What's an A1c and What You Should Know

What is A1c and Why It's Important

A1c (also called hemoglobin A1c or HbA1c) is an important blood test that reflects your average blood glucose (sugar) levels over the past two to three months. It’s commonly used to diagnose and monitor diabetes, but everyone should have a basic understanding of what it means, even if they don't have diabetes. Here's what people should know about their A1c:

1. What A1c Measures:

• A1c measures the percentage of hemoglobin (a protein in red blood cells) that is coated with sugar (glucose). Since red blood cells live for about 120 days, this test gives an indication of your average blood sugar level over the past 2-3 months.

2. A1c Range and What It Means:

• Normal: Below 5.7%. This is considered a healthy A1c level.
• Pre-diabetes (or "at risk" for diabetes): 5.7% to 6.4%. If your A1c is in this range, it means your blood sugar is higher than normal but not high enough to be diagnosed as diabetes.
• Diabetes: 6.5% or higher. A diagnosis of diabetes is typically made if you have an A1c test with results at or above 6.5%.

3. Why A1c is Important:

• It provides a long-term view of how well your blood sugar is controlled, rather than just a snapshot from a single day or meal.
• People with diabetes need to keep their A1c at a target level (usually <7%) to reduce the risk of complications like heart disease, nerve damage, kidney disease, and vision problems.
• Even if you don’t have diabetes, monitoring your A1c can help you catch signs of prediabetes early, when lifestyle changes can often reverse the condition.

4. Factors that Affect A1c:

• Diet and exercise play a significant role in managing blood sugar and can help lower A1c levels.
• Medication may be required for people with diabetes to bring their A1c within a healthy range.
• Certain health conditions can affect A1c, such as anemia, kidney disease, and certain blood disorders.
• Age, stress, and even infection can temporarily affect A1c levels.

5. What A1c Can’t Tell You:

• A1c doesn't reflect day-to-day fluctuations in blood sugar. It averages your levels over a few months, so you might still experience highs or lows on any given day.
• It also doesn't tell you about blood sugar spikes after meals, which are important for overall health management, especially for people with diabetes.

6. What to Do If Your A1c is High:

• Lifestyle changes are the first line of defense. Eating a balanced diet, exercising regularly, losing excess weight, and managing stress can help improve A1c levels.
• Work with your healthcare provider to develop a personalized plan, which may include monitoring blood sugar levels more frequently, taking medications, or making other changes to your treatment plan.

7. How Often You Should Get Tested:

• If you have diabetes, A1c should be tested about every 3-6 months to monitor your blood sugar control.
• If you’re at risk for diabetes (e.g., if you’re overweight, have a family history, or are older), consider getting an A1c test at least once a year.
• If your A1c is in the normal range, you don’t need to be tested as often unless you have risk factors for diabetes.

8. A1c Targets for People with Diabetes:

• The general target for most people with diabetes is an A1c of less than 7%. However, individual targets may vary depending on factors like age, health status, and the presence of other conditions.
• Tight control (i.e., a lower A1c) is usually beneficial, but not if it leads to frequent low blood sugars (hypoglycemia). So, achieving a balance is key.

In summary, the A1c test is a valuable tool for monitoring long-term blood sugar control. It’s important for people with diabetes to aim for an A1c within a healthy range to reduce the risk of complications, and it’s also useful for detecting early signs of prediabetes. Keeping an eye on A1c and discussing it with your healthcare provider regularly can help you take charge of your health.

If you don't have a health care provider, contact our CHS office at (419) 334-3869.  We're accepting new patients and will help you to schedule an appointment to get a check-up, including important screening tests like your A1c.