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A1C Testing

An A1C test, also known as a Hemoglobin A1C (HbA1C) test, may sound like alphabet soup, but it is an essential tool to measure your risk of diabetes. If you have a diagnosis of diabetes, an A1C test can also help you monitor your condition and make changes accordingly.

What is an A1C test?

Certain proteins known as hemoglobin that are a part of your red blood cells work hard, ferrying oxygen and carbon dioxide molecules around your body. In the process of their daily work, these hemoglobin proteins can become decorated with sticky glucose molecules as they travel throughout your bloodstream. An A1C test works by measuring the amount of these “glycolated” or “glucose-containing” hemoglobin proteins that are on your red blood cells. Because medical specialists are familiar with the typical lifespan of a red blood cell, an A1C test can be an effective way of estimating your average blood glucose level over the past three months. If your blood glucose levels have been high, the percentage of hemoglobin proteins that have a sugar molecule stuck to them will be higher than normal.

According to the National Library of Medicine, in a person without diabetes, an A1C test should be less than 5.7%. In a person with prediabetes, an A1C test will be between 5.7% and 6.4%. In a person with diabetes, A1C test results will be above 6.5%.

An A1C test can help you see how lifestyle changes or medications (or both) are impacting your blood sugar levels, which can help you make choices that can affect your future health outcomes. Keeping your average blood sugar low can help you avoid future health events like a heart attack, stroke, or kidney disease.

Who should get an A1C test?

If you’re interested in an annual health screening that assesses your blood pressure, height, weight, and other parameters, an A1C test is another helpful tool to see how you are measuring up. If your A1C is slightly elevated into the prediabetic range, it can be helpful information that can prompt you to make lifestyle changes and reduce your average blood glucose level.

If you have ever had a diagnosis of diabetes or prediabetes, you should get periodically tested with an A1C test. For people with prediabetes, an A1C test is usually checked every 1 to 2 years. For people with diabetes, an A1C test is usually checked at least every six months.

According to the Centers for Disease Control and Prevention (CDC), other reasons for getting an A1C test include:

  • Being over age 45 (if your test is normal, they recommend repeating it every three years)
  • Being under age 45 and having a medical condition that makes you more likely to develop diabetes
  • Having symptoms of diabetes, such as excessive thirst, urinating frequently, feeling very hungry, unintentional weight loss, feeling tired, having frequent infections, or having slowly healing sores

How to get an A1C test

To get an A1C test, you will possibly need to have a conversation with a healthcare provider. This could be your regular doctor or a healthcare provider affiliated with a same-day clinic such as urgent care. Depending on your specific medical situation, your healthcare provider may recommend an A1C test. This test may be particularly helpful if you’re curious about your blood sugar level but have just eaten a large meal or sugary treat (both of which could skew the results of a regular blood glucose test). Your healthcare provider can order an A1C test, and you may have the test performed at the clinic or an outside lab. You may also be able to order an at-home A1C test online without a doctor’s order.

What to expect during an A1C test

An A1C test is a simple blood test. Your healthcare provider will use a small needle to draw blood from a vein, typically in your arm. This should cause minimal pain. Your A1C test results may be available that same day or within the next few days, depending on the laboratory. You do not need to do anything specific to prepare for an A1C test, including no fasting before the test.

Interpreting the results of an A1C test

After an A1C test, you may be very curious about your results. Your A1C test result will be returned as a percentage, which indicates the proportion of the hemoglobin molecules in your red blood cells that are coated with glucose. The lifespan of a red blood cell is three months, so the test will only be a valid measurement of your average blood glucose level over the past three months. The following thresholds, according to the National Library of Medicine, can help you interpret your A1C test:

  • Normal A1C range: Less than 5.7%
  • Prediabetic A1C range: Between 5.7 and 6.4%
  • Diabetic A1C range: 6.5% or greater

The healthcare provider who ordered your A1C test can help answer any questions that you may have about interpreting the test. An A1C test can help make an initial diagnosis of prediabetes or Type 2 diabetes, but according to the National Library of Medicine, an A1C test is not typically used to make an initial diagnosis of Type 1 diabetes or gestational diabetes.

What to do if an A1C test is elevated

If you have an A1C test result that is 5.7% or greater, it is very important to have a follow-up conversation with your healthcare provider, notes the National Library of Medicine This can help you understand more about your blood glucose levels, how they can affect your health over the long term, and what lifestyle changes you can make to lower them. You can also discuss other factors that may be affecting your A1C test outside of prediabetes or diabetes.

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Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

  1. Hemoglobin A1C (HbA1C) Test (Sep 06, 2022)
  2. Pitfalls in Hemoglobin A1c Measurement: When Results may be Misleading (Feb 2014)
  3. Understanding A1C (2022)
  4. All about your A1C (Sep 30, 2022)
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