Teach Me

A1c: Why This Critical Blood Measurement Is So Significant

If you have diabetes or you’re at risk for developing diabetes, your doctor might recommend a hemoglobin A1c test. It’s a blood test that gives you an estimate of your blood sugar levels over the last three months. Mark Bridenstine, MD, an endocrinologist at Banner Health in Loveland, CO, answers some key questions about this important health marker.

Who needs a hemoglobin A1c test?

Your doctor might want to check your A1c levels if you:

  • Are at higher risk of developing diabetes/have prediabetes
  • Could be diagnosed with diabetes
  • Have diabetes and need to see how well your blood sugar is controlled

How is my hemoglobin A1c tested?

Most of the time you’ll have blood drawn in a lab. It’s also possible to do an A1c test from a finger-stick drop of blood.

What information can I learn from my A1c test?

In your body, glucose attaches to the hemoglobin in your red blood cells. The hemoglobin A1c test measures how much of your hemoglobin has glucose attached to it.

So, if your reading is 7.0%, it means that 7.0% of your hemoglobin contains glucose. Your red blood cells live for around three months, so your reading is an estimate of your average blood sugar level for the past three months.

A1c is different from your blood glucose level, which tells you what your blood sugar level is at that moment in time. “If A1c is the birds-eye-view of the forest, then blood glucose is the hikers-eye-view,” Dr. Bridenstine said. Both blood measurements give you valuable information.

What should my A1c level be?

For most people, a good target A1c level is 7.0% or less. But your target hemoglobin A1c level depends on a lot of factors:

  • Your age
  • How long you’ve had diabetes
  • Your risk of complications from diabetes
  • Other medical conditions
  • Your risk of hypoglycemia (low blood sugar)
  • Your ability to manage your diabetes with medication

Your doctor can help determine the best target A1c level for you.

How can I improve my A1c level?

There are steps you can take to lower your hemoglobin A1c levels and help keep your diabetes well controlled. “Lifestyle efforts are paramount,” Dr. Bridenstine said.

  • You can make changes to your diet. Dr. Bridenstine recommends limiting highly processed foods, avoiding sugary drinks, and choosing smaller portions of foods that are high in calories and carbohydrates.
  • You can exercise more. Dr. Bridenstine said to find activities that you enjoy, so you keep doing them. And he pointed out that even short bursts of exercise are useful. “Walking for 10 minutes after a meal can help your body process and manage blood sugars,” he said.
  • You can take medication if your doctor recommends it. “Even with optimizing lifestyle, some people are going to need more help with diabetes drug therapy,” he said.

What can happen if my A1c levels are high?

High A1c levels mean your diabetes isn’t controlled very well. That can increase your risk for complications, so you may need to be screened for kidney damage, nerve damage, eye damage, and heart disease. Additionally, according to the American Diabetes Association, diabetes is the seventh-leading cause of death in the United States. “It’s worth mentioning that the top six causes of death are all influenced and/or worsened by diabetes, too,” Dr. Bridenstine said.

Got more questions? Whether you’re at risk for developing diabetes or already have it, discuss with your doctor if an A1c test is right for you. To find a doctor in your area, visit bannerhealth.com. To evaluate your risk for diabetes, take our free diabetes risk assessment

Other useful articles:

Diabetes Endocrinology