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.
What Is The A1c Test Measuring
There can be several reasons for a spike in blood sugar levels, and itâs a good idea to know whatâs causing yours. But first, itâs essential to understand what A1C is and what the A1C test measures.
Any sugar that enters your bloodstream attaches itself to your hemoglobin on your red blood cells. The A1C test measures the amount of glucose âstuckâ to the hemoglobin, which provides a good proxy of how much average blood glucose was in your bloodstream over a two to three-month period.
A simple way to remember how to read the results is: the higher the percentage, the higher the risk of diabetes. According to the Centers for Disease Control and Prevention, under 5.7% is a regular A1C reading. A reading between 5.7% and 6.4% is considered a pre-diabetic range, while values above 6.4% indicate diabetes.
Before you start overanalyzing your results, remember that there are variables at play. For example, the U.S. National Library of Medicine found that adults without a history of diabetes often have A1C levels at 6% or greater. This means not every higher test result is cause for concern. Still, itâs worth checking with a doctor if you see consistently high values. High A1C levels lead to impaired fasting glucose, and an increased risk of type 2 diabetes and cardiovascular diseases.
How To Lower Your A1c Levels
Its important to get your hemoglobin A1C levels as close to normal as possible, says Dr. Bellatoni, Decreasing your hemoglobin A1C decreases your risk of having complications from diabetes. Even if you cannot get your A1C back to the normal range, any improvement lowers your risk of diabetes complications.
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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.
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.
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The Big Picture: Monitoring Treatment
This relatively simple blood test can tell you a lot. The test results give you a picture of your average blood sugar level over the past two to three months. The higher the levels, the greater your risk of developing diabetes complications. Your doctor will tell you how often you need the A1C test, but usually youll have the test at least twice a year if youre meeting your treatment goals. If you’re not meeting your goals or you change treatments, you may need to get an A1C test more often.
Follow The Diabetes Treatment Plan Your Healthcare Team Recommends
Diabetes treatment is very individualized, noted an article published in May 2014 in Diabetes Spectrum. After all, factors including how long youve lived with the disease, your socioeconomic status, and any other conditions youre living with can play a role in the best treatment approach for you.
Your healthcare team will help you determine the steps you need to take to successfully manage diabetes. Always talk to your doctor before making any changes, such as starting a very-low-carbohydrate diet or beginning a new exercise regimen, and especially before making any medication or insulin changes.
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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.
You Have High Triglyceride Levels
Your triglycerides are a type of fat in your blood, serving as an energy source for your body. Your body can convert energy it doesnât need to burn right away into triglycerides. It then uses them as an energy source between meals.
The NIH has found that A1C levels can be an indicator of your triglyceride count. If one is high, the other most likely is as well. This is especially true if your diet is high in added sugars.
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Is Banana Good For Diabetic
Bananas are a safe and nutritious fruit for people with diabetes to eat in moderation as part of a balanced, individualized diet plan. A person with diabetes should include fresh, plant food options in the diet, such as fruits and vegetables. Bananas provide plenty of nutrition without adding many calories.
What Is A1c And What Does It Measure
The A1C test is a blood test that measures a persons average blood sugar levels over the past 3 months. In particular, it measures the percentage of hemoglobin in the blood with an attached molecule of glucose.
When glucose attaches to hemoglobin, experts refer to the resulting compound as glycosylated hemoglobin. The name of the test derives from the fact that about 9598% of the hemoglobin present in the body is type A1. Type A1 hemoglobin has subtypes, including A1C. As this is the most abundant subtype, it is a good marker for glucose control.
The test uses a 3-month average because RBCs typically live for about 3 months. Therefore, this timeframe reflects the sugar exposure to the cells over that time. The test does not require any specific preparations, so a person does not need to fast prior to the test, and a doctor can perform it at any time of the day.
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Fatty Deep Fried Foods
When a person eats an unhealthy typical Western diet, it usually contains too many deep fried fatty foods. And unfortunately, these have been linked to increased risk of diabetes.
While eating healthy fats like avocado or olive oil are considered good for our health. Bad fats such as the kind created from deep frying, promotes insulin resistance, weight gain, inflammation, and other unpleasant things.
And unfortunately, deep fried foods are often fried in cheap vegetable oils, which increase inflammation in diabetes.
One of the main reasons they are bad is that the oils become oxidized, and studies show oxidized oils contribute to higher levels of LDL cholesterol and heart disease.
Fatty deep fried foods also make higher levels of advanced glycated endproducts substances in the body that are promoted by high heat cooking. Deep frying is one of the highest heats we can cook at. In diabetes, higher levels of AGE contribute to increased oxidative damage and more inflammation.
There are plenty more reasons why you should avoid deep fried fatty foods, but hopefully thats enough to convince you to avoid them.
