Why Do You Need An A1c Level Chart
The A1C result is significant for long-term glucose monitoring. It helps to know how well or bad your past three months of blood glucose control.
A1C test in % is confusing, because we used to measure glucose levels in mg/dl or mmol/l. A1C chart help convert A1C in % to its equivalent average blood glucose, which is easier to interpret.
DCCT A1C conversion formula seems to work best in people with high blood sugars. Because this formula derived from such a group.
A1C level chart in this article shows the relationship between A1C and its average blood sugar equivalent, based on the DCCT A1C conversion formula.
Diabetes Control and Complications Trial or DCCT, New England Journal of Medicine 1993 329:977-986. They studied 1400 T1D quarterly A1C tests were the primary measure of glycemic control. The study subjects performed quarterly 24-hour, 7-point capillary blood glucose profiles in the home. These are three pre-meal tests, three post-meal tests, and one at bedtime.
Diabetes Care 25:275-278, 2002 result showed a linear relationship between HbA1c and eAG. eAG in mg/dl = â 77.3 or eAG in mmol/l = 4.29.
Reference: âDefining the Relationship Between Plasma Glucose and HbA1c, Analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial,â Published in Diabetes Care 25:275-278, 2002.
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What Are Foods I Can Eat To Lower My Number
- Monitoring your carbohydrate intake is essential to lowering blood glucose levels and therefore A1C levels. The foods you eat can have a direct impact on your blood glucose. Carbohydrate examples include potatoes, rice, bread, fruit, milk,and other starchy foods. When too many carbs are eaten, the blood sugar may rise too high. Frequent blood sugar spikes will be reflected as a high A1C level.
- Lower carb recipes and diabetes friendly meals will help lower blood sugar levels and therefore be reflected as a lower A1C level. Be careful of hidden sources of carbohydrate. These include breading on meat, sauces, and low fat dressings.
- Label reading is important when grocery shopping. Check the total carbohydrates on the label in order to stay in your ideal carbohydrate range. Try to focus on measuring carbs and eating non-starchy vegetables, lean meats and unsaturated fats. Eating 3 medium size meals each day and 1-2 snacks will also help stabilize blood sugar.
- Be sure to ask your health care provider for individualized advice regarding any changes you would like to make in your eating habits including cooking tips, lower carb snacks and eating out with diabetes. Planning ahead will increase your chances of success regarding your diet and will help you include diabetes friendly comfort foods.
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What Is A1c And Why Is It Used
A1c estimates a persons average blood sugar levels over a 2 to 3-month span. It is the best measure we have of how well blood glucose is controlled and an indicator of diabetes management.
Though A1c doesnt provide day-to-day information, keeping A1c low has been proven to lower the risk of microvascular complications like kidney disease , vision loss , and nerve damage . The relationship between A1c and macrovascular complications like heart disease is harder to show in clinical trials, but having high blood sugar is a major risk factor for heart disease.
A1c is usually measured in a lab with routine blood work, or with a countertop machine in a doctors office using a fingerstick.
A1c measures the quantity of glycated hemoglobin, which refers to sugar attached to a red blood cell protein called hemoglobin. The number is reported as a percentage of the total hemoglobin in the blood. If a person consistently has higher blood glucose levels over time, A1c levels go up because more red blood cells are coated with sugar. The test is representative of a 2 to 3-month average because once a red blood cell becomes coated with sugar, the link is irreversible. It is only when the red blood cell is “recycled” that the sugar coating disappears.
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Bottom Line About Average Blood Glucose And A1c
Your average blood glucose is not really intended to predict your A1C. Rather, A1C is supposed to provide a way to estimate your average blood glucose over time. Any A1C-based prediction may be off by as much as 20 to 25 mg/dL. For some people, it may make more sense to base diabetes treatment decisions off of their BG meter average than their laboratory-measured A1C.
Finally: A1c Is Also Defined As Estimated Average Glucose Or Eag
Another term you may come across when finding out your A1C is eAG. Your doctor might report your A1C results as eAG. eAG is similar to what you see when monitoring your blood sugar at home on your meter. However, because you are more likely to check your blood sugar in the morning and before meals, your meter readings will likely be lower than your eAG.
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A1c/eag Vs Daily Monitoring
While A1C/eAG values are important for long-term diabetes management, they cant replace daily blood glucose tests. Neither is indicative of current blood sugar levels. You need that information one or more times a day in order to adjust your insulin dose, food intake, and activity level.
