If you have diabetes, or if your doctor has told you that you are at risk for developing diabetes, you have probably heard the term A1c. This is actually a very common blood test that is important for many people and gives us very valuable information about your blood sugar levels. So let's talk about it all in a very simple way today.
What kind of test is A1c?
Simply put, the A1c test is the main way to find out if someone has diabetes and how well someone who already has diabetes is controlling it. Your doctor may also call it the hemoglobin A1c, HbA1c, or glycohemoglobin test. These are all the same test.
The A1c test measures your blood sugar level, or what doctors call your blood glucose level, over the past 2-3 months . This test can give you a clear idea of how well your diabetes treatment plan is working, or whether you actually have diabetes.
This is like a cricketer's batting average. You can't tell exactly whether he's a good player or not from one match. Similarly, you can't get a complete picture of how successful your treatment is by checking your blood sugar levels on one day. That's why the A1c test, which shows the average over several months, is important.
If you have diabetes, it's a good idea to get an A1c test at least twice a year. Another great thing about this test is that you don't have to fast before taking it. You can take the test at any time of day, before or after meals.
Why is this A1c test so important?
Okay, now let's see how this works. Think of it this way.
Our red blood cells contain a protein called hemoglobin. Its main function is to pick up oxygen from the lungs and distribute it to cells throughout the body.
Now, when your blood sugar (glucose) levels rise, these glucose molecules go and attach to those hemoglobin molecules. It's like sugar sticking to a candy cane. As your blood sugar levels increase , the amount of hemoglobin that has sugar attached to it also increases.
The A1c test measures how much of your total hemoglobin is bound to sugar. So a high A1c reading means your blood sugar has been high for the past few months. It can also indicate that you are at higher risk for future complications and that your current blood sugar control plan is not working well.
How often should I take this test?
Your doctor will usually order this A1c test when you're first diagnosed with diabetes. They'll also do it if you think you're at risk for developing diabetes. It can give you an idea of your baseline level. It can then help you see how your blood sugar control is changing over time.
How often you need to do this test then depends on several factors:
- The type of diabetes you have
- The level of control of your blood sugar
- Your treatment plan
If you explain this a little more...
- If you have prediabetes , meaning you have a high risk of developing diabetes, you will usually be asked to have this test about once a year .
- If you have type 2 diabetes , are not using insulin, and your blood sugar levels are usually within the target range, you can do this about twice a year .
- If you have type 1 diabetes , you may need to do this three or four times a year .
- If you have type 2 diabetes and use insulin , or if you have difficulty keeping your blood sugar levels in the target range, your doctor may also advise you to have this test about four times a year .
Additionally, if you change your diabetes treatment plan or start a new medication, you may need to have this test more frequently to see how the change has affected you.
What does your A1c value mean?
You will receive your test results as a percentage. See the table below to understand what these values mean.
| A1c level (as a percentage) | Meaning |
|---|---|
| Less than 5.7% | Healthy level. (People without diabetes) |
| Between 5.7% and 6.4% | Prediabetes: A high risk of developing diabetes. |
| 7% or less | Common treatment goal for people with diabetes. This is the recommended level of control for most people with diabetes. |
| More than 8% | An uncontrolled level. May indicate long-term untreated or poorly controlled diabetes. |
If you have diabetes and your A1c is higher than your target, don't panic. Your doctor will likely recommend changes to your treatment plan, possibly medications or lifestyle, to lower your levels. That's why it's important to always discuss your results with your doctor.
Take-Home Message
- An A1c (HbA1c) test does not show your blood sugar levels on a single day, but your average blood sugar levels over the past 2-3 months .
- This is an essential test to diagnose diabetes and monitor how well diabetes is being controlled.
- An increase in your A1c level is a sign that you are at increased risk for future diabetes complications.
- How often you should have this test depends on your type of diabetes and level of control.
- Always discuss your A1c results and future treatment plan with your doctor .
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