I’d never heard of hemoglobin A1C until my husband, Mike, was diagnosed with Type 1 diabetes in 2002. At the time of his diagnosis, Mike’s A1C was 15.8%. The normal range of A1C is generally considered between 4-5.7%. (According to DiabetesMine, Dr. Francine Kaufman has seen an A1C as high as 22%.)
A hemoglobin A1C blood test reflects a person’s average blood sugar levels over the course of about three months. Hemoglobin is a protein in red blood cells that carries oxygen, and the A1C test measures how much sugar has “stuck” to those cells. The test is used both to diagnose and monitor Type 1 and Type 2 diabetes.
- A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c.
- The A in A1C stands for adult.
- In 2013, the FDA approved the first A1C test for diagnosing diabetes.
- In people without diabetes A1C values are higher in blacks, Asians, and Latinos when compared to white persons. Although the differences are small, they could have an impact on the use of a sole A1C value to diagnose diabetes in all ethnic populations.
For most adults, the American Diabetes Association recommends a target A1C of below 7 percent. New and much debated guidance from the American College of Physicians, however, suggests that A1C should be between 7 and 8 percent for most .
- Iron deficiency anemia is associated with a higher A1C. However, blood loss from surgery, heavy menstrual cycles, other types of anemia may cause an A1C to be falsely low.
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.”
- An A1C result is an average. It does not necessarily reflect time spent with in-range blood sugars. For example, a person’s A1C of 6% could be the average of many highs and lows, not simply the result of steady in-range blood sugar.
- There is no need to fast before an A1C test.
- It is possible to lower your A1C by making small lifestyle changes, like adding more exercise to your routine, or eating low carb meals and snacks.
|A1C level||Estimated average blood sugar level|
|5 percent||97 mg/dL (5.4 mmol/L)|
|6 percent||126 mg/dL (7 mmol/L)|
|7 percent||154 mg/dL (8.5 mmol/L)|
|8 percent||183 mg/dL (10.2 mmol/L)|
|9 percent||212 mg/dL (11.8 mmol/L)|
|10 percent||240 mg/dL (13.3 mmol/L)|
|11 percent||269 mg/dL (14.9 mmol/L)|
|12 percent||298 mg/dL (16.5 mmol/L)|
|13 percent||326 mg/dL (18.1 mmol/L)|
|14 percent||355 mg/dL (19.7 mmol/L)|
*Source: Mayo Clinic