The ABCs of A1C
Today we are breaking down what an A1C test means and why it’s so significant for us to know for our diabetes. It’s a benchmark test used by your healthcare providers to diagnose diabetes, make medication decisions, assess your risk factor for complications, and help you manage your diabetes.
First of all, the A1C goes by a lot of other names that you may or may not have heard of before. They include: glycated hemoglobin, glycohemoglobin, glycosylated hemoglobin, HA1c, HbA1c, HgbA1c. No matter what you call it, the test measures the level of hemoglobin in your red blood cells that has sugar attached to it over a 2 to 3 month period. This level indicates the measure of glucose control, with the previous month having the most influence on the number. In other words, whatever your blood sugar has been doing for the last month will have more of an effect on the overall A1C result than the previous months. The reason this test looks at a 2 to 3 month period is because your red blood cells have an average 2 to 3 month lifespan, so how much glucose your red blood cells are exposed to during this time frame can tell us the average level of glucose in your blood over time.
If you have diabetes, it’s a good idea to have an A1C test at least twice a year, preferably every 3 months to stay on top of your blood glucose control.
Here are some numbers to keep in mind regarding the A1C:
- less than 5.7%= no diabetes
- 5.7–6.4%= pre-diabetes
- Greater than 6.4%=diabetes
The A1C test is useful as one way to monitor your diabetes, though there may be variants between races and among people within a race due to genetic variations. The A1C result can be inaccurate for a number of reasons including: people with sickle cell anemia (typically for those who are African American, Mediterranean, or Southeast Asian), iron deficiency, B12 and folate deficiency, asplenia (a condition that affects the lifespan of the red blood cell), people who take high doses of vitamin C and Vitamin E, those with renal failure, anemia from blood loss, people who have gotten transfusions, and in other medical conditions and on certain medications. If you fall into one of these categories talk to your medical provider about an oral glucose tolerance test or another test to confirm a diabetes diagnosis rather than the A1C test.
And finally, here are some conversions of A1C levels to what they equate to in terms of the blood glucose readings you see on your glucometer:
5.0% = 80 mg/dl or 4.7 mmol/L (which is a measurement used outside of the U.S.)
6.0% =115 mg/dl or 6.3 mmol/L
7.0% =154 mg/dl or 8.2 mmol/L
8.0% =180 mg/dl or 10.0 mmol/L
9.0% =215 mg/dl or 11.9 mmol/L
We suggest you speak to your healthcare provider about what they feel is the best A1C level for you depending on the type of diabetes you have, the medications you are on, and any other factors they may be taking into consideration. Once you have a good understanding of where your doctor would like your blood sugars to be, then be sure to join us in the GlucoseZone so you can get a killer workout, track your blood sugars in a safe way, and start to lower your number if that’s your goal. Remember whatever your A1C currently is, it’s not the whole story. You have the power to change it with hard work, dedication, and lots of help and support from the GlucoseZone.
By: Lauren Szalkiewicz and LaurieAnn Scher, MS, RD, CDE
