When Should Hemoglobin A1c Levels Be Tested
In addition to random fasting blood glucose levels, HbA1c levels are routinely measured in the monitoring of people with type 1 and type 2 diabetes. HbA1c levels depend on the blood glucose concentration. That is, the higher the glucose concentration in blood, the higher the level of HbA1c. Levels of HbA1c are not influenced by daily fluctuations in the blood glucose concentration but reflect the average glucose levels over the prior six to eight weeks. Therefore, HbA1c is a useful indicator of how well the blood glucose level has been controlled in the recent past and may be used to monitor the effects of diet, exercise, and drug therapy on blood glucose in people with diabetes.
Sometimes The Test Isnt Accurate And Heres Why:
- If you are bleeding a lot, the protein in your red bold cells may be low, so it could say your A1C is lower than it actually is.
- If youve just had a blood transfusion or have other forms of hemolytic anemia, your A1C test results may be lower than it actually is.
- If you are low in iron in the blood, your A1C test results may be higher than it actually is.
- If you have a special hemoglobin . Most people have Hemoglobin A. With the variant, you can be falsely high or low. A lab test can be done to see which one you are and special lab tests can then give you an accurate A1C.
- A new lab can give different results as well. Keep this in mind if your results were sent away to a new facility. It could account for minor reading variations.
Medications With A1c Of 74
There are a variety of medications available to treat diabetes. Type 1 and type 2 diabetes are generally treated with different medications.
Type 1 diabetics need insulin to replace what their body no longer produces. There are four main forms of insulin.
- Rapid-Acting Injections The insulin takes effect within 5 to 15 minutes and lasts for 2 to 4 hours. Popular brands include Humalog and NovoLog
- Short-Acting Injections The insulin takes effect between 30 minutes and 1 hour and lasts for 3 to 6 hours. Often referred to as regular insulin, popular brands include Humulin R and Novolin R.
- Intermediate-Acting Injections The insulin takes effect between 1 to 4 hours and lasts for 12 to 18 hours. Often referred to as NPH insulin, popular brands include Humulin N and Novolin N.
- Long-Acting Injections The insulin takes effect after 1 or 2 hours and lasts up to 24 hours. Popular brands include Lantus, Toujeo, Levemir and Tresiba.
Type 1 diabetics may also take a premixed injection of the above to better manage their specific blood sugar levels throughout the day. In addition, your doctor might prescribe one of the following type 2 diabetes medications in conjunction with insulin.
Insulin can also be used to treat type 2 diabetes but doctors often resort to insulin only after other medications have failed to control a patients blood sugar.
The good news is there are a lot of type 2 diabetes medications out there.
What Do Your A1c Results Mean
The A1C test measures the glucose in your blood by assessing the amount of whats 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.
According to the ADA, A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 percent signals prediabetes, according to the ADA. Type 2 diabetes is diagnosed when the A1C is at or over 6.5 percent. For many people with type 2 diabetes, the goal is to lower A1C levels to a healthier percentage.
Your A1C goal is specific to you. Several factors come into play, such as your age, how advanced the diabetes is, and any other heath conditions you have. A common A1C goal for people with diabetes is less than 7 percent, Dodell says. If you can keep your A1C number below your goal, you help to reduce the risk of diabetes complications, such as nerve damage and eye problems.
What Tools Are Available If An A1c Test Is Not Accurate Or Sufficient
Besides A1c tests, the most common measures of blood sugar are the oral glucose tolerance test , CGM, and self-monitored blood glucose tests.
The OGTT is a diagnostic tool diabetes and prediabetes, assessing a persons response to consuming a fixed amount of sugar. After taking the sugar drink, blood sugar levels are measured two hours later. Below 140 mg/dl is considered normal, between 140 mg/dl and 200 mg/dl points to prediabetes or impaired glucose tolerance, and above 200 mg/dl indicates diabetes. It is not useful for tracking diabetes management.
For those with established diabetes, CGM has the advantage of monitoring blood sugar levels consistently throughout the day , providing more detailed insight into time spent in-range, low blood sugars, and high blood sugars. Examples of CGM include:
Senseonics implantable Eversense CGM
If CGM is not available, taking frequent fingersticks with a blood glucose meter when waking up, before and after meals, and before bed can also indicate when blood sugar levels are going low, high, and staying in range.
You May Like: Are Omelettes Good For Diabetics
What Do The Results Of The Test Mean
The test result is usually given as a percentage. The normal range for A1c is 4.5% to 5.7%. Most experts recommend a target A1c of less than 7.5% in children with type 1 diabetes and a target A1c of less than 7% in children with type 2 diabetes. Work with your child’s doctor to set your child’s target A1c.
