There are many ways to measure your blood sugar levels, but one that health care providers use often is a measurement called the A1C test.
The A1C test can be used to diagnose prediabetes, and in conjunction with other tests to diagnose type 1 and type 2 diabetes. Your provider will also use an A1C test to monitor your diabetes treatment plan if you are on one.
What Is the A1C Test?
Your blood sugar varies throughout the day. It is typically lower in the morning when you wake up, before you’ve had a meal. Food increases your blood sugar for about an hour or two after your meal. Exercise and stress can also temporarily increase blood sugar levels while alcohol can decrease it.
“Variations in blood sugar is all in a day’s work for your body,” said Tim Arakawa, MD, PhD, from Samaritan Endocrinology in Corvallis. “It is normal and healthy for blood sugar levels to vary within a certain range. The A1C test lets us see what the average of that range is over time which helps us determine if your body is using glucose in an effective manner.”
The A1C test looks at the hemoglobin in your blood to see how much glucose, a form of sugar that provides energy to your body, is attached to it. Red blood cells, oxygen-carrying cells that contain hemoglobin, live about three months before dying and being replaced by new blood cells. Looking at glucose on the hemoglobin gives a good average of what a person’s blood sugar has been over the previous three months.
You do not need to fast for an A1C test. Results are given as a percent; the higher the percentage, the higher your average blood sugar has been.
A test result of less than 5.7% is considered normal. Between 5.7% and 6.5% indicates prediabetes, and over 6.5% is in the range of diabetes. If your test results are above 6.5%, your provider will use another test like a fasting blood sugar test or glucose tolerance test to confirm that you have diabetes.
Your provider can use the number from the A1C test to calculate your estimated average glucose, or eAG, which is similar to the average of the measurement used by home glucose meters.
Who Needs an A1C Test?
Your provider may order an A1C test as part of a routine physical, if you have other symptoms of diabetes.
If you have already been diagnosed with diabetes, the American Diabetes Association recommends being tested twice a year if you are meeting your treatment goals. However, you may need to be tested more often if you are having difficulty managing your health.
“Blood sugar levels that are consistently too high puts people at risk for complications like nerve damage, loss of vision, chronic kidney disease and cardiovascular disease,” said Dr. Arakawa. “Being able to see a big-picture average of how well blood sugar levels are being managed can help us custom-fit your treatment plan for you.”
How to Improve Your A1C Levels
An A1C test is a reflection of how well daily blood sugar levels are being controlled, so always follow your health care provider’s recommendations.
In general, Dr. Arakawa notes the following tips can help manage blood sugar levels:
- Eat a healthy diet, as discussed with your health care team. Don’t skip meals.
- Drink plenty of water.
- Get at least 150 minutes of exercise a week. Exercise is helpful for normalizing how your body manages blood sugar so try to exercise every day.
- Get seven to nine hours of sleep every night.
- Manage stress.
- If you use tobacco, quit.
- Take medications as directed.
“The A1C test is just one tool we use to gather information about how your body is managing glucose, so talk to your doctor if you have questions about your blood sugar levels or the best treatment plan for your situation,” said Dr. Arakawa.