What A1c Reading Equates 100 Fasting Finger Stick

The A1C is a blood test that gives us an estimated average of what your blood carbohydrate has been over the past ii-3 months. The A1c goes past several dissimilar names, such equally Hemoglobin A1C, HbA1C, Hb1C, A1C, glycated hemoglobin, glycohemoglobin and estimated glucose average.

What is Hemoglobin?

ultimate-guide-to-a1c

Hemoglobin is a protein in your blood cells that carries oxygen. When sugar is in the claret, and information technology hangs around for a while, it starts to attach to the red blood cells. The A1C test is a measurement of how many red blood cells have sugar attached. So, if your A1C upshot is vii%, that means that 7% of your reddish blood cells have sugar attached to them.

What are the Symptoms of a High A1C Test Level?

Sometimes there are NO symptoms! That is probably 1 of the scariest things about diabetes, your sugar can be loftier for a while and you may not even know it. When your claret sugar goes loftier and stays high for longer periods of time you lot may notice the following:

tired, low energy, particularly after meals
experience very thirsty
you lot may be peeing more than normal, waking a lot in the centre of the night to go
dry out, itchy skin
unexplained weight loss
crave sugar, hungrier than normal
blurred vision, may experience like you need new glasses
tingling in anxiety or hands
cuts or sores take a long time to heal or don't heal well at all
frequent infections (urinary tract, yeast infections, etc.)

When your blood sugar is high, this means the energy that you are giving your body isn't getting into the cells. Think most a car that has a gas leak. You put gas in, but if the gas tin can't get to the engine, the car will not get. When you eat, some of the nutrient is cleaved downwardly into sugar and goes into your bloodstream. If your body tin't get the sugar to the cells, then your torso tin't "go." Some of the saccharide that is edifice up in the blood, you end upwards peeing out. When you lot pee out some of your carbohydrate, you will run into aridity, increased risk of infection, and weight loss. Ultimately, your cells don't go the energy they demand and your body starts to breakup. Medication and/or lifestyle changes can help to get your body up and running properly once more.

How Oft Exercise You Measure out A1C?

Your doctor will want to see what your A1C results is ii-4 times a year, and will typically social club this lab with other important labs when it'south fourth dimension for your blood depict. You can buy at home A1c exam kits at your local chemist's shop for approximately $20-$40. The kits in this cost range unremarkably include 2 tests and you lot can see the results in well-nigh five minutes. It is possible to see a significant change in your A1C in a i month time period, only the test typically isn't washed too ofttimes considering red blood cells just turnover about every 120 days. On the plus side, if you have fabricated some changes in the month prior to going to visit your doctor, those positive changes in the concluding 30 days are going to make more of an impact on your event than what y'all did 2 months agone.

What is My Goal?

It'southward of import to talk to your physician about what your private A1c goal should be. Typically the younger and healthier you are, the lower your A1c should exist. For example, if you are 25yr old and have Type 1 diabetes and you are healthy, your doctor might recommend an A1C in the range of half-dozen-6.5%. On the other hand, if you lot are 75 year sometime with Type 2 diabetes, with a history of a heart attack and a stroke, your doc might recommend an A1c of vii.5-8%. Your doctor will take into account your age, your general health, your take a chance of hypoglycemia, other wellness conditions/complications and your ability to care for yourself, when it comes to choosing the right A1C goal for you. Young children with Type 1 diabetes have a different set up of goals due to the dangers and run a risk of hypoglycemia.

If your A1c is at the target goal that you and your doc have agreed upon, and you lot are at depression hazard for complications, your doc may simply bank check your A1C every vi months. If you take Blazon 1 diabetes, a more complicated treatment regimen or if you have recently had higher blood sugar than normal, your dr. may cull to get your A1C checked at least every 3 months.

American Diabetes Association Goals

Age	ADA A1C goal
19 twelvemonth and under	7.5%
*Adults	vii%

A1C should exist individualized based on age, how long they have had diabetes, complications present, run a risk of hypoglycemia, quality of life, life expectancy

How Accurate is the A1C Test?

The A1C examination has been standardized past the National Glycohemoglobin Standardization Program (NGSP). In the past, the A1C test was not used to diagnosis diabetes because there were many different types of A1C tests and the results could vary. The A1C is at present standardized, and the acceptable variance tin be upward to 0.v% from what your bodily event is. And so if you result is 6.5% your actual reading could exist anywhere from half dozen-7%. The A1c exam is just one measure of your overall blood sugar control. Y'all will also have a good thought of how well your diabetes is controlled by your daily blood sugar checks and how consistent yous are with your medications and lifestyle interventions.

