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Explain Hemoglobin A1c

Hemoglobin A1C is a blood test for diabetics that measures how well their blood sugar has been controlled over the last 2 to 3 months. This information tells the health care provider how well the medication, diet and/or exercise plan have been working, and allows adjustments to be made as needed.

  1. Diabetes Statistics

    • According to the American Diabetes Association, there are 23.6 million people in the United States with diabetes. The prevalence of diabetes increased 13.5 percent from 2005 to 2007. Diabetes costs everyone, not just diabetics. In 2007 the total annual economic cost of diabetes was estimated to be $174 billion.

    How is Diabetes Diagnosed?

    • A person is considered diabetic after a series of blood glucose tests resulting in a fasting blood sugar greater than 126. A fasting blood sugar between 100 and 126 is considered pre-diabetic and a risk factor for developing diabetes.

    Hemoglobin A1c Test

    • The hemoglobin A1c test reveals how well blood sugar has been controlled over the past 2 to 3 months. A person can have a few days of normal blood sugars, and be elevated the rest of the time. The A1c gives the big picture.

    Hemoglobin's Role in Blood Sugar

    • The hemoglobin in red blood cells carries oxygen to all the body's cells. Hemoglobin is a protein, and protein links up with sugars such as glucose. Sugar sticks, and the longer it's around, the harder it is to get off. Think of sugar as hitching a ride on the hemoglobin. Red blood cells have an average life of 120 days. The A1c looks back over that time to see how much sugar linked up with hemoglobin. Even with a few days of hypoglycemia (low blood sugar) the A1c detects the evidence of the hyperglycemic (high blood sugar) days.

    Using A1c to Manage Diabetes

    • An A1c level should be taken upon diagnosis of diabetes, and at certain other times such as when changing diabetic medication or insulin. Levels should be checked at least twice a year, and may need to be monitored every three months during the first year of managing diabetes. By following the health care provider's recommendations on diet, exercise and medication it is possible to achieve tight glycemic control.

    What are the Numbers?

    • A1c is expressed as a percentage. A normal range is 4 to 5.9 percent. A poorly controlled diabetic is 8 percent or above. The ADA currently recommends an A1c goal of less than 7 percent. An A1c of 7 percent is a blood glucose of approximately 170 mg/dL. An A1c of 8 percent correlates to a blood sugar of 205 mg/dl. Studies show that for every 1 percent drop in A1c, there is a 10 percent reduction in risk of diabetic complications.

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