What Does A1c Measure
You may be wondering what makes this test different, especially if you already check your blood sugar multiple times a day. The A1C test goes by a few names, including glycosylated hemoglobin, glycated hemoglobin, or hemoglobin A1C . All of these names hint at what is being measured the amount of sugar attached to hemoglobin.
Hemoglobin is a protein found inside red blood cells, and its job is to carry oxygen to the lungs and all of the cells in your body. Glucose enters your blood stream and sticks, or glycates, with the hemoglobin. The higher your blood glucose, the more sugar-coated or glycated the hemoglobin becomes.
Since the lifecycle of a red blood cell is about four months, the A1C percentage reflects average blood sugar levels detected on hemoglobin cells of varying ages days, weeks, or months old. If your blood glucose control has generally been steady, your hemoglobin cells will not be highly sugar-coated, or glycated, leading to a lower A1C value.
What Are Some Top Tips For Lowering A1c
Your A1C score is a helpful tool, Dodell says, but it is not the only indicator of how healthy you are.
For example, you could hit your A1C goal but still have wide fluctuations in your blood sugar levels, which is more common among people who take insulin. Youll need to bring these day-to-day fluctuations under control, since they can lower your quality of life and increase your risk of complications, he says.
Think of your diabetes as you would a job, Dodell says. It takes work, but the time and effort you put into it can result in good control and an improved quality of life. The key to reaching your A1C goal is trying to follow a healthy lifestyle, he says.
Making these changes can help you improve your day-to-day blood sugar management and lower your A1C.
Target Blood Sugar Levels For Children And Adolescents With Diabetes
Age 6-12 Bedtime 100-180
Kids aged 6 to 12 should have blood sugar levels that range between 80 to 180 mg/dL over the course of a day. Blood sugar levels go up after eating a meal because the body breaks down carbohydrates into glucose, which is then distributed throughout the bloodstream. Other macronutrientsprotein and fatturn into glucose as well, but at a slower rate. Many people learn how to use these factors to their advantage. For example, if a childs sugar is trending low, a bedtime snack that includes something with protein and fat, like chocolate milk or peanut butter, will help raise blood sugar levels and help keep blood sugar levels steady through the night.
Bedtime | 100-140 |
When you wake up in the morning, your fasting blood sugar is generally at its lowest because you havent consumed food for about eight hours. However, many people experience an increase in blood sugar levels in the early morning hours. If youre an adult and struggling with glucose control, your healthcare provider can help you develop a treatment plan to manage your blood sugar better.
Blood glucose levels outside the ranges listed above are categorized as either high or low blood sugar. For example, according to this chart, blood sugar levels are considered high if theyre over 130 mg/dL before a meal or 180 mg/dL within one to two hours after a meal. Many people wont start to experience symptoms from high blood sugar until their levels are at 250 mg/dL or higher. .
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Healthy Eating And Meal Tracking
Diet has a huge impact on your blood sugar. In particular, carbohydrates like bread, rice, potatoes, and sweets raise your blood sugar. During digestion, the body breaks carbohydrates down into glucose.
One way to find out how certain foods affect your blood sugar is to test two hours after eating. Keeping a food journal along with blood sugar logs helps identify high blood sugar patterns. This can help you learn to manage your glucose levels better and lower your A1C.
Talk to your healthcare team if you are unsure what you should eat to manage your blood sugar. A dietitian or certified diabetes educator can help you learn how to balance meals for lower blood sugar.
What Number Should My Blood Glucose Be

Blood glucose is measured in mg/dl. The normal range for blood glucose for people without diabetes is 70 to 120 mg/dl.
The Diabetes Center has guidelines for blood glucose readings. This is called a target range. There may be times when your healthcare provider gives you a different target range, like for bedtime, with exercise, or after eating.
Nationwide Childrens Hospital Diabetes Center Target Blood Glucose Ranges
Age |
The goal is to keep the blood glucose within the target range most of the time.
