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 >>
What Is A Good Score On The A1c Diabetes Test?
Normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time can have an A1C level above 9 percent. A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate dates indicates diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which is high risk of developing diabetes. For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications. A good score on the A1C test depends on whether you’ve been diagnosed with diabetes. For those who do not have diabetes, a score of less than 5.7% is considered normal, while 5.7% to 6.4% indicates prediabetes and 6.5% or higher means you have diabetes. If you already have diabetes, a score of 7% or lower is desired. You and your doctor can decide what score is best for you. The A1C diabetes test is a way to get an average of how well your blood sugar has been controlled for the past three months. The standard A1C goal for most people with diabetes is less than 7%. However, the goal may be individualized or may be different for some people, especially older adults, people with heart disease or those who are prone to frequent low blood glucose. It's a good idea to find out what your A1C goal should be from your healthcare provider and then use that as a benchmark for your A1C results. No one quite agrees on where your A1C score should be, but we all agree on where it shouldn’t be. The scale does not look anything like the BGL numbers you are used Continue reading >>
The A1c Test & Diabetes
What is the A1C test? The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. How does the A1C test work? The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent. Can the A1C test be used to diagnose type 2 diabetes and prediabetes? Yes. In 2009, an international expert committee recommended the A1C test as one of the tests available to help diagnose type 2 diabetes and prediabetes.1 Previously, only the traditional blood glucose tests were used to diagnose diabetes and prediabetes. Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes. However, some medical organizations continue to recommend using blood glucose tests for diagnosis. Why should a person be tested for diabetes? Testing is especially important because early in the disease diabetes has no symptoms. Although no test is perfect, the A1C and blood glucose tests are the best tools available to diagnose diabetes—a serious and li 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 >>
The A1c Score: The A1c Score Is Well Within The Dental Hygiene Scope Of Practice
The A1C score: The A1C score is well within the dental hygiene scope of practice It's not just a casual conversation. The A1C score is well within the dental hygiene scope of practice Knowing the diabetic patient's HbA1c (A1C) score is a critical part of the medical history questioning. Recently, I asked a diabetic patient about his last A1C score. He did not know offhand, but said he would follow up with his physician as he recently had the blood test. His doctor replied that requesting this information from a dental hygienist is "beyond the scope of their practice." The doctor was even reluctant to tell the patient what his score was. Relentless, this patient did get his score and brought it to our attention; it was normal. In terms of comanaging health, this experience shows we have a long way to go in integrating medical-dental relationships. It also shows that not all physicians know the scope of the dental hygiene practice. What's new in diabetes research, care, and prevention? ----------------------------------------- Regardless of this experience, it is important for the patient and the dental team to know each patient's diabetic stability. Evidence-based research shows the bidirectional effect periodontal disease has on diabetes and vice versa. A patient with a higher A1C score (suspect uncontrolled diabetes) may require specialized services, referrals for extractions, or more aggressive periodontal treatment, for example, due to this higher risk factor. This article will explore the bidirectional effects between periodontal disease and diabetes, what an A1C score actually measures, why it is important for dental hygienists to know the A1C score, and how we can empower our patients to better manage their oral health and diabetes. The A1C score is a simple bloo Continue reading >>
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Hemoglobin A1c (hba1c) Test For Diabetes
The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can Continue reading >>
What Does Your A1c Number Really Mean?
We dFolk are bombarded with numbers, goals, and targets. We’re frequently told where we should be, but not how high our risk is when we can’t reach our targets. Here, we break down A1C numbers into a simple green-light, yellow-light, red-light format, to give you perspective on when (and how much) to worry, when to relax, when to call your doc, and when to call 911. Green-light A1C score For most people, the target for A1C, the green light, is between 6.0% and 6.9%. These numbers are commonly expressed simply as 6.0 and 6.9, without the % sign. If your A1C falls into this zone, you’re considered to be in control. For perspective, these numbers can be converted into “meter” numbers called estimated average glucose—eAG for short. The green light eAG range is 126 mg/dL (7 mmol/l) to 151 mg/dL (8.39 mmol/l). But what if your numbers are higher than target? Or lower than target? When are you actually in danger? Yellow-light A1C score If the light turns yellow as you approach the intersection, you need to either speed up or stop. Whichever is safe under the circumstances, right? If your A1C is between 7.0 and 8.9, you’ll be classified as “out of control.” But how much danger are you in? Frankly, it depends upon how close you are to either end of the spectrum. Yellow-light A1Cs are higher than is strictly healthy, but pose no immediate harm. However, the higher you are in this range, the closer you are to a red light. We’ll talk about just how serious that can be in a minute. I should point out that there are some special cases. If you’re a very young type 1, a yellow-light A1C score may be considered in-target for you until you get older. Similarly, if you’re an elderly type 2, or have a history of severe hypoglycemia, you doctor may choose to “green Continue reading >>
Passing The A1c “test”…what Do I Need To Score?
