Did I Pass or Fail? Decoding the A1c Blood Test

by Cindy

The A1c Blood Test: Decoded

It took several weeks but now you have mastered checking your blood sugar every day with your glucometer. You have a good understanding of how food and exercise habits influence your readings. You’ve been a good patient and have taken your metformin, injected your insulin or diligently stuck to your diabetic diet.  It has been three months and you are scheduled for a follow up appointment with your doctor to review your test results. But are you still wondering, what does the Alc blood test actually mean?

What is the A1c blood test for diabetes?

Hemoglobin (Hb) is a protein within your red blood cells that transports oxygen to tissues in your body.

Hemoglobin A1c (Hba1c) is a variation of that hemoglobin molecule and it is measured in diabetic patients because HbA1c attracts glucose molecules. As blood glucose levels rise, hemoglobin A1c becomes glycosylated, which means that sugar particles stick to HbA1c. The amount of glycosylation, or attached glucose molecules, can be measured by the a1c blood test. This measurement gives an indication of the average amount of glucose that has been circulating in the blood over the last 2-3 months.

Why is this test necessary?

Test tubes
Creative Commons License photo credit: Håkan Dahlström

The hemoglobin A1c blood test plays an important role in the management of diabetes because it provides your doctor with a picture of your overall sugar control.  It is important to understand that if your results are high, your blood glucose control is not optimal.  The benefit of the alc blood test is that it is does not change dramatically on a daily basis and the test can be checked when you are not fasting.  It does not give an indication of how your body processes sugars after meals or what your fasting blood glucose is. To monitor your blood sugar levels before and after meals, ask your doctor for a glucose meter. Your physician will use your home readings in combination with your A1c values to determine how best to manage your diabetes.

What do my levels mean?

Your A1c is a measure that reflects the amount of glucose that is in your bloodstream over an average of two months.  This measurement is reported differently than you may be used to seeing on your glucometer.  Blood glucose readings are reported in mg/dL in the United States and the a1c test results are reported as a percentage.

  • Normal A1c: An A1c value of less than 5.7% correlates with an average blood sugar of less than 126 mg/dl. This is considered normal.
  • Prediabetes: If your A1c blood test results are higher than 5.7% but less than 6.5% you are considered to be at risk for developing diabetes and your doctor will likely recommend dietary changes, weight loss and exercise to prevent increases in your blood sugar.
  • Type 2 Diabetes: A1c levels that are greater than 6.5% are diagnostic for diabetes and correlates with an average blood glucose level of 140 mg/dl.
  • Treatment with medications is typically recommended when the A1c rises above 7%. When the Hemoglobin A1c blood test ranges higher than 7.0% it correlates with an average glucose level greater than 154 mg/dl.

As you can see, increasing values are the direct result of high blood glucose levels. Your doctor will continue to check your blood every 3-6 months to monitor your diabetes. This doesn’t mean that you should stop checking your daily sugars as this information is also important and can help your doctor chose medications that best suit your individual needs.

Since many patients do not understand how A1c correlates with daily glucometer readings, check out the HbA1c converter tool to find out what your results really mean!  Input your lab value, hit calculate and find out what your average blood glucose levels are.  This tool is a simple way to convert confusing numbers into to familiar blood sugar readings!

How often should my levels be checked?

The Alc test is typically performed every three months to monitor your diabetes closely. Careful monitoring of your blood sugar levels is essential for improving your health and preventing complications of diabetes.

Is this a fasting test?

Fasting is NOT required for the a1c blood test but always check with your doctor before heading to the lab because fasting blood work to check your cholesterol and kidney function is often performed at the same time. Always ask your doctor if you can eat prior to any testing.

Although the HbA1c blood test is an important tool in the management of diabetes, it is no substitute for daily blood sugar monitoring. Patients who understand the importance of both tests are more likely to be inspired to better manage their diabetes, improve their health and prevent diabetic complications. Still confused?  For more information click here!  Or explore our site to learn more about diabetes at knowyoursugar.com!

Graduated cylinders and beaker filled with chemical compounds
Creative Commons License photo credit: Horia Varlan

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