Hemoglobin A1c (HbA1c)

Optimal Result: 4.8 - 5.6 %.

HbA1C Test: Understanding Glycated Hemoglobin for Diabetes Management

Other names: HbA1C, A1C, glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin

Quick Overview:

  • Measures: Average blood sugar levels over the past 3 months.
  • Purpose: Diagnose diabetes and prediabetes; manage diabetes effectively.

What Is the A1C Test?

The A1C test—also known as hemoglobin A1C or HbA1C—is a simple, vital blood test that tracks your average blood sugar levels over the past three months. It’s widely used to diagnose prediabetes and diabetes and serves as the key tool for managing blood sugar levels if you have diabetes. Higher A1C levels indicate increased risks for diabetes complications, including heart disease, kidney damage, and nerve issues.

How It Works:

  • Why 3 months? Glucose attaches to hemoglobin in red blood cells, which live about 90 days.
  • High A1C levels signal elevated blood glucose levels over time, indicating poorly controlled diabetes or prediabetes.

Importance of Glucose:

Glucose, a sugar from the foods you eat, provides energy for your body’s cells. Insulin helps transport glucose into cells. If you have diabetes, insufficient insulin or insulin resistance can cause glucose buildup in your blood, raising blood sugar levels and increasing HbA1C.

A1C Test Measures:

  • Sugar-coated hemoglobin: The percentage of hemoglobin in your blood with glucose attached.
  • Result ranges:
    • Normal: Below 5.7%.
    • Prediabetes: 5.7%–6.4%.
    • Diabetes: 6.5% or above.

Who Should Get Tested?

  1. For diagnosis:

    • Adults over 45.
    • Younger individuals who are overweight and have risk factors like high blood pressure, high cholesterol, a sedentary lifestyle, or a family history of diabetes.
    • Women with gestational diabetes or PCOS.
    • Certain ethnic groups (e.g., African American, Hispanic, Native American).
  2. To manage diabetes:

    • Regular A1C testing (at least twice a year or more frequently if treatments change).

Why You Need an A1C Test:

  • Screening: Detect prediabetes and reduce your risk of progressing to type 2 diabetes.
  • Monitoring: Evaluate how well treatments or lifestyle changes control your blood sugar.
  • Risk prevention: Identify potential complications early.

Limitations of A1C Testing:

The A1C test may not accurately diagnose diabetes in individuals with blood disorders like anemia, kidney failure, or liver disease. In these cases, alternative tests may be recommended. Additionally, it is not used to diagnose gestational diabetes or type 1 diabetes.

What Your A1C Results Mean:

  • Below 5.7%: Normal.
  • 5.7%–6.4%: Prediabetes, with a higher risk of developing type 2 diabetes.
  • 6.5% or above: Diabetes, requiring management to prevent complications.

Stay in Control:

Knowing your HbA1C level empowers you to take action. Maintaining a healthy A1C reduces risks of serious complications. Regular testing, a balanced diet, exercise, and proper medication can make a significant difference in controlling diabetes or preventing it altogether.


References:

  • Eyth E, Naik R. Hemoglobin A1C. StatPearls.
  • Aggarwal V, et al. Diabetes Care. 2012;35(10):2055-60.
  • Pfister R, et al. Diabetologia. 2011;54(8):2025-32.
  • UpToDate.

What does it mean if your Hemoglobin A1c (HbA1c) result is too high?

Elevated levels of hemoglobin A1c (HbA1c) signify that there has been a prolonged period of high blood sugar levels, indicating poor blood glucose control over the past two to three months. This is a key diagnostic marker for diabetes and prediabetes. The HbA1c test measures the percentage of glucose bound to hemoglobin in the blood, with higher percentages indicating higher average blood sugar levels. Causes of elevated HbA1c include type 1 and type 2 diabetes, poor dietary habits, lack of exercise, obesity, and sometimes certain medical conditions or medications. Symptoms of high HbA1c levels often align with those of diabetes, such as increased thirst, frequent urination, fatigue, blurred vision, and slow healing of wounds. Diagnosis is typically confirmed with an HbA1c blood test, where a result of 6.5% or higher indicates diabetes, and 5.7% to 6.4% suggests prediabetes. Treatment options focus on lifestyle changes like a balanced diet, regular exercise, and weight management, alongside medication such as metformin or insulin therapy to help manage blood sugar levels. Regular monitoring and management of blood glucose are crucial to prevent complications like cardiovascular disease, neuropathy, and retinopathy, thereby improving overall health and quality of life.

What does it mean if your Hemoglobin A1c (HbA1c) result is too low?

A low HgA1c may indicate that diabetes treatment is too aggressive. In people without diabetes, it is unclear whether a low HgA1c is harmful. Some researchers have found that low HbA1c may be problematic, while others have not. Compared with persons with normal HbA1c, low HbA1c values are associated with an increased risk of and death from various causes in some studies. Low HbA1c values generally reflect a level of chronic low blood sugar or hypoglycemia. There may be an increased risk of liver disease in people with low HbA1c.

Frequently asked questions

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For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.

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Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.

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