No one quite agrees on where your A1C score should be, but we all agree on where it shouldn’t be. The scale does not look anything like the BGL numbers you are used to. For all practical purposes, it runs from 5.0 up to 14.0 where most in-house A1C machines max out. Labs can test higher, but at 14.0 your doctor will run screaming for the hills anyway, so it really doesn’t matter. At that level your blood sugar is lethal and your body is slowly dissolving, just as if you had battery acid in your veins and arteries. As a side note, many offices have in-house A1C machines that give results in six minutes. Very handy. I personally love being able to discuss the score with the patient during the visit. Other offices do a “send out.” We generally do them in-house, but if we are also running other lab tests we’ll sometimes piggyback the test onto the blood draw. Both are highly accurate and reliable. So back to your score. Scores below 6.0 are usually considered to be in the non-diabetic range. At 9.0 we cross the threshold where kidney damage starts. So we can all agree that above 9.0 you are in deep shit and the higher above 9.0 that the number is, the worse off you are because A1C tests are curvilinear. Just like Category 3 hurricanes are much worse than Category 2 storms, or like 7.3 earthquakes are much worse than 7.0s, each increase in your A1C number packs a larger punch than you’d expect. The numbers are sufficiently confusing that the ADA has introduced a new measure called eAG, for estimated average glucose. This is a formula that “translates” an A1C score into a “meter number.” It hasn’t been widely adopted yet and the jury is still out on how useful eAG is. I use it for some patients, but not for others, but I always like to have a lot of tool 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 >>
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 >>
Is A Lower A1c Level Better Or Worse?
It seems logical that the lower our blood glucose levels are the better we will be. Most of us have always assumed that lower blood glucose levels would protect us better from the complications of diabetes. In fact, during the past two decades several studies showed a linear relationship between blood glucose, as measured by A1C levels, and worsened health. But now, several recent A1C studies have shown a J-shaped relationships, in which at the lower end some bad things happen, at the center things are better, and at the top end things are terrible. While linear relationships are the rule in observational studies, U-shaped and J-shaped curves aren’t uncommon, and some authors lump both of these shapes as U-shaped. All of the studies relating A1C levels and ill health — the earlier ones and the recent ones alike — are observational. They study correlations, which aren’t proof, because other confounding factors that the researchers didn’t take into account could have been the problem. 5.4-5.6 Seems Safest The first of these newer studies showing that a very low A1C level is unhealthier than a higher one came out in the February 2015 issue of Diabetes Care. This analysis of the German National Health Interview and Examination Survey 1998 that studied about 6,300 people for about 12 years indicated that people with an A1C level of 5.4 to 5.6 had the lowest risk of excess mortality. Because this result puzzled me so much, I asked Dr. Richard K. Bernstein for his reaction. “These A1c measurements were made years ago in Germany,” he replied, “before international agreement on how it would be measured. The modern elution method would likely give considerably different results. It is even possible that several different methods were being used at different sites 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 >>
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 >>
How To Lower Your A1c Levels: A Healthful Guide
An A1C blood test measures average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommend the use of A1C tests to help diagnose cases of prediabetes, type 1, and type 2 diabetes. A1C tests are also used to monitor diabetes treatment plans. What is an A1C test? An A1C test measures how well the body is maintaining blood glucose levels. To do this, an A1C test averages the percentage of sugar-bound hemoglobin in a blood sample. When glucose enters the blood, it binds to a red blood cell protein called hemoglobin. The higher blood glucose levels are, the more hemoglobin is bound. Red blood cells live for around 4 months, so A1C results reflect long-term blood glucose levels. A1C tests are done using blood obtained by a finger prick or blood draw. Physicians will usually repeat A1C tests before diagnosing diabetes. Initial A1C tests help physicians work out an individual's baseline A1C level for later comparison. How often A1C tests are required after diagnosis varies depending on the type of diabetes and management factors. Lowering A1C levels Many studies have shown that lowering A1C levels can help reduce the risk or intensity of diabetes complications. With type 1 diabetes, more controlled blood glucose levels are associated with reduced rates of disease progression. With type 2 diabetes, more controlled A1C levels have also been shown to reduce symptoms affecting the small arteries and nerves in the body. This influences eyesight and pain while decreasing complications. Long-term studies have also shown that early and intensive blood glucose control can reduce cardiovascular complications in people with type 1 or 2 diabetes. Even small changes in A1C levels can have big effects. The ADA recommend that maintaining fair control 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 >>