There are some health conditions that could issue the accuracy of the A1c:

Iron deficiency anemia may crusade your A1C result to be falsely high.
Blood loss from surgery, heavy menstrual cycles, other types of anemia may cause your A1C to be falsely low.
Sickle prison cell anemia or thalasemmia may cause your A1C to be aberrant.
Liver illness may cause your A1C to be abnormal.
Kidney Failure may cause your A1C to exist abnormal.

Talk to your physician if you have any of these weather.

Paying for A1C Test

Insurance typically covers your A1c test 2-3 times per year. Every plan is unlike so if at that place is any question, you lot should check with your insurance company directly. Be certain to bank check if they have a specified amount of fourth dimension between the tests. If yous want to have the A1c test washed more frequently and your insurance says they won't pay, you could ever do the at dwelling exam and get similar results.

Preparing for the A1C Examination

An A1c test lone does not require you to be fasting, but your provider is probable drawing other labs at the same time and some of those may require you to exist fasting. Y'all should e'er cheque with your doc to see if the labs they are drawing require you to be fasting or not. If so, you are meliorate off scheduling your lab describe before long later on you wake up and so that you don't have to go too long without eating, especially if you take any diabetes medications that could crusade a low blood saccharide reaction. Once your claret has been drawn, the results can come back as soon every bit an hour or as long as several days. How quickly the results come up back depends on the lab and if they process it in house or if it has to be sent out. Steroids can cause high blood sugars and depending on the dosage and duration of use, they could upshot your A1C result. Drinking plenty of water before a blood depict is also important.

Diagnosing with and Interpreting the A1C

The A1C exam is one style to diagnose diabetes. A fasting plasma glucose, oral glucose tolerance and a random blood glucose >than 200 with signs and symptoms of diabetes are all acceptable ways to diagnose diabetes. The important thing to remember is that each test must be repeated and in that location needs to be 2 abnormal lab results for a diagnosis. For instance, if someone had an A1c of 6.6% and a FPG of 135, that would be considered a diagnosis of diabetes. Or if a person had ii subsequent A1C's at vi.5% or above, that would also be a diagnosis.

In one case y'all have been diagnosed, y'all and your dr. volition desire to know your A1C is on a regular basis. The test is an indicator of your adventure for complications and gives your provider feedback on how well the treatment plan is working. Diabetes is a progressive illness and what works at present for handling, may non exist the same thing that works 2 or three years from now. Knowing your numbers can assistance you stay on top of your treatment and possibly prevent complications.

Making Sense of the Numbers

There are charts bachelor that tell you your estimated average glucose (eAG) value, based on your A1c test result. For instance, if your A1c comes back at 8%, that may non mean a whole lot to you. The eAG translates the A1C into what our average glucose would read on our monitor if we checked blood sugar all day, every day, for the previous 2-3 months. And then, and 8% A1C is an estimated blood glucose boilerplate of 183mg/dl. Milligrams per deciliter (Mg/dl) is the unit of measurement used in our blood sugar monitor. One affair that the A1C test does non account for is daily variability. For example, Bob's blood sugar could range from 50-300 on a regular basis and Mary'south blood sugar could range from 120-250 on a regular basis, but they both could really end up with the aforementioned A1C. That broad variability is being studied in more item because many health experts wonder if variability in your daily claret sugars matter just as much, or more than, than what your estimated average blood saccharide is. Regardless, studies accept shown us that if your A1c is 7% or lower, you're risk for certain complications related to diabetes is lower.

A1C Test Result %	Estimated Average Glucose (eAG) mg/dl
half-dozen	126
7	154
8	183
9	212
10	240
11	269
12	298
13	326

Source: Adapted from American Diabetes Association. Standards of medical
care in diabetes—2014. Diabetes Care. 2014;37(Supp i):S14–S80, table viii.

An A1c less than 7% means your a in a healthy range. When your result is betwixt 7-nine%, this is a time your should be cautious and kickoff troubleshooting your elevated readings. Once your A1c is 9% and higher, firsthand action should be taken to get your sugars downwardly because you are in a unsafe zone. When A1c is higher, recall of your claret as a thicker substance like syrup. When "syrup" travels through your blood vessels, information technology can do some damage, peculiarly if your blood carbohydrate goes loftier and stays loftier for long periods of fourth dimension. Your tiny blood vessels were designed to carry claret that is more like water, than gluey syrup. When your center has to pump to pump thick, sticky blood through the blood vessels over and over, damage can occur. This makes your middle work harder and your claret vessels were not designed to bear this thick sticky substance. Loftier blood carbohydrate can impact every part of your body. The but way to actually know if your A1C is elevated is to get it checked regularly. Brand sure you lot ever enquire what your actual event is. You are the all-time person to manage your diabetes and y'all need to make sure you take all the information available to y'all. Plus, it'southward nice to encounter when your hard work pays off! Any decrease in A1C should be celebrated. So if your last test result was ten%, and this fourth dimension it's nine.3%, give yourself a pat on the dorsum, it's moving in the correct direction.