The American Diabetes Association recommends that you get an A1C test twice a year if you are meeting glycemic goals and at least every three months if your therapy recently changed and/or you are not meeting treatment goals.
Arterial Versus Venous Glucose
As glucose is usually taken up by the cells, we expect that venous glucose is approximately 510 mg/dl lower than arterial glucose. However, the arteriovenous gradient will depend on the insulin level that determines the degree of glucose uptake.15 The decrease also correlates with the difference in oxygen saturations.16 Not only may this decrease vary, but glucose may even be generated in peripheral tissues, most notably in muscle, during critical illness and released into the venous system.17 Nevertheless, an 8% decrease is generally expected .
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The Importance Of A1c
One way to monitor your blood sugar is to extract a little blood with a glucometer device. This gives you a blood sugar reading at that point in time. Your doctor may ask you to do this once a day or several times a day.
Another way to monitor your blood sugar is by wearing a continuous glucose monitoring device. This approach has become more popular in recent years, says Carla Cox, PhD, RD, a registered dietitian and certified diabetes educator in Missoula, Montana, and spokesperson for the American Association of Diabetes Educators.
A third way is to obtain your hemoglobin A1C number regularly when you go for lab work. The A1C, which is given as a percentage, indicates your average blood sugar over a two- to three-month period. This number can help show you and your diabetes team if your current diabetes treatment plan is effective, according to the American Diabetes Association . Most people with diabetes will get their A1C measured at least twice a year.
Sometimes, it’s helpful to convert a series of blood glucose readings into an A1C number. You may do this to further your own understanding of your blood sugar numbers or to share that number with your diabetes care team.
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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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Venous Plasma Versus Capillary Whole Blood
We can now compare the two most common methods of glucose measurement. First, whole blood glucose meters should be calibrated to give venous plasma equivalents . However, because capillary samples reflect arterial blood, they would be expected to be 8% higher than venous plasma. Criteria for the diagnosis of diabetes generally reflect this, as a diagnostic 2 h oral glucose tolerance test venous plasma level of 200 mg/dl is 8% higher for capillary whole blood/plasma , but this continues to cause some confusion.26
Prediabetes: The Best Time To Get Diagnosis
Prediabetes is a serious condition that gives way to the more dreaded diabetes. People with prediabetes already have an impaired fasting glucose metabolism and typically experience an increase in high blood sugar.
Prediabetes isnt considered diabetes because the blood sugar range isnt high enough to meet diabetes requirements despite being higher than normal. However, its only a matter of time before people with the condition slip into full-blown diabetes.
A staggering 96 million US adults were diagnosed with prediabetes in 2019. In a broader perspective, over one-third of adults in the country had prediabetes at the time, with projections suggesting even higher numbers in 2022.
The risk of developing diabetes after getting prediabetes is significantly high. CDC reports on prediabetes show that up to 30% of those diagnosed with prediabetes will develop diabetes in 5 years or less. Undiagnosed prediabetes patients are even more likely to slip into fully-fledged diabetes sooner.
These prediabetes-associated risks reinforce why this stage is considered the best time for people to undergo diagnosis. Notably, people in the prediabetes stage are yet to develop impaired glucose tolerance that comes with significantly high blood glucose levels. With an appropriate diagnosis, people with prediabetes can avoid falling into the diabetes range and subsequent cardiovascular disease complications that extremely high blood sugar presents.
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What A1c % Is Normal
In terms of blood sugar, people with diabetes aim for a fasting/before meals blood sugar of 70-130 mg/dL and 2 hours after meal < 180 mg/dL.
If you notice your A1C increase to more than 7%, your doctor may re-evaluate your treatment for better blood glucose control.
A high A1C can put you at increased risk for complications like cardiovascular disease, retinopathy and neuropathy. Additionally, constant high blood sugars can negatively affect all of your organs due to the thickening of your blood.
|A1C Test Result %|
Do you measure in metric? Convert these values.
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.
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Translating The A1c Assay Into Estimated Average Glucose Values
A complete list of the members of the ADAG Study Group can be found in the appendix.
David M. Nathan, Judith Kuenen, Rikke Borg, Hui Zheng, David Schoenfeld, Robert J. Heine, for the A1c-Derived Average Glucose Study Group Translating the A1C Assay Into Estimated Average Glucose Values. Diabetes Care 1 August 2008 31 : 14731478.
