What is the HbA1c Test for Diabetic Patients?

  • The hemoglobin A1C or HbA1c is one diagnosing tool for measuring the average blood sugar level of a person over the past 3 months.
  • It is an essential test to help people with diabetes manage their conditions and avoid complications.
  • Maintaining the A1C levels should be the goal of all diabetes patients.

Among the different tests that people with diabetes undergo, the hemoglobin A1C test is the most common diagnosing test to diagnose prediabetes and diabetes. Commonly known as the A1C test, it is a simple blood test to measure the average blood sugar levels from the previous three months. The A1C test is also vital in helping patients and their doctors manage their conditions and prevent complications.

Below are the important things you need to know more about the A1C test.

Who needs to be tested and how frequently?

  1. The baseline A1C test is recommended for:
  • Adults over 45 years
  • Adults below 45 years but are overweight and have one or more prediabetes or diabetes 2 risk factors
  • An A1C test every three years is suggested for people with normal baseline A1C but who are over 45 years and had gestational diabetes.
  • A confirmatory test on a different day should be done if the baseline A1C test shows that a patient has prediabetes or diabetes but shows no symptoms.
  • The frequency of an A1C test should be according to the doctor’s recommendation or as often as needed if a prediabetes condition result comes out based on the baseline A1C test.
  • If the baseline A1C test shows a diabetes condition, it is time to start the treatment and management diabetes plan and A1C test should be done twice a year or each time diabetes medication changes.

What are the preparations before an A1C test and where to get the test?

There are no special preparations needed before an A1C test. But if the A1C test is to be carried out together with other tests, ask for instructions and guidance from physicians beforehand. The test can be done in the lab or even in the doctor’s clinic by collecting blood from a finger stick or the arm.

What does an A1C result mean?

The sugar in the bloodstream attaches to the protein in the red blood cells (RBCs) called the hemoglobin. The A1C test can measure the percentage of RBCs with sugar-coated hemoglobins.

There are three levels to which an A1C result falls under. A normal A1C level falls below 5.7%, while a prediabetes level is between 5.7-6.4 % and a 6.5% or above indicates a diabetes condition.  The higher the A1C level, the greater will be the risk for type 2 diabetes. Also, the A1C levels can be expressed as estimated average glucose (eAG) and it is usually what is reflected on blood glucose meters.

Why do A1C results become inaccurate? 

Sometimes, A1C results can falsely increase or decrease because of certain factors like:

  • Medical conditions like severe anemia, liver disease, and kidney failure
  • Some medications, including opioids, some HIV medicines
  • Certain blood disorders like sickle cell anemia and thalassemia
  • Blood loss and blood transfusions
  • Early or late pregnancy

What should be the A1C goal level?

People with diabetes should goal for a 7% or lesser A1C level. Still, the A1C level goal will be different for everyone and will depend on age and other health conditions. Older people with diabetes and who have other serious health problems should goal for a lower A1C level while younger people should set a goal enough to reduce their risk of diabetes complications.  

Is the A1C test enough?

Although the A1C test is a vital diagnosing tool, it is not enough and it should not replace regular blood sugar tests done at home. Blood sugar levels can fluctuate any time of the day and the A1C test might not capture it. So it is important to keep track of your blood sugar levels and share the results with your doctors so they can do some changes and advise you on how to manage your condition.

Source: CDC

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