If you lot didn't take a chart to testify the conversion from A1c to estimated average glucose (eAG), you could use the following adding: 28.7 x HbA1c — 46.7 = eAG (in mg/dl). But, my gauge is that you won't commit that calculation to retention, so the next time y'all are wondering what a vii.two% A1C equates to, yous tin can easily find many conversion charts on the internet.
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Managing My Numbers

Staying on top of your diabetes tin seem like another part of full-time job. There are some routine things that you tin can exercise to reach and maintain your blood sugar goal:

Get your A1C checked 2-4 times per year AND always ask what your number is.
Make sure to stay hydrated before your lab tests. Beingness dehydrated can impact many lab results related to diabetes, and then to prevent yourself from having to get your blood re drawn, proceed yourself hydrated.
Take your medications as prescribed. Talk to your pharmacist, doctor or diabetes educator virtually any problems related to taking your medication. Whether information technology be a side effect or but forgetfulness about taking it, your squad tin help you troubleshoot and come up with a better plan.
Choosing foods close to nature and closest to their natural course can help proceed your diabetes nether control. For instance, choose to consume an orange, rather than drinking orangish juice, brown rice instead of white rice, and cull salmon or chicken rather than bologna or hot dogs. By lowering your overall calories, this will help lower your blood sugar. So if you take always wanted to try a vegetarian, paleo, Mediterranean diet (or whatever), get for it. The fundamental to diet is to finding something that can work for the long booty, non something yous feel forced to practice that can only last a week or two. Bank check in with your dietitian to create a long term programme that will work for you!
Movement your body, especially after a meal. Taking a walk after y'all eat can practise wonders for how your body processes your sugar and how well your medicine works. Regular exercise, spread throughout the week, totaling at least 150 minutes is one of the all-time natural treatments for diabetes.

Getting Back on Track

If your A1C slipped away from you and you got a number you lot didn't like on your last A1c exam.

Start an investigation.

Allow'due south wait at the evidence:

Blood Glucose (BG)Checks

How frequently have you lot been checking blood sugars?
What kind of patterns do you see? Highs? Lows?
What fourth dimension of day do you notice patterns of highs or lows? Tin can you lot identify the cause?

Medication bank check

Has anything kept you from being consistent with your meds?
Any side effects?
How long have you been taking these same meds?
Have whatsoever medications been added for infections or inflammation (can crusade loftier BG)?
Where have your medications been stored?

Nutrient Check

Has anything changed with your diet? (visitors, traveling, finances, holidays, etc)
Have you lot felt hungrier lately?
How many times a week do you eat out?
Are your portions larger than normal?
Do you consume while doing other things, like watching Television set or while on the computer?

Exercise Cheque

Have you been exercising less or not at all?
Have you changed the blazon or intensity of exercise?
Did you lot have an injury that prevented yous from exercising?

Stress Bank check

Have you been under more stress than usual?
How do yous relieve the stress?

Once your accept investigated and looked at the evidence, y'all may be able to pick 1 or 2 things to piece of work on. Footling changes can oftentimes translate into big results over fourth dimension!

Frequently Asked Questions:

Tin my A1C levels be too low?

Yes, peculiarly if you are on diabetes medications and take had symptoms of hypoglycemia (low blood sugar). If y'all have a really low A1c, less than 6% and are experiencing hypoglycemia, then your doctor may desire to adjust your medications. On the other hand, if you are not on diabetes medications and have non been having symptoms of hypoglycemia and your A1C is low, then that is cracking.

How can I lower my A1C levels while pregnant?

Staying agile, choosing healthy foods, taking medicine if prescribed, avoiding sugary drinks/junk food, are the best way to go on your blood sugars in target while meaning. It'southward besides of import to gain the right amount of weight. "Eating for two" is a myth. The infant is so small-scale, that during the commencement trimester no additional calories are needed and past the second and third trimester the amount of actress calories needed would equal 1c of milk and one/2 a sandwich. Talk to your doctor virtually a good for you weight gain goal.

What medication tin reduce the A1C levels?

All classes of diabetes medications were designed to lower blood sugars and A1C. Some medications will lower your A1C more than others. If y'all are already on one medication but your A1C is non at target, your doctor may consider adding an additional medication to help. It is mutual to be on more than than 1 diabetes medication at a fourth dimension.

