August 3, 2022

A1C Overview: What is A1C? | US MED

One reliable method of diagnosing diabetes is the hemoglobin A1C test. If you're asking yourself, “What is A1C testing, anyway?” Learn more with US MED.


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Home / Living with Diabetes / A1C Overview: What is A1C? | US MED

If you notice diabetes symptoms or are at risk for type 1 or type 2 diabetes, it’s crucial to get tested for this condition. One of the most reliable methods of diagnosing diabetes is the hemoglobin A1C test – or the A1C test for short. 

Are you asking yourself, “What is A1C testing, anyway?” If so, you’re in the right place. Read on for a complete A1C test guide. Here, you’ll find an A1C chart, information on how to lower A1C levels, and much more. 

What is A1C? 

The A1C test is a blood test often used in the diagnosis and treatment of diabetes. This test measures average blood glucose levels over three months. The higher your A1C levels are, the more likely you are to experience diabetes-related complications. 

Who should get an A1C test, why, and when?

Setting up an A1C test is a wise idea for anyone over the age of 45. This straightforward blood test can help you spot diabetes or prediabetes early on.

People aged 45 and older aren’t the only group that can benefit from an A1C test. Even if you’re not 45 yet, you should get this test if you have excess weight and/or diabetes risk factors.

Are you curious about your ideal A1C testing frequency? Here’s the complete breakdown:

  • If you get normal A1C results but are older than 45, have had gestational diabetes, or are living with diabetes risk factors, plan to repeat this test once every three years.
  • If your results point to prediabetes, ask your doctor how you can reduce your type 2 diabetes risk. On top of that, your doctor will inform you of how often you should repeat this test – usually, you’ll do so every year or two in this situation.
  • If your results indicate you have type 2 diabetes but you have no symptoms, schedule another A1C test for another day to ensure your results are accurate.
  • If you have type 2 diabetes, ask your doctor for advice on diabetes management and support. Along with that, plan on repeating the A1C test twice a year at a minimum (and whenever you change medications).

What does the A1C test measure?

A1C testing focuses on measuring a red blood cell protein known as hemoglobin, which is what blood glucose attaches to in the bloodstream. While having some sugar attached to hemoglobin is normal, people with diabetes have a higher amount of hemoglobin covered with sugar. That means measuring the percentage of hemoglobin with attached glucose in a person’s bloodstream is an ideal way to test for diabetes.  

A1C and prediabetes

Along with its role in diabetes management, the A1C test can help diagnose and control prediabetes. Prediabetes is basically an “early” form of type 2 diabetes, where blood glucose levels are elevated but have not reached the levels associated with full diabetes. A1C testing can detect the lower – but still higher than ideal – blood sugar levels associated with this condition. 

Types of diabetes diagnosed by A1C tests

The A1C test is capable of diagnosing both major forms of diabetes, along with prediabetes. Here, we’ll take a closer look at the two main types of diabetes this test can help identify:

Type 1 diabetes

A1C testing is the most common method of diagnosing type 1 diabetes. That form of diabetes starts when a person’s immune system starts attacking the pancreas cells responsible for producing insulin. From what we know, there is no method of preventing type 1 diabetes. 

Type 2 diabetes

Type 2 diabetes is also usually diagnosed with an A1C test. Unlike type 1 diabetes, this disease involves heightened insulin resistance in cells. The pancreas can eventually “burn out” while trying to meet the body’s increased insulin needs in type 2 diabetes. While people with prediabetes are at risk of developing type 2 diabetes, the progression of this disease may be reversible through lifestyle changes like diet and exercise.

Hemoglobin A1C 

A1C testing focuses on measuring a red blood cell protein known as hemoglobin, which is what blood glucose attaches to in the bloodstream. While having some sugar attached to hemoglobin is normal, people with diabetes have a higher amount of hemoglobin covered with sugar. That means measuring the percentage of hemoglobin with attached glucose in a person’s bloodstream is an ideal way to test for diabetes.  

Prediabetes A1C 

Along with its role in diabetes management, the A1C test can help diagnose and control prediabetes. Prediabetes is basically an “early” form of type 2 diabetes, where blood glucose levels are elevated but have not reached the levels associated with full diabetes. A1C testing can detect the lower – but still higher than ideal – blood sugar levels associated with this condition. 

What is hyperglycemia? 

If you suspect you have diabetes, it’s critical to be aware of the signs associated with high blood sugar – whether or not you’ve gone through A1C testing. Especially high blood glucose levels are known as “hyperglycemia,” and they are connected to symptoms such as: 

  • Confusion 
  • Slow healing of wounds 
  • Headache 
  • Tiredness 
  • Vomiting and nausea 
  • Blurry vision and other visual changes 
  • Increased urination and thirst 

 Any level of blood sugar higher than 200 mg/dl is considered hyperglycemia. If your blood glucose is above this value but under 240 mg/dl, you can lower it with physical activity. If your blood sugar is in excess of 240 mg/dl or your urine contains ketones, contact your healthcare team. 

What is hypoglycemia? 

