Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if Continue reading >>
Your A1c Levels – What Goal To Shoot For?
Measuring Your A1C An A1C test gives you and your provider insight into all of your blood glucose ups and downs over the past two or three months. It’s like the 24/7 video of your blood sugar levels. Observing your A1C results and your blood glucose (also known as blood sugar) results together over time are two of the key tools you and your health care provider can use to monitor your progress and revise your therapy as needed over the years. Recent research is changing the way health professionals look at A1C levels. Instead of setting tight controls across the board, a healthy A1C level is now a moving target that depends on the patient. In the past, an A1C of 7 percent was considered a healthy goal for everyone. Yehuda Handelsman, M.D., medical director of the Metabolic Institute of America in Tarzana, California, says experts now recommend taking a patient-centered approach to managing A1C levels, which means evaluating goals based on individual diabetes management needs and personal and lifestyle preferences. Current ADA Goals The 2015 American Diabetes Association (ADA) Standards of Medical Care in Diabetes advise the following A1C levels: • 6.5 percent or less: This is a more stringent goal. Health care providers might suggest this for people who can achieve this goal without experiencing a lot of hypoglycemia episodes or other negative effects of having lower blood glucose levels. This may be people who have not had diabetes for many years (short duration); people with type 2 diabetes using lifestyle changes and/or a glucose-lowering medication that doesn’t cause hypoglycemia; younger adults with many years to live healthfully; and people with no significant heart and blood vessel disease. • 7 percent: This is a reasonable A1C goal for many adults with d Continue reading >>
David’s Guide To Getting Our A1c Under 6.0
The A1C test is our best scorecard to show how well we are controlling our diabetes. It measures how much glucose has been sticking to our red blood cells for the previous two or three months. Since our bodies replace each red blood cell with a new one every four months, this test tells us the average of how high our glucose levels have been during the life of the cells. The experts recommend that we should get our A1C level tested at least twice a year. People who take insulin need to get it about four times a year. If the test shows that our blood glucose level is high, it means that we have a greater risk of having diabetes problems. Think of the A1C as an early warning system for the insidious complications that we can get down the road when we don’t control our condition. But what do we mean by a “high” A1C level? Here the experts disagree. The American Diabetes Association says that we need to keep our A1C results below 7.0 percent. The American Association of Clinical Endocrinologists sets the target at 6.5 percent. The International Diabetes Federation, or IDF, also recommends that most people with diabetes keep their levels below 6.5 percent. The more our A1C level is higher than normal, the greater the likelihood that we will suffer from one or more of the complications of diabetes. And here too the experts disagree with how they define “normal.” People who don’t have diabetes have A1C levels below 6.0 percent. That’s the gist of what I wrote here recently in “The Normal A1C Level.” The IDF agrees. But more aggressive endocrinologists say that a truly normal A1C ranges from 4.2 percent to 4.6 percent. That’s what Dr. Richard K. Bernstein wrote in Dr. Bernstein’s Diabetes Solution. No matter what our level is, we can be sure that lower is Continue reading >>
What Is The A1c Test? How Does A1c Relate To Blood Glucose?
Anyone with diabetes will be familiar with finger-prick testing for monitoring blood glucose to see how well they are managing their disease. This kind of regular testing is essential for most people with diabetes, but what role does an occasional hemoglobin A1C blood test play in controlling blood sugars, and how does it work? Contents of this article: What is the A1C test? The abbreviation A1C is used in the US (sometimes with a lower-case 'c' - A1c) and is short for glycated hemoglobin (sometimes called 'glycosylated' hemoglobin or glycohemoglobin). The other abbreviations in use are: HbA1c (widely used internationally) HbA1c Hb1c HgbA1C. The A1C test is a blood test used to measure the average level of glucose in the blood over the last two to three months. This test is used to check how well blood sugar levels are being controlled in a person with diabetes and can also be used in the diagnosis of diabetes.1 Hemoglobin is the protein in red blood cells which is responsible for transporting oxygen around the body. When blood glucose levels are elevated, some of the glucose binds to hemoglobin and, as red blood cells typically have a lifespan of 120 days, A1C (glycated hemoglobin) is a useful test because it offers an indication of longer term blood glucose levels.2 The particular type of hemoglobin that glucose attaches to is hemoglobin A, and the combined result is call glycated hemoglobin. As blood glucose levels rise, more glycated hemoglobin forms, and it persists for the lifespan of red blood cells, about four months.2 Therefore, the A1C level directly correlates to the average blood glucose level over the previous 8-12 weeks; A1C is a reliable test that has been refined and standardized using clinical trial data.3 There are two key things to know about the appl Continue reading >>
- Home blood glucose test: How to test for diabetes at home
- Diabetes and the A1C Test: What Does It Tell You?
