Blood Glucose

A1c Level: Understanding Its Importance

January 11, 2017   /

A1c Level: Understanding Its Importance

The A1c test, which is sometimes referred to as glycosylated hemoglobin or HbA1c, is an important test that determines how your blood glucose control is over time.

The A1c test reflects a person’s average blood glucose levels over a period of 2–3 months. While it is useful to know what your blood glucose level is at any given time, this test provides a more complete view of your overall control over a longer period of time. It is important to use the A1c test in combination with daily monitoring. 

Each 1% reduction in A1c results in a reduction of the risk of microvascular diabetic complications (nephropathy, neuropathy, and retinopathy) by approximately 40%. Good A1c results also may correlate to a reduced risk of macrovascular complications, including heart disease and stroke, although not all studies are conclusive on this point.

However, A1c control is not enough. Control of blood pressure and cholesterol also is imperative.

This is sometimes referred to as the ABCs:

  • A=A1c
  • B=blood pressure
  • C= total cholesterol 

The A1c test
Hemoglobin is a protein found in red blood cells. Red blood cells normally live for 90–120 days. Glucose attaches to hemoglobin in the blood and stays attached for the entire life of the red blood cell. The A1c test measures how much glucose is attached to your hemoglobin.

A1c results are given in percentages. These percentages are correlated to the blood glucose readings that you are used to seeing when monitoring your blood sugar at home. For instance, if your A1c is at 8%, this means that your average blood glucose over the past 2–3 months was around 205 milligrams (mg)/deciliter (dL). Your doctor may recommend a change in medication or other aspects of your treatment plan at this point. 

A1c Reading

Average Blood Glucose During the Past 2–3 Months

6%

126 mg/dL

7%

154 mg/dL

8%

183 mg/dL

9%

212 mg/dL

10%

269 mg/dL

Source: American Diabetes Association®. Standards of medical care in diabetes—2012. Diabetes Care [serial online]. 2012;35(suppl 1):S11-S63. Available at: http://care.diabetesjournals.org/content/35/Supplement_1/S11.full. Accessed July 24, 2012.

A1c level goal
In general, the American Diabetes Association recommends a goal of 7% for all people with diabetes, and the American Association of Clinical Endocrinologists recommends a goal of 6.5%. However, this varies by individual. For instance, individuals who are elderly, who are very young, or who frequently suffer from hypoglycemia sometimes are advised to aim for a slightly higher A1c level. Pregnant women sometimes are advised to aim for a lower A1c level to prevent complications. Discuss your goal with your physician, dietitian, or diabetes educator.

A1c test frequency
People with a history of good glucose control may only need to have their A1c level tested twice a year. However, individuals who struggle to maintain control or have started a new treatment regimen may need their A1c level tested every 3 months. 

 

References and recommended reading
American Diabetes Association®. Standards of medical care in diabetes—2012. Diabetes Care [serial online]. 2012;35(suppl 1):S11-S63. Available at: http://care.diabetesjournals.org/content/35/Supplement_1/S11.full. Accessed July 24, 2012.

Robertson C. Strategies to reduce the risk of diabetic complications. Available at: http://www.cecity.com/scherer/complications2/flash/print.pdf. Accessed July 24, 2012.

 

Review Date 7/12
D-0542 

D_0542_A1c_Level_Understanding_Its_Importance.doc