You Have Low Thyroid Levels
Quick review: thyroid hormones regulate the rate at which your body burns calories. The number of thyroid hormones in the bloodstream can affect your A1C level. This will cause the reading to fluctuate or give you false results. For example, hypothyroidism, or a low thyroid hormone levels, can lead to an elevated level of A1C.
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What Is A Hemoglobin A1c Test
A hemoglobin A1c test measures the amount of blood sugar attached to hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body. An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months. It’s a three-month average because that’s typically how long a red blood cell lives.
Other names: HbA1c, A1c, glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin
What Should I Eat For Breakfast To Lower My Blood Sugar
Here are 10 balanced, diabetes-friendly breakfast ideas to help you stay healthy and get on with your day. Breakfast Smoothie With Berries and Greek Yogurt. Whole-Wheat Blueberry Muffins With a Protein-Rich Side. Whole-Grain Cereal With Oatmeal, Egg, and Ground Flaxseed. Vegetarian Eggs and Lentils on Toast.
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Three Sneaky Reasons Your A1c Levels Fluctuate
When youve lived with type 2 diabetes for a while, you become a pro at managing your glucose levels. You know that its best to limit carbs, exercise regularly, check other medications for possible interactions, and avoid drinking alcohol on an empty stomach.
Sometimes, things you may not even think about can affect your blood glucose, which can in turn lead to serious complications, such as heart attacks, kidney disease, blindness, or amputation. Learning to recognize behaviors and circumstances that you dont normally associate with blood glucose fluctuations may help you prevent more serious problems now and in the future.
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 .
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Ok But Why Do So Many People Have A1c Values That Don’t Follow The Equation
Answer: Biological variation. As it turns out, the biological processes that dictate A1C are not exactly the same for everyone.
The rate that glucose attaches to hemoglobin can vary significantly from person to person:
For some people, glucose attaches to hemoglobin very quickly. So even if their average blood glucose is 154 mg/dL , their actual A1C may 8% or even higher.
For others, glucose attaches to hemoglobin very slowly, and for the same average glucose of 154 mg/dL, they may have an actual A1C value in the 6% range or lower.
The rate of red blood cell turnover varies from person to person:
For some, red blood cells turnover much faster than the typical ~3 months. The faster red blood cells turn over, the less hemoglobin can attach before the red blood cells die, which may lead to a lower-than-expected A1C result.
For others, red blood cells live much longer than the typical ~3 months. The longer the cells live, the more glucose can attach to the hemoglobin, which may lead to a higher-than-expected A1C result.
Various other factors may also be at play, such as:
People with spleen damage may have more of the older red blood cells, because the spleen is responsible for removing older red blood cells from the body.
So, if there’s reason to believe that your A1C isn’t a good proxy for blood glucose, you and your healthcare team should not base your diabetes management plan on your A1C. Instead, your plan should be based on your CGM average or BG meter average .
Check Your Blood Sugar Levels As Your Doctor Has Directed
Work with your doctor to determine if, and how often, you should check your blood sugar. You may be tempted to pick up an A1C home testing kit, but Dowdell does not recommend doing that. As he mentions, day-to-day fluctuations in your blood sugar can be masked by an A1C result that is at your goal level. Instead, if you have a personal continuous glucose monitor, such as a Dexcom G6 or a Freestyle Libre , Dowdell recommends checking your time in range to see if you are at the optimal level. For many people that is 70 to 180 milligrams per decilter , according to ADA guidelines. Having your A1C checked by your healthcare provider every three to six months is sufficient, he adds.
Understanding your A1C levels is an important part of your overall diabetes management. If you have any questions about your A1C levels or what they mean, dont hesitate to ask your doctor.
Additional reporting by Mikel Theobald.
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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.
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
Reasons Your A1c Might Be High When Youre Not Diabetic
Are you worried youâre at risk of diabetes because of high blood sugar levels on your A1C test? Does your blood sugar spike even when youâre eating healthy foods like apples and pears?
While high blood sugar is a common sign of diabetes, itâs not exclusive to those with the health condition. In fact, people often encounter high levels even if they donât have a history of diabetes.
Can You Have High A1c And Not Be Diabetic
According to one 2009 study, 3.8% of people without a history of diabetes have an elevated A1C level . This group is more likely to have other risk factors for Type 2 diabetes and cardiovascular disease. Researchers found that the following groups were more likely to have an elevated A1C without having a diagnosis of diabetes:
- Higher C-reactive protein levels
A high A1C result might signal that there is a problem. Even a modest increase in your blood sugar, above normal levels, can increase your risk of heart disease, even when you dont have full-blown diabetes, says Dr. Bellatoni. A physician can review test results and talk to patients about risk factors and lifestyle changes to improve blood sugar levels.
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