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
A1c Tips: Getting Your A1c Under 6%
Type 1 Diabetic striving to get A1C below 7 I struggled for 20 years to get my A1C out of the 8s and into the 7s and until 7 months ago, I had never seen an A1C below 7. I never thought it was possible to get it that low. I thought people who had lower blood sugars all the time must not eat any carbs and I love my carbs too much to give them up for a lower A1C. I know in the Diabetes Online Community people are torn over if its good to share their A1C or not. I like to share my A1C because I hope people read my blog and see that its not easy for me (and Ive definitely had my fair share of bad A1Cs) but attaining a good A1C is possible (I never thought I could get a really good number!). 5.5 translates to an average blood sugar around 111mg/dl. Ive been hovering between an average of 107 and 120 (thanks to my CGM data) so I was surprised to see my recent A1C come in at 5.5. An A1C of 5.5 is listed for what a normal pancreas functioning non-diabetics A1C would be. According to sources, you arent considered pre-diabetic until your A1C reaches 5.7 and arent considered diabetic until it gets to 6.5. So I am cured, right?! Wrong. A LOT of hard work went into this number and heres how I did it: Pre-bolus, pre-bolus, pre-bolus This is especially important to remove high spikes from my day so I have more straight lines than roller coasters. Dont eat more than every three hours This gives my insulin time to work and my blood sugar time to come down from meals. Try to keep carbs under 50 for meals and 15 for snacks I try to stick to this rule for the most part, but snacks usually go over. Also, Im not perfect. I will gladly add a 40 carb cupcake to my dinner, setting me over 50 carbs or I will eat a Panera bagel for breakfast that is 80 carbs. I do love my carbs. Changed my targe Continue reading >>
Hemoglobin A1c Test (hba1c, A1c, Hb1c)
Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl Continue reading >>
Why Doesn't My Average Blood Glucose Match My A1c?!
Want to learn more about A1C? Download our Guide to A1C here! So, for most people, BGmeter average doesntaccuratelyreflect average blood glucose over a full 24 hours.A1C, on the other hand, does. If you want your BG meter average to better reflect your A1C values, check more often! And make sure you check at various times throughout the day, including 1-3 hours after eating. 2. The Average BG to A1C conversionequation is not perfect Most (if not all) average BG to A1C conversiontables and calculators use the below equation to estimate A1C: Average BG (mg/dL) = 28.7 X A1C (%) 46.7 This equation is based on data froma 2008 study of over 500 subjects (268 T1Ds, 159 T2Ds, and 80 non-diabetics)at 10 internationalcenters aroundthe world. The A1C values were all measured in a central laboratory, sodifferences in laboratory method or technique were not a factor. People were studied for 12 weeks, with two days of CGM and three days of 7-point glucose profiles each week. The BG meters used were carefully standardized and calibrated. The graph below shows the data used to derive the relationship between average glucose and A1C. As you can see, there is A LOTofscatter. A number ofdata points are offthe trend line by 1%. And for some A1C values,the spread is enormous Check out the range ofA1Cs for people with an average glucose of ~110 mg/dL it goesfrom below 4% to almost 9%! So, importantly, the study concluded that the equation could be used to convertA1C toaverage blood glucose values for most patients. Notallpatients, just most. Results of a study of 507 subjects. Published in Diabetes Care 31:1473-1478, 2008 . OK But whydo so many people have A1C values that dont follow the equation? As it turns out, the biological processesthat dictate A1C arenot exactly the same for everyone Continue reading >>
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- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Type 2 diabetes: What is the average age of onset?
