Hemoglobin A1C Test

What Is The Hemoglobin A1C Test?

It is a relatively new type of diabetes test, which is used to test for prediabetes, type 1 diabetes and type 2 diabetes. Unlike older more complex tests, the A1C test only requires a pin-prick of blood and no fasting beforehand is required. For this reason, an international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation now recommends that the A1C test be the primary test to diagnose all types of diabetes (except gestational diabetes).

How Does It Work?

The test is used both:

1. To diagnosis diabetes in people with diabetes symptoms.
2. To monitor blood glucose (sugar) levels in people with diabetes to ensure they are managing their disease.

The AIC test reflects your average blood sugar level for the previous 3 months. It does this by measuring the percentage of a certain type of hemoglobin in your blood. Hemoglobin is a protein in the red blood cell that transports oxygen. As glucose circulates in your blood some binds to hemoglobin forming glycated hemoglobin. The higher the concentration of glucose, the higher the concentration of glycated hemoglobin. Once glucose combines with hemoglobin it stays there for the life of the red blood cell which is about 120 days. So measuring the level of glycated hemoglobin gives an indication of your glucose control for the previous few months. In comparison, a glucose test will only be able to tell your doctor what your level of glucose is at the time of the test.

A1C Test Procedure

Small blood sample is analyzed by portable test machine.

Can I Do The Test At Home?

Yes, if you have already been diagnosed with diabetes, a home test can be used to help self-monitor your glucose levels (in addition to daily glucose monitoring). Tests sold for this purpose over the counter in pharmacies include A1C Now Self-Check by Bayer which costs around $30. Note: a home test is not recommended for diagnosing or screening for diabetes. It only meant for ongoing monitoring after diagnosis. See, also: are there any home tests for diabetes?

How Often Should I Test?

After diagnosis, how often you need the test depends on which type of diabetes you have and how well you manage your blood sugar. In general the A1C test is recommended:

2 times a year: If you have type 2 diabetes, do not use insulin and your glucose levels are consistently within target range.
3 to 4 times a year: If you have type 1 diabetes.
4 times a year: If you have type 2 diabetes and you need insulin.

If your doctor changes your diabetes treatment plan at any time, you may need even more frequent testing to monitor your progress.

Understanding Your A1C Test Results

When Used As A Diagnostic Test

If you take the test to diagnose diabetes, the following results can be expected:

A1C Test Result What It Means
Between 4 and 6 percent (20-42 mmol/mol) You do not have diabetes.
5.7 to 6.4 percent (39-46 mmol/mol) You are at risk of developing diabetes in the future.
6.5 percent (47 mmol/mol) or higher You have diabetes.

When Used For Glucose Monitoring

When used for glucose control it is currently recommended that most diabetics keep their A1C test result below 7 percent. The closer you can keep your levels to 7 percent, without experiencing excessive low blood sugar symptoms (hypoglycemia), the better your diabetes control and the lower your risk of diabetes complications. Here is how A1C results correspond to blood sugar levels:

A1C level Average blood sugar level
5 percent
6 percent
7 percent
8 percent
9 percent
10 percent
11 percent
12 percent
13 percent
14 percent
80 mg/dL (4.4 mmol/L)
120 mg/dL (6.7 mmol/L)
150 mg/dL (8.3 mmol/L)
180 mg/dL (10 mmol/L)
210 mg/dL (11.7 mmol/L)
240 mg/dL (13.3 mmol/L)
270 mg/dL (15 mmol/L)
300 mg/dL (16.7 mmol/L)
333 mg/dL (18.5 mmol/L)
360 mg/dL (20 mmol/L)

A1C Test Limitations

• Results are not reliable for patients who have suffered recent significant blood loss; or for patients with conditions that shorten red blood cell survival such as pregnancy, hemolytic anemia or hemolytic diseases.
• Patients with high rheumatoid factors may receive inaccurate results.
• It is not a substitute for regular blood glucose monitoring.

• Need more information? See: Diabetes Guide

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