You've probably had your blood glucose level checked — a quick prick of the finger and a drop of blood reveals how much sugar is in your bloodstream. This is a helpful tool for diagnosing and managing diabetes, but it only shows your blood glucose level at that moment. Unless you've fasted and timed the test correctly, it's not an accurate way to know how your body processes sugar all the time. Show
Your A1C level is your average blood glucose level over the past three months. Knowing this number helps your doctor find and treat diabetes (and prediabetes) before you experience serious complications. Why Your A1C Level MattersDiabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Most cases of type 2 diabetes can be managed with diet, exercise, and medication, but uncontrolled blood glucose levels increase the risk for heart disease, stroke, eye problems, foot and leg amputations, and kidney failure. Approximately 30.3 million Americans have diabetes — that's about 9 percent of the U.S. population. Of those living with diabetes, 7.2 million are undiagnosed. Another 84.1 million American adults have prediabetes, meaning they're at risk of developing diabetes without medical intervention and lifestyle changes. Regular A1C testing would help your doctor catch the disease early, often while it's preventable. If you've already been diagnosed with diabetes, your A1C tells your doctor whether the current treatment plan is working. What the Numbers MeanThe A1C test measures how much glucose is attached to the hemoglobin in your blood. The results are reported as percentages. To diagnose diabetes with an A1C test, physicians use the following scale:
It's recommended that diabetics maintain an A1C level below 7 percent to prevent complications. 7 Ways to Improve Your A1CWhether you're managing diabetes or trying to avoid it, you can lower your blood glucose levels by: 1. ExercisePhysical activity helps your body use insulin more efficiently, so it can better process the glucose in your blood. Consistent exercise can lower blood glucose and improve your A1C. It also lowers your risk for heart disease, stroke, and other serious diseases for which diabetics are susceptible. Aim for 30 minutes of exercise at least five days per week. 2. Eat RightGo easy on the sweets and sugary beverages, white breads, potatoes, pastas, starchy vegetables, and other carbohydrate-rich foods as these increase your blood sugar levels. Instead, opt for foods that are high in fiber, fruits and vegetables, small servings of lean meats and poultry, and low-fat milk or cheese. 3. Take Medications as PrescribedSome people can manage diabetes and prediabetes with diet and exercise; others need medication. The right medication and dosage varies from person to person, so work with your doctor to create an individualized treatment plan, and then stick to it. 4. Manage Your StressStress causes your body to behave as if you're under attack. To prepare for a fight-or-flight response, the body stores up energy in the form of glucose and fat. Over time, this can increase your A1C level. To reduce stress, make time to relax, spend time with people you love, and do things you enjoy. Mindful meditation and other relaxation techniques can also help. If you still feel chronically stressed, talk to your doctor. 5. Stick to a ScheduleIf you go too long without eating, your blood glucose levels could drop too low. You'll also be more likely to overeat later, causing your blood sugar to spike. Plan to eat three well-balanced meals and two healthy snacks each day. 6. Drink in ModerationDrinking alcohol can cause drops in your blood sugar, especially if you haven't eaten or if your glucose levels are already low. Otherwise, the American Diabetes Association recommends that diabetics follow the same guidelines as everyone else: no more than one drink per day for women and two drinks per day for men. 7. Monitor Your NumbersIf you've been diagnosed with diabetes or prediabetes, it's important to check your blood glucose levels as often as your doctor recommends to prevent spikes and dangerous drops. Your doctor will also want to keep a close watch on your A1C level to ensure your current treatment plan is keeping your condition under control. Diabetes is a serious, lifelong condition, but with some healthy changes and the right care providers in your corner, you can still live a full and healthy life. The A1C test is a blood test that provides information about your average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test can be used to diagnose type 2 diabetes and prediabetes.1 The A1C test is also the primary test used for diabetes management.  The A1C test is sometimes called the hemoglobin A1C, HbA1c, glycated hemoglobin, or glycohemoglobin test. Hemoglobin is the part of a red blood cell that carries oxygen to the cells. Glucose attaches to or binds with hemoglobin in your blood cells, and the A1C test is based on this attachment of glucose to hemoglobin. The higher the glucose level in your bloodstream, the more glucose will attach to the hemoglobin. The A1C test measures the amount of hemoglobin with attached glucose and reflects your average blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher your blood glucose levels have been. A normal A1C level is below 5.7 percent. Why should a person get the A1C test?Testing can help health care professionals
