider may recommend maintaining an A1C that's between 7.0–8.5 percent¹ if you:
Are older or have a shorter life expectancy
Have had diabetes for a long time
Have a difficult time managing your diabetes, even with medication
Have other serious health conditions
Have experienced complications from diabetes such as hypoglycemia or metabolic decompensation
Your A1C goals may need to be adjusted over time. It's important to work closely with your healthcare provider to help manage your diabetes and live a long, healthy life.
Certain factors can cause your A1C levels to increase or decrease. These include:
Severe anemia, liver disease, or kidney failure
Early or late pregnancy
Blood transfusions or loss
Certain medications, such as opioids
Having a less common type of hemoglobin than hemoglobin A, which is the most common variant, can lead to false results. This could occur in some people with certain blood disorders or people of Mediterranean, African, or Southeast Asian descent
If you have one or more of these factors, talk to your doctor about whether you may need other blood glucose tests to monitor your diabetes.
Working closely with your healthcare provider is the best way to manage your diabetes and maintain normal A1C goals. Even if you haven't been diagnosed with diabetes, it's important to have your A1C levels checked if you have certain risk factors. Be sure to schedule an appointment with your healthcare provider if you:
Have symptoms of high or low blood sugar
Are having a difficult time managing your diabetes or maintaining normal A1C levels
Are experiencing complications from diabetes
Have questions about your condition or treatment plan
Signs of diabetes include:
Being very thirsty
Signs of low blood sugar include:
Nervousness or irritability
The A1C test is a blood test commonly used to diagnose and monitor diabetes. It works by measuring the percentage of hemoglobin in your blood coated with glucose and indicating your average blood sugar levels from the previous three months. A1C test results are presented in percentage form.
Generally speaking, people with an A1C of less than 5.7 percent are within a normal blood sugar range, while anyone between 5.7 and 6.5 percent is considered prediabetic. Most adults who have already been diagnosed with diabetes are encouraged to maintain an A1C of less than 7 percent.
Of course, this varies on your overall health, other medical conditions, genetics, and lifestyle choices, among other factors. It's important to work closely with your healthcare provider and have your A1C checked regularly if you are at risk of developing diabetes or have already been diagnosed. Doing so can help you determine if your current treatment plan is working as well as if any changes need to be made.