What Is The A1c Metric
An A1C has many names. It can be called a hemoglobin A1C, glycated hemoglobin or HbA1c. Overall, its the lab that your provider collects when they want to see what your average blood sugar is over the course of three months. It is used to diagnose prediabetes or diabetes, or if you already have diabetes, monitor how youve been managing your blood sugars over a long period of time. A higher A1C means your blood sugars have been running higher lower A1C means your blood sugars have been running lower.
Think about it this way when you spill honey on your countertop, it gets sticky. When your blood sugar is high, your blood gets sticky, too, and the little sugar molecules will stick onto the protein on your red blood cells at a higher rate. The test is telling you what percentage of your red blood cells have a sugar-coated hemoglobin.
How Often Should I Get An A1c Test
Theres no one-size-fits-all when it comes to how often you should get tested. The frequency will be determined by your healthcare provider and will depend on a few factors unique to you including your age as well as if youre on any current diabetes treatment plan with certain goals.
In general, however, if you have prediabetes, the Mayo Clinic recommends getting tested once a year. If you have diabetes, and if your blood sugar level is consistently within your target range and you dont use insulin, twice a year is recommended. If your blood sugar levels have been out of your target range and you are using insulin, your doctor might recommend up to four times per year. Additionally, if your diabetes treatment plan changes or you begin taking a new diabetes medication, that could also increase the frequency of A1C testing. You can work with your healthcare provider to decide what works best.
Whether you’re navigating medications for a recent diagnosis or are looking to learn more about diabetes prevention, we know it can be a lot to sort through. Thats why were here to help every step of the way.
From glucose monitors to test strips to medications, our team of patient care pharmacists at Alto is available to chat whenever questions come up. Feel free to reach out any time via in-app secure messaging or phone at 1-800-874-5881.
Oral Glucose Tolerance Test
The OGTT is a two-hour test that checks your blood glucose levels before and two hours after you drink a special sweet drink. It tells the doctor how your body processes sugar.
- Diabetes is diagnosed at two-hour blood glucose of greater than or equal to 200 mg/dl
|
Oral Glucose Tolerance Test |
| Normal |
| 200 mg/dl or higher |
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Hemoglobin A1c Not Reliable In Diagnosing Type 2 Diabetes
With Maria Mercedes Chang Villacreses, MD, and Elena Christofides, MD, FACE
The test that doctors most often rely on to detect a persons risk for prediabetes and type 2 diabetesthe hemoglobin A1c blood testtoo often delivers a poor reading, thereby missing the diagnosis in nearly three out of four at-risk individuals,1 according to research presented at the Endocrine Society meeting in New Orleans, Louisiana.
The investigators compared the accuracy of the A1c test with the other screening method used to assess patients risk of diabetesthe oral glucose tolerance test to arrive at this startling conclusion.1
The common use of the hemoglobin A1c test to screen for prediabetes and type 2 diabetes should be skipped in place of more reliable tests. Photo: 123rf
The A1c missed almost 73% of the people with diabetes in comparison to the oral glucose tolerance test, says Maria Mercedes Chang Villacreses, MD, a clinical endocrinology fellow at the City of Hope Diabetes and Metabolism Research Institute in Duarte, California, who introduced the findings at the annual meeting of the Endocrine Society but are considered preliminary until published in a peer-reviewed medical journal.
Since the fasting blood test requires a person to fast, the OGTT measures the bodys response to sugar it requires a person to fast overnight. First, blood is taken, then the person drinks a sugary drink. Blood is taken again two hours later.
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How Often Do You Need The Test
Your doctor probably will have you take the A1c test as soon as youâre diagnosed with diabetes. Youâll also have the test if your doctor thinks you may get diabetes. The test will set a baseline level so you can see how well youâre controlling your blood sugar.
How often youâll need the test after that depends on several things, like:
- The type of diabetes you have
- Your blood sugar control
- Your treatment plan
Youâll probably get tested once a year if you have prediabetes, which means you have a strong chance of developing diabetes.
You may get tested twice each year if you have type 2 diabetes, you don’t use insulin, and your blood sugar level is usually in your target range.
You could get it three or four times each year if you have type 1 diabetes.
You may also need the test more often if your diabetes plan changes or if you start a new medicine.
Itâs not a fasting test. You can take it any time of day, before or after eating.
People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can affect the results of the hemoglobin A1c include supplements, such as vitamins C and E, and high cholesterol levels. Kidney disease and liver disease may also affect the test.