What practice I do if my A1C levels are slightly elevated?

If your blood sugars are only slightly elevated, yous may just increase your exercise or tweak your diet by calculation more than vegetables, peradventure yous just got off track. It can be helpful to do more than blood carbohydrate checks during this time as well and then you know what time of day your claret sugar is the highest and piece of work on a programme to target those specific times.

What is the A1C limit for Section of Transportation (DOT)?

The DOT requires your A1C to be less than x%, but at that place are as well other restrictions regarding hypoglycemia, complications related to diabetes, and insulin. You tin can work with your doctor to brand a plan to continue your commercial driver's license (CDL). Addressing your diabetes early on is one step yous can take to preserving your license.

Tin the A1C test be used during pregnancy?

If you have Type i or Blazon 2 diabetes prior to pregnancy, the medico volition likely go on to check your A1C. It is uncommon to use an A1c test in gestational diabetes because it typically doesn't prove upwards until 24-28 weeks of the pregnancy. Since an A1c examination measures upward to the last 120 days, this test would non be as relevant in gestational diabetes. Call up, if you lot experience anemia in pregnancy, this could produce a false A1C issue. Daily blood glucose checks tend to be more beneficial in managing blood sugar during pregnancy.

Can the A1C test issue in a different diagnosis than the blood glucose tests?

Aye, that is why it's required to have two lab tests showing aberrant values in social club for a diagnosis to be made.

Are diabetes blood examination results always authentic?

The tests that we have to diagnose diabetes are held to the high standards of lab tests that were used in landmark diabetes studies. With that said, labs can sometimes make errors. If yous or your doctor question your results, consider having the labs re fatigued.

Volition vitamins assistance my A1C levels?

Vitamin D, Calcium, and Magnesium are all vitamins that may assistance to amend insulin resistance, which in render could ameliorate your blood sugar command. Yous should talk to your doctor or dietitian before starting whatsoever vitamins or supplements to observe out which ones would be best for yous.

Can I drink alcohol if I take high A1C test results?

Booze is a tricky subject. Depending on the blazon you drink, could either increase drastically or lower your blood sugar. Sugariness drinks similar margaritas or annihilation mixed with soda is more than likely to raise your blood sugar. Hard alcohol or some shots, could actually prevent your liver from being able to produce sugar and could crusade a depression blood sugar, especially if yous take diabetes medications. As well, many medications in general are not indicated for use with alcohol. So, generally speaking, fugitive alcohol when you lot take diabetes and are on medications is best. If y'all prefer non to avert booze, then have a talk with your doctor about how often and how much is appropriate for you.

Utilize the converter beneath to translate your A1C percentage into an eAG number, or vice versa.

Is at that place a perfect a1c level? The American Diabetes Association recommends the general population of people with diabetes maintain a claret carbohydrate of seven% or less to reduce take chances of complications. The American Association of Clinical Endocrinologists land that people with low risk of complications and no other major health issues should have an A1C of <6.5%. Just the general consensus from all major wellness organizations setting A1C goals is that these guidelines should be adjusted based on each individual and their circumstances.

Bottomline

The A1C examination is a very useful test in helping people with diabetes and their doctors judge how well their treatment plan is working. It's of import for people with diabetes to understand this exam result and be in charge of their diabetes management. With that said, there are too many other ways to decide if your treatment program is working. The A1c is non the end all be all! On a day to twenty-four hours basis you lot may use your blood carbohydrate monitor throughout the day to give yous information about how your medications, do or eating plan is working. People too pay attention to how they feel and what their energy level and mood is like. Some people are actively striving for weight loss, then they are stepping on the calibration weekly. The almost important thing is to have modest daily measures to help go along you lot on track, so when you get that A1C done every 3 months or then, you don't go defenseless off guard.

My hope is that you lot have a better understanding of what an A1C test is and how it is used. If your have other questions or if you lot would similar learn more about me and how I can assistance yous, please write in the comments below. And besides share this article with anyone who might need a diabetes guide.

Angela Manderfeld, MS, RD, LD, CDE
Registered Dietitian and Certified Diabetes Educator

TheDiabetesCouncil Article | Reviewed by Dr. Sergii Vasyliuk Dr. on June ten, 2020

References:

1. https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-exam
2. https://world wide web.ncbi.nlm.nih.gov/pmc/articles/PMC3632159/
3. https://www.ncbi.nlm.nih.gov/pubmed/15345893
4. https://www.ncbi.nlm.nih.gov/pmc/manufactures/PMC4515445/
5. https://world wide web.ncbi.nlm.nih.gov/pubmed/19317814
6. http://care.diabetesjournals.org/content/26/iv/1147

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