People with diabetes should also know that steps to lower their blood glucose can be too effective. Low blood sugar, AKA “hypoglycemia,” can lead to: 

  • Seizures 
  • Headaches 
  • Blurred vision 
  • Fatigue 
  • Nausea 
  • Hunger 
  • Changes in mood (irritability or anxiety) 
  • Chills and sweating 
  • Shakiness 

Blood glucose levels below 80 70 mg/dl fall into the hypoglycemia range. To treat this condition, use the “15-15 rule.” Consume 15 grams of fast-acting carbohydrates, wait 15 minutes, and recheck your blood sugar. If your blood glucose is still low, repeat the process. Seek medical attention if you go through this process twice and still have low blood sugar levels. 

Why is an A1C test done? 

The A1C test is a valuable tool that can help you at any point in your diabetes management journey. More specifically, it can be used for: 

  • Diagnosing type 1/type 2 diabetes. A single A1C test can point to diabetes, but you’ll need more than one test to be sure. Your healthcare provider will run two blood tests on two separate days when attempting to diagnose diabetes. The second test may be another A1C test, a random blood sugar test, or a fasting test. 
  • Diagnosing prediabetes. Prediabetes may not “officially” be diabetes, but it comes with an increased risk of type 2 diabetes and heart disease. 
  • Tracking the progress of your diabetes treatment plan. Your first A1C tests will set your “baseline” A1C level. Repeating this test regularly will help you measure your blood sugar from that point on. 

How do I prepare for an A1C test? 

Unlike some blood tests, you shouldn’t need to fast or do anything else out of the ordinary when preparing for an A1C test. This test will be performed in a doctor’s office or lab and will involve collecting a blood sample from your finger or arm. (Still, it is a good idea to ask your doctor if they are planning to do any other tests on the same day and how you can prepare for additional tests.) 

A1C Chart  

Normal A1C  Lower than 5.7 percent 
Prediabetes A1C  5.7 to 6.4 percent 
Diabetes A1C  6.5 percent or higher 

How do you calculate A1C levels? 

An A1C calculator can help you convert your estimated average glucose to A1C or vice versa. You can use the American Diabetes Association’s A1C calculator online. 

What is a normal A1C level? 

Normal A1C – Men 

Men’s A1c levels should be lower than 5.7 percent if they do not have diabetes. While managing diabetes, most men should aim for an A1C goal of 7 percent or lower. 

Normal A1C – Women 

Are you wondering, “What is a normal A1C level for woman?” As is the case for men, an A1C level under 5.7 percent is considered normal. 

What is a dangerous level of A1C? 

Technically, an A1C level of 6.5 percent or higher indicates diabetes. That said, lower A1C measurements can also be dangerous. Readings in the 5.7 percent to 6.4 percent range point to prediabetes, which can easily lead to type 2 diabetes if left alone. 

What can affect your A1C results?

Several factors can skew your A1C test results. Some of these factors are:

  • Hemoglobin variants other than hemoglobin A
  • Anemias (conditions resulting in low red blood cell counts)
  • Blood transfusions in the recent past
  • Recently losing significant amounts of blood
  • Pregnancy

Can A1C results be inaccurate?

Aside from interference involving the factors listed above, A1C tests tend to be quite accurate. That said, there is a small margin of error to keep in mind – your A1C test could be off by up to 0.4 percent.

How to keep your blood sugar A1C in check 

If your A1C levels indicate that you have diabetes or prediabetes, follow these steps to control your blood glucose levels: 

  • Develop and follow a healthy diabetes diet. Your healthcare team will assist in a nutritious diet that meets your nutritional needs. The ideal diabetes meal plan  includes balanced portions of proteins, fresh fruits and vegetables, and whole grains packed with fiber. Meanwhile, try to avoid processed sugars and unhealthy fats. 
  • Get more physical exercise. Working out can lower your blood sugar level. Even if you can’t do a “real” workout every day, activities like gardening, climbing stairs, and parking farther than usual from stores can help. 
  • Lose excess weight. Reducing your overall weight by just five to 10 percent can have a noticeably positive effect on your blood sugar levels. medicare-coverage-for-cgm
  • Take any medications your doctor prescribes. While insulin is the most prominent diabetes medication, you may also receive prescriptions for other medicines. 
  • Check your blood sugar regularly. You can perform this task with a simple blood glucose meter. If you don’t enjoy using these devices, consider buying a continuous glucose monitor. These products can’t replace finger prick tests, but they can certainly reduce your reliance on them. 

How to treat high blood sugar A1C levels 

Even when you follow the steps listed above, you may find yourself dealing with hyperglycemia from time to time. When that happens, follow the steps listed under the “What is hyperglycemia?” section of this article. 

When should I seek medical attention? 

If your blood sugar is severely low or high, you need professional medical treatment. Be aware of the symptoms associated with hypo- and hyperglycemia, and know when at-home treatment methods aren’t enough to control these conditions. 

Where can I find supplies for diabetes management? 

US MED is America’s most reliable source of diabetes supplies. Whether you’re looking for CGMs, insulin pumps, or diabetes testing supplies, we have the products you need! 

Sources:

American Diabetes Association

Shirley DeLeon Certified Diabetes Care & Education Specialist

Medical Review by Shirley DeLeon, Certified Diabetes Care and Education Specialist

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