Tips For Getting An A1c Below 6
Last week, I went to my monthly endocrinologist appointment (monthly because I am pregnant). I got blood work done for the appointment and at the appointment I found out my A1C was 5.5!!! I struggled for 20 years to get my A1C out of the 8’s and into the 7’s and until 7 months ago, I had never seen an A1C below 7. I never thought it was possible to get it that low. I thought people who had lower blood sugars all the time must not eat any carbs and I love my carbs too much to give them up for a lower A1C. I know in the Diabetes Online Community people are torn over if it’s good to share their A1C or not. I like to share my A1C because I hope people read my blog and see that it’s not easy for me (and I’ve definitely had my fair share of bad A1Cs) but attaining a good A1C is possible (I never thought I could get a really good number!). 5.5 translates to an average blood sugar around 111mg/dl. I’ve been hovering between an average of 107 and 120 (thanks to my CGM data) so I was surprised to see my A1C come in at 5.5. An A1C of 5.5 is listed for what a “normal” pancreas functioning non-diabetic’s A1C would be. According to sources, you aren’t considered pre-diabetic until your A1C reaches 5.7 and aren’t considered diabetic until it gets to 6.5. So I am cured, right?! Wrong. A LOT of hard work went into this number and here’s how I did it: Pre-bolus, pre-bolus, pre-bolus – This is especially important to remove high spikes from my day so I have more straight lines than roller coasters. Don’t eat more than every three hours – This gives my insulin time to work and my blood sugar time to come down from meals. Try to keep carbs under 50 for meals and 15 for snacks – I try to stick to this rule for the most part, but snacks usually go over. Also, I Continue reading >>
All About The Hemoglobin A1c Test
People with diabetes used to depend only on urine tests or daily finger sticks to measure their blood sugars. These tests are accurate, but only in the moment. As an overall measurement of blood sugar control, they’re very limited. This is because blood sugar can vary wildly depending on the time of day, activity levels, and even hormone changes. Some people may have high blood sugars at 3 a.m. and be totally unaware of it. Once A1C tests became available in the 1980s, they became an important tool in controlling diabetes. A1C tests measure average blood glucose over the past two to three months. So even if you have a high fasting blood sugar, your overall blood sugars may be normal, or vice versa. A normal fasting blood sugar may not eliminate the possibility of type 2 diabetes. This is why A1C tests are now being used for diagnosis and screening of prediabetes. Because it doesn’t require fasting, the test can be given as part of an overall blood screening. The A1C test is also known as the hemoglobin A1C test or HbA1C test. Other alternate names include the glycosylated hemoglobin test, glycohemoglobin test, and glycated hemoglobin test. A1C measures the amount of hemoglobin in the blood that has glucose attached to it. Hemoglobin is a protein found inside red blood cells that carries oxygen to the body. Hemoglobin cells are constantly dying and regenerating, but they have a lifespan of approximately three months. Glucose attaches, or glycates, to hemoglobin, so the record of how much glucose is attached to your hemoglobin also lasts for about three months. If there’s too much glucose attached to the hemoglobin cells, you’ll have a high A1C. If the amount of glucose is normal, your A1C will be normal. The test is effective because of the lifespan of the hemogl Continue reading >>
Exceeding All Expectations: A 7.1 Drop In A1c In 4 Months
As a mission-driven entrepreneur and angel investor I am always trying to use the products of the companies I work with and their advice. I hadn’t anticipated getting diabetes when I first started working with John Moore and Frank Moss as they started Twine Health, but last Spring I had a unique opportunity to become a user of Twine and it literally saved my life. Diabetes is a huge problem as we all know - there are an estimated 350 million people living with this condition globally and every 7 seconds one person dies as a result of it. In mid-February of this year my son, Jonah, convinced me to stop drinking diet coke. I had a serious habit of drinking 2+ liters per day. The first week after Jonah and I stopped drinking diet coke I felt like I was losing weight. I started measuring my weight daily and was consistently losing about 1 lb every 2 - 3 days. Over the course of 8 weeks, I had lost 30 lbs and remarkably hadn’t changed my eating habits AT ALL. I was eating anything I wanted in any quantity I craved. I figured that the stars had aligned - similar to my friends with high metabolism, I could finally indulge my love for food without consequence. (I know, right?!) In April, I was in DC visiting my buddies Peter Barris and Harry Weller at New Enterprise Associates and wasn’t feeling quite right. My wife, Amy, suggested my unease might be related to blood sugar and recommended I pick up a glucometer just to check my level. First reading: 430. OK, so what is normal? I started searching online and turns out normal is 100! Alright, so now I have my first indication that something is rotten. I make a quick call to my primary care physician (PCP) and she tells me I need to go to the Emergency Room (ER) immediately, so of course I got on a plane and flew back to Bos Continue reading >>
Understanding Your Average Blood Sugar