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Normal A1c Levels Chart For Non
According to American Diabetes Association latest guidelines 2017 and 2018,Hemoglobin A1c levels 3, 4, 5, and up to 5.7 is normal and tell that the person has no DM.Non-diabetes means your blood glucose test results are within the expected normal limits for healthy persons.The normal hemoglobin A1c means youre not diabetic or you are on the goal levels, I mean that:A1c 4.0% and A1c 5.0 means you werent diabetic and this value is the normal levels that all healthy persons must have.But A1c 5.7% means you are on the last step before prediabetes stage.
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Risks Of Chronic High Blood Glucose Level
You already know how to calculate A1c levels, but what should you do with the result? If your level is less than 5.7% congratulations this is a normal A1c level, and you have nothing to worry about. Maintain your healthy habits and keep your blood sugar level low.
If you drifted into the prediabetes group thats a red flag. Youre at a high risk of diabetes, but there is still hope. Check out the How to lower A1c? section for some hints. Do not neglect this result, as chronic high blood sugar levels can lead to severe consequences, including:
- Increased risk of cardiovascular diseases myocardial infarction or brain stroke
- Problems getting pregnant
- Diabetic foot, potentially leading to amputation!
If your A1c level is equal to or higher than 6.5%, you may be diagnosed as diabetic. If this is your result, book an appointment with your doctor immediately!
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How Do You Measure A1c
A1C is typically measured by a blood test, also called a blood glucose test, ordered by your doctor. Compared to traditional blood glucose tests, fasting is not required for A1C tests.
You can also measure A1C levels at home with digital A1C meters. To use one, you typically prick a finger with a lancet or fingerstick, add a drop of blood to a test strip, and insert the strip into the meter. While convenient, the reliability of readings from at-home A1C tests is debated.
Is The A1c Test Accurate For Everyone
Since the A1C test has been made available , is has become a common way to measure glucose control. However, in the last several years some questions have been raised about potential limitations of A1C:
- Is the A1C accurate for everyone?
- It may not be accurate for some people, including people of African-American descent, people with liver and kidney disease, or with some anemias and sickle cell disease.
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Roller Coaster: Female Hormones
When a womans hormones change, so does their blood sugar. Keep a monthly record of your levels to get a better idea of how your menstrual cycle affects you. Hormone changes during menopause may make blood sugar even harder to control. Talk to your doctor about whether hormone replacement therapy is a good idea.
A1c Levels In People With Diabetes
For people with diabetes, an A1C under 7% is typically considered good control. Research shows an A1C above 9% significantly increases the risk of diabetic complications. For adults with diabetes, the target A1C range is typically between 7% and 8%. This depends on your age and other health factors.
A1C levels correspond to the following average blood sugar levels:
A1C Level |
240 mg/dL |
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How To Calculate Your A1c Levels
Do you feel overwhelmed by the jargon and measurements involved in controlling your blood sugar? It can be challenging to keep track of everything, especially if youâre already preoccupied with a diabetes diagnosis. Still, itâs worth carving out a little more space in your memory for something as important as A1C.
If youâve recently taken a blood test or if youâve been discussing or treating diabetes with your doctor, youâve likely heard about A1C. Only a lab test can accurately measure A1C, and itâs best if a medical professional analyzes it. The results help provide an approximate value for how much glucose has been in your bloodstream on average for the past 2-3 months. Managing A1C effectively will keep you out of your doctorâs office longer, prevent the onset of diabetes and help bring you back from the brink of a diagnosis. In this article, weâll fill you in on what exactly A1C is and how you can keep an eye on it yourself between blood tests.
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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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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.
What Changes They Have Made To The A1c Guidelines
For most adults, the American Diabetes Association currently recommends an A1C of less than 7%, a TIR of over 70%, and a time below the range of less than 4%. In past years, the Standards of Care contained an âA1C Testingâ section that advised diabetics to test their A1C two to four times a year with an A1C target of less than 7%.