The A1c test result also can be used to find your child’s estimated average glucose, or eAG. The eAG and A1c show the same thing in two different ways. They both help you learn more about your child’s average blood sugar range over the past 2 to 3 months. A1C is shown as a percent, while eAG uses the same units as your child’s glucose meter.
Top Diabetes Exercise Mistakes And How To Avoid Them
Physical activity can help prevent diabetes from beginning and progressing so long as you do it smartly. Avoid these common mistakes in the gym for a safer, more effective workout.
Right now more than ever, staying healthy is priority No. 1. According to the American Diabetes Association , scientists dont know if people with diabetes are at an increased risk of contracting the novel coronavirus that causes COVID-19, but its clear that they are at a higher risk for complications if they are infected. Dont let that add to your worries. Rather, take this fact as a push to make sure youre managing your blood sugar as well as you can.
Exercise can help, but people with diabetes need to keep a few factors in mind to stay safe. Some people may experience hypoglycemia when they exercise, while others report blood glucose spikes if they work out at certain times of the day or for longer than usual.
But dont let that deter you from exercising. Making sure youre being active and eating healthy will help prevent the progression of the disease, says Jessica Crandall Snyder, RDN, CDE, CEO of Vital RD in Englewood, Colorado.
With your doctors approval, no type of exercise is off-limits biking, walking, stair climbing, and lifting weights are all good ideas.
You May Like: What Is An Insulin Pump
Ways To Lower A1c And Manage Your Blood
An A1C test measures the amount of glucose in your blood over the previous 12 weeks. This is important because it provides a long-term measure of blood-sugar levels, which are used to diagnose and manage diabetes or prediabetes.
Those with type 1 or type 2 diabetes should have their A1C levels measured about every three months. If youre at an increased risk, you should have A1C measured twice a year, says Dr. Charles Richardson, the CEO of Cleveland Diabetes Care.
Through an A1C test, early detection of elevated blood-sugar levels can help reduce the risk of health complications from diabetes, like heart disease or kidney disease. Heres what you need to know about A1C levels and how to lower them.
Lifestyle Tips To Help Maintain Good A1c Levels
Heres the good news: There are lots of different ways to lower your A1c without medication. Well review some below:
Change what youre eating: This is a big one. Your A1c will naturally drop if youre able to eat less of certain foods and more of other foods .
Move your body: Exercise is a great tool to improve your overall health. And it can help to lower your A1c.
Lose unwanted weight: Weight loss isnt easy. But it can be an effective way to improve the way your body regulates blood glucose levels.
Find support in your community: Diabetes is common. Chances are that there are people in your community who have faced similar health challenges and can support you in your journey.
Read Also: Best Type 2 Diabetes App
Professional Organization Take Issue With Acp’s Proposed Changes To Hba1c Goals
The Endocrine Society, American Association of Clinical Endocrinologists, American Diabetes Association, and the American Association of Diabetes Educators have issued a harsh rebuke to the ACP guidance, which proposed that it may be more beneficial to relax current goals for nonpregnant adults with type 2 diabetes.13 ,14
“While there are several topics listed in the American College of Physicians statement on which we agree, there are several significant areas that do not align with ADAs 2018 Standards of Medical Care in Diabetes,”13 according to the ADA press release.
One main criticism the ADA raised about the ACPs guidance is that it does not consider the positive legacy effects of intensive blood glucose control confirmed in multiple clinical trials, and therefore, are not reflective of the long-term benefits of lower A1c targets.13
The ADA argued, “There is clear, convincing evidence of a long-term reduction in diabetes complications with A1cs at and below 7 percent. ADA is also concerned by the missing consideration of the positive impact of several newer medication classes that are associated with low risk for hypoglycemia have favorable effects on weight and improved cardiovascular disease outcomes.”6,13
In the end, patient-centered care will determine the best approach to care something about which both professional organizations could agree.
As if to break the tie, Dr. Ende said, Ultimately, we have to take the lead from our patients.
How The Test Works
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.
Also Check: Protein Shake For Diabetic Patients
How Is The A1c Test Used To Diagnose Type 2 Diabetes And Prediabetes
Health care professionals can use the A1C test alone or in combination with other diabetes tests to diagnose type 2 diabetes and prediabetes. You dont have to fast before having your blood drawn for an A1C test, which means that blood can be drawn for the test at any time of the day.
If you dont have symptoms but the A1C test shows you have diabetes or prediabetes, you should have a repeat test on a different day using the A1C test or one of the other diabetes tests to confirm the diagnosis.2
Interestingly Your Ethnicity Can Also Affect Your A1c Result
Everyone has a different type of hemoglobin, depending on their ethnicity. A1C test works best with type A hemoglobin. Hemoglobin variants such, C, D or E, can affect the precision of A1C as well .