If you have risk factors for prediabetes or diabetes, talk with your doctor about whether you should be tested. How is the A1C test used to diagnose type 2 diabetes and prediabetes?Health care professionals can use the A1C test alone or in combination with other diabetes tests to diagnose type 2 diabetes and prediabetes. You don’t have to fast before having your blood drawn for an A1C test, which means that blood can be drawn for the test at any time of the day. If you don’t have symptoms but the A1C test shows you have diabetes or prediabetes, you should have a repeat test on a different day using the A1C test or one of the other diabetes tests to confirm the diagnosis.2 A1C results and what the numbers mean*Any test used to diagnose diabetes requires confirmation with a second measurement, unless there are clear symptoms of diabetes.Diagnosis*A1C LevelNormalbelow 5.7 percentPrediabetes5.7 to 6.4 percentDiabetes6.5 percent or aboveWhen using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial. Blood samples analyzed in a doctor’s office or clinic, known as point-of-care tests, should not be used for diagnosis. The A1C test should not be used to diagnose type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes. The A1C test may give false results in people with certain conditions. Having prediabetes is a risk factor for developing type 2 diabetes. Within the prediabetes A1C range of 5.7 to 6.4 percent, the higher the A1C, the greater the risk of diabetes. Is the A1C test used during pregnancy?Health care professionals may use the A1C test early in pregnancy to see if a woman with risk factors had undiagnosed diabetes before becoming pregnant. Since the A1C test reflects your average blood glucose levels over the past 3 months, testing early in pregnancy may include values reflecting time before you were pregnant. The glucose challenge test or the oral glucose tolerance test (OGTT) are used to check for gestational diabetes, usually between 24 and 28 weeks of pregnancy. If you had gestational diabetes, you should be tested for diabetes no later than 12 weeks after your baby is born. If your blood glucose is still high, you may have type 2 diabetes. Even if your blood glucose is normal, you still have a greater chance of developing type 2 diabetes in the future and should get tested every 3 years. Can other blood glucose tests be used to diagnose type 2 diabetes and prediabetes?Yes. Health care professionals also use the fasting plasma glucose (FPG) test and the OGTT to diagnose type 2 diabetes and prediabetes. For these blood glucose tests used to diagnose diabetes, you must fast at least 8 hours before you have your blood drawn. If you have symptoms of diabetes, your doctor may use the random plasma glucose test, which doesn’t require fasting. In some cases, health care professionals use the A1C test to help confirm the results of another blood glucose test. Can the A1C test result in a different diagnosis than the blood glucose tests?Yes. In some people, a blood glucose test may show diabetes when an A1C test does not. The reverse can also occur—an A1C test may indicate diabetes even though a blood glucose test does not. Because of these differences in test results, health care professionals repeat tests before making a diagnosis. People with differing test results may be in an early stage of the disease, when blood glucose levels have not risen high enough to show up on every test. In this case, health care professionals may choose to follow the person closely and repeat the test in several months. Why do diabetes blood test results vary?Lab test results can vary from day to day and from test to test. This can be a result of the following factors: Blood glucose levels move up and downYour results can vary because of natural changes in your blood glucose level. For example, your blood glucose level moves up and down when you eat or exercise. Sickness and stress also can affect your blood glucose test results. A1C tests are less likely to be affected by short-term changes than FPG or OGTT tests. The following chart shows how multiple blood glucose measurements over 4 days compare with an A1C measurement. Blood Glucose Measurements Compared with A1C Measurements over 4 DaysThe straight black line shows an A1C measurement of 7.0 percent. The blue line shows an example of how blood glucose test results might look from self-monitoring four times a day over a 4-day period. A1C tests can be affected by changes in red blood cells or hemoglobinConditions that change the life span of red blood cells, such as recent blood loss, sickle cell disease, erythropoietin treatment, hemodialysis, or transfusion, can change A1C levels. A falsely high A1C result can occur in people who are very low in iron; for example, those with iron-deficiency anemia. Other causes of false A1C results include kidney failure or liver disease. If you’re of African, Mediterranean, or Southeast Asian descent or have family members with sickle cell anemia or a thalassemia, an A1C test can be unreliable for diagnosing or monitoring diabetes and prediabetes. People in these groups may have a different type of hemoglobin, known as a hemoglobin variant, which can interfere with some A1C tests. Most people with a hemoglobin variant have no symptoms and may not know that they carry this type of hemoglobin. Health care professionals may suspect interference—a falsely high or low result—when your A1C and blood glucose test results don’t match. Not all A1C tests are unreliable for people with a hemoglobin variant. People