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Use This Chart To View A1c Values And Comparable Blood Glucose Values:
A1c | |
---|---|
12% | 298 |
A note of caution: the A1c measurement is not always accurate. For example, if someone has certain type of hemoglobin mutations , is severely anemic , or is being treated blood transfusions or medications to increase the production of new red blood cells, the A1c test may not be accurate.
If your finger-stick blood tests give an average blood sugar that is much higher or lower than your A1c test, ask your doctor if the A1c is the right test for you. An alternative test to the A1c is a fructosamine test. Unfortunately, the fructosamine test and the A1c are not interchangeable because they are measuring different things. The fructosamine test reflects the average blood sugars only over a 2-3 week period.
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What Is Hb A1c Test
The HbA1c test, or the glycated haemoglobin A1c test, is a blood test that can be taken at any time as you dont need to fast before taking the test. It indicates what your average blood glucose levels are over the past 3 months, by measuring the percentage of blood glucose that has attached to haemoglobin. Haemoglobin is the oxygen carrying protein found in red blood cells.
It is normal for all people to have some glucose attached to haemoglobin. In people with diabetes, the higher the blood glucose levels are, the more glucose you have attached to haemoglobin. A HbA1c level of 6.5% or higher, on two separate tests, can indicate that you have diabetes. Whereas a HbA1c level between 5.7 and 6.4% can indicate prediabetes. Levels below 5.7% are considered normal. In other words, higher A1c percentages indicate an increased risk of diabetes.
The HbA1c test should not be used alone to diagnose diabetes. It should be used in combination with other blood glucose tests.
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What Does An A1c Of 65 Mean
An A1C of 6.5 means that you have diabetes.
The A1c test measures blood sugar over the last three months by looking at the percentage of hemoglobin saturated with sugar. An A1c of 6.5 means that 6.5% of the hemoglobin in your blood are saturated with sugar.
You may already be experiencing symptoms of diabetes, which include increased thirst, frequent urination, general fatigue and blurred vision.
Diabetes is a serious condition. Left untreated diabetes can lead to heart disease, stroke, nerve damage, blindness, kidney disease and amputation.
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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Normal Blood Sugar Levels For Teens
There are no set guidelines by the American Diabetes Association for typical blood glucose for teens without diabetes. So, the NutriSense Team recommends aiming for the same guidelines for healthy children/adults without diabetes, keeping glucose between 70-140 mg/dL.
For teenagers with diabetes, glucose should stay between 70-150 mg/dL throughout the day. Controlling blood glucose during the teenage years could be more difficult, so maintaining a healthy diet and exercise become even more critical.
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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Conversion From Old Units To New Units
In the past 15 years, to report the results from the glycated hemoglobin test a new unit has been proposed and introduced . Some countries already adopted the new unit in their lab reports, while others still stick to the old unit or use both.
While the results reported are the same, the numbers differ substantially and can create confusion. Here below you can find the conversion table from NGSP to IFCC units.
Start An Exercise Plan You Enjoy And Do It Regularly
Find something you enjoy doing that gets your body moving, whether its taking your dog for a walk, playing a sport with a friend, or riding your bike.
The ADA recommends getting 150 minutes of moderate exercise per week, says Jordana Turkel, a certified diabetes care and education specialist and registered dietitian at Park Avenue Endocrinology & Nutrition in New York City. Different types of exercise can lower your A1C by making your body more sensitive to insulin, Turkel says. She encourages her patients not to go more than two days in a row without exercising and to aim for two days of strength training per week.
Be sure to check with your healthcare provider before embarking on an exercise plan, though. Together, you can come up with an individualized plan.
And if you monitor your blood sugar daily, check it before and after exercise. As the ADA explains, exercise improves insulin sensitivity and lowers your blood sugar levels. In certain circumstances, though, stress hormones produced during more intense exercise can also increase blood sugar levels. In addition, other factors, such as what you eat before exercise and the timing of your workout, may also affect your numbers.
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