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Underlying Factors For Enhanced A1c For Seniors
Disease Duration: Obviously if the onset is during the middle age, you have suffered longer compared to the onset during your seniors years .Life Expectancy: You are expected to live more or less than 10 yearsRelevant Diabetes and Other Unrelated Medical Symptoms: The diseases and symptoms determine your overall wellbeing, how you function on day-to-day basis.Pancreas Overwhelmed Addressing the Insulin Requirement for Years Up to Senior Life: In many cases it cant support converting your body glucose entirely or partially to energy. The glucose stays on the blood stream resulting in higher A1c.
This accompanied table can help you quickly looking at the conversion if you are more familiar with Mmol/dL. The implications of these numbers In context to health are described following this table.
A1c. Mmol/ dL
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How Do You Treat Prediabetes
If you have been diagnosed with prediabetes, there are a number of things you can do to prevent or delay the onset of type 2 diabetes.
These include:
- Exercising for at least 30 minutes a day five days a week
- Quitting smoking if you smoke
- Limiting your alcohol intake
If you implement these lifestyle changes and your A1C test results are still high, you may need to start taking medication for prediabetes such as metformin.
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What Can Affect Your A1c Results
Anyone whos had diabetes for any length of time knows that A1C tests havent been reliable until recently. In the past, many different types of A1C tests gave different results depending on the lab that analyzed them. But the National Glycohemoglobin Standardization Program has helped improve the accuracy of these tests.
Manufacturers of A1C tests now have to prove that their tests are consistent with those used in a major diabetes study. Accurate home test kits are also now available for purchase.
But accuracy is relative when it comes to A1C or even blood glucose tests. The A1C test result can be up to half a percent higher or lower than the actual percentage. That means if your A1C is 6, it might indicate a range from 5.5 to 6.5.
Some people may have a blood glucose test that indicates diabetes but their A1C is normal, or vice versa. Before confirming a diagnosis of diabetes, your doctor should repeat the test that was abnormal on a different day. This isnt necessary in the presence of unequivocal symptoms of diabetes and a random sugar over 200 mg/dl.
Some people may get false results if they have kidney failure, liver disease, or severe anemia. Ethnicity can also influence the test. People of African, Mediterranean, or Southeast Asian descent may have a
changes in lifestyle can make a big difference and even put your diabetes in remission. Starting an exercise program can help. Type 1 diabetes needs insulin treatment as soon as its diagnosed.
The Big Picture: Monitoring Treatment
This relatively simple blood test can tell you a lot. The test results give you a picture of your average blood sugar level over the past two to three months. The higher the levels, the greater your risk of developing diabetes complications. Your doctor will tell you how often you need the A1C test, but usually youll have the test at least twice a year if youre meeting your treatment goals. If you’re not meeting your goals or you change treatments, you may need to get an A1C test more often.
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Diabetic Nerve Pain In Ankle Feet And Legs
Diabetic neuropathy is a condition that results from damage to the nerves due to high blood sugar levels and nerve damage can cause a wide range of symptoms including pain, numbness, tingling, burning sensations, and weakness. In some cases, diabetic neuropathy can lead to serious complications such as diabetic foot ulcers.
A1c Results And What The Numbers Mean
| Diagnosis* | |
|---|---|
| Diabetes | 6.5 percent or above |
When using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial.
Blood samples analyzed in a doctors office or clinic, known as point-of-care tests, should not be used for diagnosis.
The A1C test should not be used to diagnose type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes. The A1C test may give false results in people with certain conditions.
Having prediabetes is a risk factor for developing type 2 diabetes. Within the prediabetes A1C range of 5.7 to 6.4 percent, the higher the A1C, the greater the risk of diabetes.
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Official Fasting Blood Sugar Ada Recommendation For Someone With Diabetes
The American Diabetes Association recommends a fasting blood sugar target of 80 to 130 mg/dl for most nonpregnant adults with diabetes. However, the fasting blood sugar target may need to be individualized for certain people based on such factors as duration of diabetes, age and life expectancy, cognitive status, other health conditions, cardiovascular complications, and hypoglycemia unawareness. Its important that people with diabetes discuss their target blood sugar goals with their health care provider.
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How Often Do You Need To Test
Starting at age 45, adults should get a baseline A1C test. If youre younger than 45, overweight, and have any , you should get tested.
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If your result is normal but youre over 45, have risk factors, or have ever had , repeat the test every three years.
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If your result indicates prediabetes, your doctor will likely recommend testing every one to two years.
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If you have diabetes, at least twice a year. You may need more frequent tests if your medication changes or you have other health conditions.
