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By Jenilee Matz, M.P.H., Staff Writer
Checking your blood sugar every day, sometimes several times a day, is very important. These checks give you an instant reading to keep tabs on your blood sugar. Sometimes your readings are in target range, but other times they're not. While you can adjust your meals, activity or sometimes your insulin daily, it's hard to get the big picture of how well your diabetes is controlled. That's where the hemoglobin A1C test comes in.
A hemoglobin A1C test shows what your average blood glucose level has been over the past two to three months. Rounding out the daily ups and downs, this test is a helpful tool that shows you and your doctor how well your diabetes treatment plan has been working.
What is hemoglobin A1C?
Hemoglobin is a protein inside your red blood cells. It binds (or glycates) to sugars, and carries oxygen from the lungs to the cells. When you have a high blood sugar, more hemoglobin attaches to the sugars. The product, called glycated hemoglobin, is what the HbA1C test measures.
Red blood cells stay in the bloodstream for about 120 days, or around four months. So measuring the glycated hemoglobin shows what's been happening over this time period. The A1C test shows your average blood sugar levels over the past two to three months.
A higher hemoglobin A1C reading means your blood sugar levels have been high. A lower A1C reading indicates your blood sugar levels are likely under control.
What is a "good" A1C reading?
Hemoglobin A1C is measured in percentages. A hemoglobin A1C of less than 7 percent is often the goal for people with diabetes (5 percent is the average for people who do not have diabetes). But, your doctor may suggest a different target range. If you're pregnant, your doctor may want your target A1C level to be less than 6 percent.
The goal is to keep your A1C level as close to non-diabetic levels as possible without having episodes of low blood sugar or hypoglycemia. This will reduce your risk of diabetes-related complications, such as heart disease, kidney failure, nerve damage and eye disease.
Your doctor will go over your test results with you. If your results are high, your treatment plan may not be working. Review your diabetes care plan with your doctor. He or she may make adjustments to your plan to get your blood sugar levels in check.
How is the test performed?
The A1C test is a simple blood test that is usually performed in a lab. You don't need to change your diet or medications before the A1C test. A small sample of blood will be drawn from a vein in your arm.
How often do I need this test?
A1C should be tested at least twice a year, or as often as your doctor advises. If your results are high or your treatment plan has changed, your doctor may want to test your A1C levels every three months until your blood glucose levels stabilize.
Should I still check my blood sugar at home, too?
Yes. The hemoglobin A1C test should be done in addition to regular blood glucose monitoring at home. It is not meant to replace it.
The A1C test cannot measure day-to-day blood sugar levels. This is why regular blood sugar checks are so important. Not only will self glucose monitoring help show if your diabetes plan is working, but it will also indicate when you:
- Need to eat
- Should adjust the amount of insulin or medication you take
- Can start, continue or should stop exercising
- Need to treat a low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia) reaction
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This article was reviewed and updated
08-01-2009.
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