OBJECTIVEThe A1C assay, expressed as the percent of hemoglobin that is glycated, measures chronic glycemia and is widely used to judge the adequacy of diabetes treatment and adjust therapy. Day-to-day management is guided by self-monitoring of capillary glucose concentrations . We sought to define the mathematical relationship between A1C and average glucose levels and determine whether A1C could be expressed and reported as AG in the same units as used in self-monitoring.
RESULTSApproximately 2,700 glucose values were obtained by each subject during 3 months. Linear regression analysis between the A1C and AG values provided the tightest correlations , allowing calculation of an estimated average glucose for A1C values. The linear regression equations did not differ significantly across subgroups based on age, sex, diabetes type, race/ethnicity, or smoking status.
A1C levels can be expressed as eAG for most patients with type 1 and type 2 diabetes.
How Often Do You Need The Test
Your doctor probably will have you take the A1c test as soon as youÃ¢re diagnosed with diabetes. YouÃ¢ll 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 youÃ¢re controlling your blood sugar.
How often youÃ¢ll need the test after that depends on several things, like:
- The type of diabetes you have
- Your blood sugar control
- Your treatment plan
YouÃ¢ll 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 donât 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.
ItÃ¢s 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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How To Lower Hba1c And Blood Glucose Levels
Adopt a more vegetarian diet, including beans & nuts
Vegetarian diets are inversely associated with the risk of developing type 2 diabetes. In a meta analysis comparing nine different experiments, researchers found that vegetarian diets consistently improved fasting blood glucose and HbA1c. Why? They generally emphasize a diet rich in whole grains, fruits, vegetables, beans, and nuts, and lower levels of saturated and trans fat. Plus, beans often replace meat in these diets by acting as a protein source. Thanks to their high fiber content and low glycemic index , beans stabilize blood glucose and insulin levels. So individuals with type 2 diabetes may notice significantly lower A1c levels if they increase their bean intake to at least one cup per day. Similar to beans, nuts are low glycemic and help regulate blood sugar levels. In a recent experiment, people who replaced some of their food with a serving of nuts saw improved glycemic control and HbA1c levels. On a grander scale, eating nuts has an inverse association with type 2 diabetesthat is, people who include nuts in their daily lives tend to have a lower risk of developing diabetes.
Exercise is a crucial component in managing glucose and insulin levels. It directly improves blood glucose control, increases insulin sensitivity, and helps maintain a healthy weight. Exercise is a very effective tool in preventing the development of type 2 diabetes.
Some Of The Ways Medicines Can Lower A1c Include:
- cause the liver to reduce its output of glucose
- adding insulin when the body is not producing a sufficient quantity
- reducing insulin resistance by making the body more sensitive to its own insulin
- cause the body to increase production of insulin
Keep in mind that illness or infection can also affect A1C. Be sure to make a note of any illnesses you may have had so you can offer your health care provider this information at your next visit.
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Hemoglobin A1c Versus Glucose Levels From Oral Glucose Tolerance Tests
Table 2 shows the correlation between HbA1c and the single fasting 1 and 2 h fluoride plasma glucose levels taken during a 75 gm oral glucose tolerance test. The correlation between HbA1c and each of the glucose levels is at least as strong as described previously . While the strongest correlation was against fasting glucose, the 2 h glucose correlations were also strong. Although we might consider the intraindividual biological variability of fasting glucose to be much smaller than 2 h biological variability ,32 this is possibly averaged out in this large study of 2116 procedures.
Who Should Get An A1c Test And When
Testing for diabetes or prediabetes:Get a baseline A1C test if youre an adult over age 45or if youre under 45, are overweight, and have one or more risk factors for prediabetes or type 2 diabetes:
- If your result is normal but youre over 45, have risk factors, or have ever had gestational diabetes, repeat the A1C test every 3 years.
- If your result shows you have prediabetes, talk to your doctor about taking steps now to improve your health and lower your risk for type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.
- If you dont have symptoms but your result shows you have prediabetes or diabetes, get a second test on a different day to confirm the result.
- If your test shows you have diabetes, ask your doctor to refer you to diabetes self-management education and support services so you can have the best start in managing your diabetes.
Managing diabetes:If you have diabetes, get an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your doctor about how often is right for you.
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