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An A1c Goal Of Between 7% And 8% Is Reasonable And Beneficial For Most Patients With Type 2 Diabetes
though if lifestyle changes can get that number lower, then go for it. For patients who want to live a long and healthy life and try to avoid the complications of diabetes, they will need to keep their blood sugars as normal as possible that means an A1c under 6.5%. However, studies show that using medications to achieve that goal significantly increases the risk of harmful side effects like hypoglycemia and weight gain. To live longer and healthier and avoid both the complications of diabetes as well as the risks of medications, theres this amazing thing called lifestyle change. This involves exercise, healthy diet, weight loss, and not smoking. It is very effective. Lifestyle change also can help achieve healthy blood pressure and cholesterol levels, which in turn reduce the risk for heart disease. And heart disease is a serious and common complication of diabetes.
Lifestyle change should be the cornerstone of treatment for type 2 diabetes. The recommendations go on to say that for patients who achieve an A1c below 6.5% with medications, we should decrease or even discontinue those drugs. Doing so requires careful monitoring to ensure that the person stays at the goal set with his or her doctor, which should be no lower than 7%, for the reasons stated above.
Diabetes: Influencing Factors In Who Can Donate Blood
Diabetes must be under control before donating blood. This means youre able to maintain healthy blood sugar levels. This requires daily diabetes management with lifestyle habits that include a range of nutritious foods, exercise, and stress management. For some people, it may also require taking certain diabetes medications.
If you have questions about other medications, you may be taking for diabetes management or other health conditions and how these impact your eligibility to donate blood, you can ask your healthcare provider or the staff at the blood donation clinic. Many medications are acceptable.
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Why Should A Person Get The A1c Test
Testing can help health care professionals
- find prediabetes and counsel you about lifestyle changes to help you delay or prevent type 2 diabetes
- find type 2 diabetes
- work with you to monitor the disease and help make treatment decisions to prevent complications
If you have risk factors for prediabetes or diabetes, talk with your doctor about whether you should be tested.
Eat A Balanced Diet With Proper Portion Sizes
Its best to check with a CDCES or registered dietitian/nutritionist to determine what a balanced diet and appropriate portion sizes mean for you. But a great rule of thumb is to fill half of your plate with veggies, a quarter with protein, and a quarter with whole grains, says Turkel. If you like fruit, limit your portion to a small cup, eaten with a little protein or lean fat to help you digest the carbohydrates in a way that is less likely to spike your blood sugar.
Also, avoid processed foods as much as possible, and try to avoid sugary sodas and fruit juice, which are high in carbs and calories, and thus can lead to spikes in blood sugar and contribute to weight gain, according to the ADA.
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The Difference Between Eag/a1c And The Average On Your Monitor
The catch is that eAG/A1C is not the same average glucose level as the average of the readings on your meter.
Monitoring measures your blood glucose at a moment in time, whereas eAG/A1C represent an average of your glucose levels 24 hours a day, including times when people are less likely to check their blood sugar .
People with diabetes are also more likely to check their blood glucose more often when they are low , so the average of readings on their meter is likely to be lower than their eAG.
How Often To Get A1c Checked
The frequency of your A1C tests depends on your diabetes goals, how well youre doing with your management, and your providers guidance. If youve been recently diagnosed made some changes in your diabetes management, like started a new glucose-lowering medication or had a medical problem or surgery, you may need to have a your A1C checked quarterly. However, if your glucose levels and A1C are pretty stable, you may do well having your A1C checked just twice a year. Talk to your health care provider about how frequently you should have the test and your individual goal.
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Ways To Lower Your A1c
A1C is a blood test that shows how well your diabetes management plan is working. Heres how to reach a healthy A1C number and avoid diabetes complications.
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 whats happening in the moment, not a full picture of whats happened in the long term, 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 another lens on how well your type 2 diabetes management plan is working.
How Often Do You Need To Take An A1c Test
If your blood sugar levels have remained stable and your A1C is within your target range, the American Diabetes Association recommends getting the test two times a year. If your therapy has changed or you are not meeting your blood sugar targets, the ADA recommends getting the test four times per year. This simple blood draw can be done in your doctors office.
The A1C test results provide insight into how your treatment plan is working and how it might be modified to better control the condition. Often, your blood sample is sent out to a lab, though 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.
While in-office tests can be used to monitor the disease, the National Institute of Diabetes and Digestive and Kidney Diseases notes that most point-of-care tests should not be used for diagnosis. That can only be done by lab tests certified by the NGSP, an organization that standardizes A1C test results. Any in-office test results pointing to a change in your health should be confirmed by conventional lab tests.
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