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An HbA1c test is also known by other names such as:

  • Hemoglobin A1c
  • Glycated hemoglobin
  • Glycosylated hemoglobin
  • Glycohemoglobin

HbA1c tests are typically used to diagnose diabetes or prediabetes in adults. Prediabetes means your blood levels are higher than normal. Thus, increasing your chance of developing diabetes and cardiovascular diseases.

What is an HbA1c test?

The red blood cells inside your body contain hemoglobin – a molecule that provides oxygen to the body’s tissues. A small portion of sugar (glucose) is attached to hemoglobin called hemoglobin A1c.

The amount of hemoglobin A1c in your blood correlates with the amount of glucose in your blood. The higher the amount of glucose in your blood, the higher is the level of hemoglobin A1c detected, and the higher the risk of diabetes. But for normal glucose levels, your A1c levels will also be normal.

An HbA1c test is used to measure the hemoglobin A1c level or the amount of glucose attached to the hemoglobin over the past three months. However, the test can only check sugar levels for the past three months because the average lifespan of red blood cells is three months.

Why it is done

You may need an HbA1c test if you show symptoms such as:

  • Fatigue
  • Increased thirst
  • Blurred vision
  • Increased urination

Based on the results of your HbA1c test, doctors can diagnose:

  • Prediabetes: If you have prediabetes, you are more likely to develop diabetes and cardiovascular diseases.
  • Type I and II diabetes: Your doctor will examine either two A1c tests or one A1c test with another diabetes blood test, usually performed on two separate days – to confirm the diabetes diagnosis.

Besides, HbA1c tests are also used to monitor your diabetes treatment plan and to see how effective the plan is in lowering your blood sugar levels. Based on the type of diabetes and how you manage your blood sugar levels, you may need the test more often.

However, if your doctor alters your medication or changes your treatment plan, you may need HbA1c tests more frequently.  

How the test works

HbA1c is a normal blood test so you need not fast before the procedure. You can eat and drink to your heart’s content. Also, there are no risks involved since HbA1c is a simple blood test.

On the day of the test, your healthcare provider will take your blood sample. They will use a needle to draw blood from a vein in your arm, in a small tube or vial and send it to the lab for analysis. The whole procedure usually takes less than 5 minutes.

Nowadays, some doctors also use a finger prick method to check your sugar levels. The results are analyzed in the doctor’s office, on the same day

What do the results mean?

The results of an HbA1c test are presented in percentages.

  • Normal: A1c level between 4% and 5.9%
  • Diabetes: A1c level of 6.5% or above
  • Prediabetes: A1c level between 5.7% and 6.4%

However, the effectiveness of an HbA1c test is limited. HbA1c test is cannot be used for diagnosing diabetes in children or for diagnosing gestational diabetes – a type of diabetes that only affects pregnant women.

In fact, hemoglobin A1c levels can be altered by factors:

  • Fasting
  • Oral or IV glucose intake
  • Use of insulin
  • High cholesterol levels
  • Supplements (like vitamin C and E)

Altered A1c levels will lead to false results.  You may receive false results if you have severe anemia or other blood disorder, liver disease, or kidney failure. Or if your red blood cell survival is decreased. In such cases, doctors usually refer you for other tests based on your overall health, weight, age, and other factors.

As per the American Diabetic Association, Hemoglobin A1c levels should be checked every six months for those with stable sugar control and every three months for those trying to establish stable sugar control.

For a high A1c number

A higher percentage result of an HbA1c test, usually above 8%, indicates that you have uncontrolled diabetes. In such a case, you are at a higher risk of developing diabetic complications and conditions such as:

  • Nerve damage
  • Eye damage
  • Kidney disease
  • Stroke
  • Heart attack
  • Lack of sensation in the feet
  • Infection
  • Slower wound healing

However, hemoglobin A1c levels can be controlled easily. For people with type 2 diabetes, a combination of medication, exercise, and appropriate diet can significantly lower your blood sugar levels. Losing weight or starting an exercise routine can also help you bring down the blood sugar levels. But for type 1 diabetes, you will need insulins as soon as it is diagnosed.

As for those diagnosed with prediabetes, a higher percentage of A1c levels means you need to start taking medicines. This is because prediabetes typically progresses to diabetes at a rate of 5-10% every year. Consult your doctor to receive an effective treatment plan. 

Nonetheless, you can significantly reduce your A1c levels with small lifestyle changes. Also, make sure to monitor your glucose levels closely to eliminate the risks of complications.

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