It is crucial to note that the A1C test is not always accurate. Repeated checks can give higher or lower measurements for the same blood samples. Doctors rely on other tests as well called fructosamine blood tests. This test gives an extended-term assessment of your sugar level.
To view the list of factors that may cause a high A1C result, please click here.
Do you need more information on the Haemoglobin A1C blood test, please click here
Recommended Reading: Symptoms Of Low Blood Sugar In Type 2 Diabetes
So What Do The Numbers Mean
When it comes to the numbers, there’s no one-size-fits-all target. A1C target levels can vary by each person’s age and other factors, and your target may be different from someone else’s. The goal for most adults with diabetes is an A1C that is less than 7%.
A1C test results are reported as a percentage. The higher the percentage, the higher your blood sugar levels over the past two to three months. The A1C test can also be used for diagnosis, based on the following guidelines:
- If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range.
- If you have an A1C level of 6.5% or higher, your levels were in the diabetes range.
What Are The Consequences If High A1c Levels Are Left Untreated
There can be serious consequences if a high A1c isnt treated. Higher than healthy levels of glucose in the bloodstream can damage blood vessels.
Macrovascular disease: These complications are similar to what we see when someone has high blood pressure and high cholesterol.
Poor blood flow to limbs
Microvascular disease: These complications are more specific to diabetes.
High glucose levels also make it more difficult for the immune system to work correctly. Elevated glucose also increases the risk of developing infections.
Recommended Reading: Long Acting Insulin Side Effects
What Are Normal A1c Levels For People Who Don’t Have Diabetes
Generally, high A1c values indicate high average blood sugar levels and that a person might be at risk for or may have diabetes. The American Diabetes Association has established the following cutoffs:
Prediabetes, meaning at risk for developing type 2 diabetes
6.5% or greater
Make sure you get a regular A1c test, especially if you think you might be at risk for diabetes.
What Is A Good A1c Level
Levels between 5.7 and 6.4 are considered prediabetes. For most people with diabetes, the general A1C goal is to have a level between 6.0 and 6.9. While it might sound like the ideal A1C target is under 6.0, for those with diabetes, this level can indicate low blood sugar levels, which can be just as dangerous as high blood sugar levels. If A1C results fall between 7.0 and 8.9, a doctor might suggest lifestyle changes or medications to help lower the levels to what is considered controlled. However, for some people, these levels might be appropriate, such as:
- Those with a limited life expectancy
- People with long-standing diabetes who have trouble reaching a lower goal
- Those with severe hypoglycemia or the inability to sense hypoglycemia
You May Like: 30 Carb Meals For Diabetics
What Is An A1c Test
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. Itâs a lot like a baseball player’s season batting average. A single game doesn’t tell you how a player is performing in their career. And 1 day’s test results don’t give you the complete picture of how your treatment is working.
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.
Breakfast Smoothie With Berries And Greek Yogurt
You dont have to say So long to smoothies for breakfast, even if you have type 2 diabetes. The key is to make sure its a balanced smoothie, with protein and fiber, and that it’s relatively low in sugar. Moderation is key, so stick to a small glass.
Take this Very Berry Smoothie recipe from Jill Weisenberger, RDN, CDCES, of Yorktown, Virginia, the author of Diabetes Weight Loss Week by Week. What I love about this smoothie besides that its delicious is that its packed with protein just from the Greek yogurt no protein powders needed, she says. Each 1½ cup serving of this smoothie offers a whopping 22 grams of protein, with 30 g of carbs and 5 g of fiber.
Plus, because the recipe has just four ingredients yogurt, frozen berries , sweetener of your choice , and milk makes it a perfect breakfast when youre in a rush. Its fast and even portable, and all the ingredients are something youd have at home or that are easy to substitute, adds Weisenberger.
You May Like: Best App To Track Diabetes
Laboratory Measurement Of A1c And Plasma Glucose
A1C measurements for NHANES 19992004 were performed by the Diabetes Diagnostic Laboratory at the University of Missouri-Columbia using Primus CLC330 and Primus CLC 385 instruments . A1C measurements in NHANES 20052006 were performed by the Diabetes Laboratory at the University of Minnesota using a Tosoh A1c 2.2 Plus Glycohemoglobin Analyzer . Both assays use a high-performance liquid chromatography system . All A1C measurements were standardized to the reference method used for the Diabetes Control and Complications Trial. The plasma glucose concentration was determined by a hexokinase enzymatic method .