with false results from one type of A1C test may need a different type of A1C test to measure their average blood glucose level. The NGSP provides information for health care professionals about which A1C tests are appropriate to use for specific hemoglobin variants. Read about diabetes blood tests for people of African, Mediterranean, or Southeast Asian descent. The NIDDK has information for health care providers on Sickle Cell Trait & Other Hemoglobinopathies & Diabetes. Small changes in temperature, equipment, or sample handlingEven when the same blood sample is repeatedly measured in the same lab, the results may vary because of small changes in temperature, equipment, or sample handling. These factors tend to affect glucose measurements—fasting and OGTT—more than the A1C test. Health care professionals understand these variations and repeat lab tests for confirmation. Diabetes develops over time, so even with variations in test results, health care professionals can tell when overall blood glucose levels are becoming too high. How precise is the A1C test?When repeated, the A1C test result can be slightly higher or lower than the first measurement. This means, for example, an A1C reported as 6.8 percent on one test could be reported in a range from 6.4 to 7.2 percent on a repeat test from the same blood sample.3 In the past, this range was larger but new, stricter quality-control standards mean more precise A1C test results. Health care professionals can visit www.ngsp.org to find information about the precision of the A1C test used by their lab. How is the A1C test used after diagnosis of diabetes?Your health care professional may use the A1C test to set your treatment goals, modify therapy, and monitor your diabetes management. Experts recommend that people with diabetes have an A1C test at least twice a year.4 Health care professionals may check your A1C more often if you aren’t meeting your treatment goals.4 What A1C goal should I have?People will have different A1C targets, depending on their diabetes history and their general health. You should discuss your A1C target with your health care professional. Studies have shown that some people with diabetes can reduce the risk of diabetes complications by keeping A1C levels below 7 percent. Managing blood glucose early in the course of diabetes may provide benefits for many years to come. However, an A1C level that is safe for one person may not be safe for another. For example, keeping an A1C level below 7 percent may not be safe if it leads to problems with hypoglycemia, also called low blood glucose. Less strict blood glucose control, or an A1C between 7 and 8 percent—or even higher in some circumstances—may be appropriate in people who have
How does A1C relate to estimated average glucose?Estimated average glucose (eAG) is calculated from your A1C. Some laboratories report eAG with A1C test results. The eAG number helps you relate your A1C to daily glucose monitoring levels. The eAG calculation converts the A1C percentage to the same units used by home glucose meters—milligrams per deciliter (mg/dL). The eAG number will not match daily glucose readings because it’s a long-term average—rather than your blood glucose level at a single time, as is measured with a home glucose meter. Will the A1C test show short-term changes in blood glucose levels?Large changes in your blood glucose levels over the past month will show up in your A1C test result, but the A1C test doesn’t show sudden, temporary increases or decreases in blood glucose levels. Even though A1C results represent a long-term average, blood glucose levels within the past 30 days have a greater effect on the A1C reading than those in previous months. Clinical Trials for the A1C Test and DiabetesThe National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. What are clinical trials and are they right for you?Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Scientists are conducting research to learn more about diabetes, including studies about A1C. For example
Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you. What clinical trials are open?Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov. References[1] Gillett MJ. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327–1334. [2] American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2018;41(suppl 1):S13–S27. [3] Penttilä I, Penttilä K, Holm P, et al. Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus. World Journal of Methodology. 2016;6(2):133–142. [4] American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2018;41(suppl 1):S55–S64. Can prediabetes go away?It's common. And most importantly, it's reversible. You can prevent or delay prediabetes from turning into type 2 diabetes with simple, proven lifestyle changes.
At what level are you considered prediabetic?Fasting Blood Sugar Test
A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have prediabetes, and 126 mg/dL or higher indicates you have diabetes.
What is a normal A1C for seniors?The key measure of diabetes control is hemoglobin A1c. For healthy over 65ers with long life expectancy, the target should be 7.0 – 7.5%.
Is an A1C of 5.4 prediabetes?If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range. If you have an A1C level of 6.5% or higher, your levels were in the diabetes range.
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What is the prediabetic range for a1c
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