A1c is an average of all your blood sugars. It does not tell you your blood sugar patterns. Use it only as yet another indicator of how well you’re doing. Glysolated Hemoglobin (or A1c) is a measure of your average blood glucose control over the previous three months. Glucose attaches to hemoglobin the oxygen carrying molecule in red blood cells. The glucose-hemoglobin unit is called glycosolated hemoglobin. As red blood cells live an average of three months, the glycosolated hemoglobin reflects the sugar exposure to the cells over that time. The higher the amount of glucose in the blood, the higher the percentage of hemoglobin molecules that will have glucose attached. Think of the A1c as a long-term blood glucose measure that changes very gradually as red blood cells die and are replaced by new cells. The A1c doesn’t replace self blood-glucose monitoring. Because the A1c is an average of all your blood sugars, it does not tell you your blood sugar patterns. For example, one person with frequent highs and lows can have the same A1c as another person with very stable blood sugars that don’t vary too much. So what’s the point? A1c is yet another indicator of how well you’re doing. An A1c measurement between 4-6% is considered the range that someone without diabetes will have. The American Diabetes Association goal is an A1c less than 7%. Research has shown that an A1c less than 7% lowers risk for complications. The American College of Endocrinology goal is an A1c less than 6.5%. For some people with diabetes an A1c goal of less than 6% is appropriate. Talk with your doctor about your A1c goal. Use this chart to view A1c values and comparable blood glucose values: A1c Estimated Average Glucose mg/dL 5% 97 6% 126 7% 154 8% 183 9% 212 10% 240 11% 269 12% 298 A not Continue reading >>
Ultimate Guide To The A1c Test: Everything You Need To Know
The A1C is a blood test that gives us an estimated average of what your blood sugar has been over the past 2-3 months. The A1c goes by several different names, such aswa Hemoglobin A1C, HbA1C, Hb1C, A1C, glycated hemoglobin, glycohemoglobin and estimated glucose average. What is Hemoglobin? Hemoglobin is a protein in your blood cells that carries oxygen. When sugar is in the blood, and it hangs around for a while, it starts to attach to the red blood cells. The A1C test is a measurement of how many red blood cells have sugar attached. So, if your A1C result is 7%, that means that 7% of your red blood cells have sugar attached to them. What are the Symptoms of a High A1C Test Level? Sometimes there are NO symptoms! That is probably one of the scariest things about diabetes, your sugar can be high for a while and you may not even know it. When your blood sugar goes high and stays high for longer periods of time you may notice the following: tired, low energy, particularly after meals feel very thirsty you may be peeing more than normal, waking a lot in the middle of the night to go dry, itchy skin unexplained weight loss crave sugar, hungrier than normal blurred vision, may feel like you need new glasses tingling in feet or hands cuts or sores take a long time to heal or don’t heal well at all frequent infections (urinary tract, yeast infections, etc.) When your blood sugar is high, this means the energy that you are giving your body isn’t getting into the cells. Think about a car that has a gas leak. You put gas in, but if the gas can’t get to the engine, the car will not go. When you eat, some of the food is broken down into sugar and goes into your bloodstream. If your body can’t get the sugar to the cells, then your body can’t “go.” Some of the sugar tha Continue reading >>
5 Ways To Lower Your A1c
For some, home blood sugar testing can be an important and useful tool for managing your blood sugar on a day-to-day basis. Still, it only provides a snapshot of what’s happening in the moment, not long-term information, says Gregory Dodell, MD, assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Health System in New York City. For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months. Called the A1C test, or the hemoglobin A1C test, this provides a more accurate picture of how well your type 2 diabetes management plan is working. Taking the A1C Test If your diabetes is well controlled and your blood sugar levels have remained stable, the American Diabetes Association recommends that you have the A1C test two times each year. This simple blood draw can be done in your doctor's office. Some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. The A1C test results provide insight into how your treatment plan is working, and how it might be modified to better control the condition. Your doctor may want to run the test as often as every three months if your A1C is not within your target range. What the A1C Results Mean The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 perce Continue reading >>
Hemoglobin A1c Test (hba1c)
Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Continue reading >>
Your A1c Results: What Do They Mean?
If you have diabetes, you should have an A1C test at least twice each year to find out your long-term blood glucose control. The A1C test measures your average blood glucose during the previous 2-3 months, but especially during the previous month. For people without diabetes, the normal A1C range is 4-6%. For people with diabetes, the lower the A1C value, the better the diabetes control and the lower the risk of developing complications such as eye, heart, and kidney disease. Your goal should be to have A1C values less than 7%. That may be a hard target to hit, but it is important to try because the lower your A1C, the lower your health risk. The table on this page shows what your A1C results say about your blood glucose control during the past few months. Some people are surprised when they have a high A1C result because when they check their blood glucose with their meter, they have relatively low numbers. But remember that checking your blood glucose gives you only a momentary sample of your blood glucose control. The A1C test measures your blood glucose control at all times during the previous 2-3 months, even times such as after meals or when you are asleep, when you don't usually check your blood glucose. Think of the A1C test as feedback to help you better control your diabetes and improve your diabetes care habits. By giving you important information about your long-term control, the A1C test can help you stay motivated to do your best on diabetes self care. Talk with your doctor and other members of the health care team about your A1C results and how you can use them to better manage diabetes. Within the next few months, the federal government will implement the first major reorganization of the Medicare system for many years: the Medicare Prescription Drug Imp Continue reading >>