Click here to jump down to a list of factors that impact A1C. Certain conditions, such as kidney disease, hemoglobin variants, certain types of anemia, and certain drugs and vitamins, impact red blood cell turnover, leading to misleading A1C values. For example, if a lab report shows an A1C value of 7.0%, the actual A1C value might range from 6.5% and 7.5%.Ī1C is based on a person’s red blood cell turnover (the lifespan of a red blood cell) and the quantity of sugar attached to each cell. Depending on the machine, a single A1C test can have up to a 0.5% margin of error, which means the “true” value might be 0.5% higher or lower than the measured A1C. Results from a non- NGSP certified lab may not be as reliable. Much progress has been made in standardizing and improving the accuracy of the A1C test thanks to the National Glycohemoglobin Standardization Program (NGSP). Where is A1C misleading or potentially inaccurate? Talk with your healthcare professional if you're curious about how your age may affect your A1C levels. However, as you age your diabetes management strategies and A1C goals may change – for example, younger people may be more focused on reducing long-term health complications, while older people may concentrate on avoiding severe lows. How does age affect A1C?Ī1C is a measure of diabetes management, so your A1C won't naturally shift as you get older. For instance, goals may differ depending on age and other health conditions. Since each person with diabetes is unique, however, healthcare providers are recommended to set individual A1C goals. What is an A1C goal for those with diagnosed diabetes?Īn A1C of less than 6.5% or 7% is the goal for many people with diabetes. Make sure you get a regular A1C test, especially if you think you might be at risk for diabetes. Your average blood glucose level for the last 2-3 months is at the level of someone with type 2 diabetes. The American Diabetes Association (ADA) has established the following cutoffs: A1C Chart A1C Level Generally, high A1C values indicate high average blood sugar levels and that a person might be at risk for or may have diabetes. What are “normal” A1C levels for people who don't have diabetes? It is only when the red blood cell is "recycled" (which happens every 2 to 3 months) that the sugar coating disappears. The test is representative of a 2 to 3-month average because once a red blood cell becomes coated with sugar, the link is irreversible. Similarly, higher A1Cs can lead to "macrovascular" complications, such as heart disease.Ī1C is usually measured in a lab with routine blood work, or with a countertop machine in a doctor’s office (and some pharmacies) using a fingerstick.Ī1C measures the relative percentage of “glycated hemoglobin,” which refers to red blood cells called hemoglobin with sugar attached to it. If a person consistently has higher blood glucose levels, A1C levels go up because more red blood cells are coated with sugar. Though A1C doesn’t provide day-to-day information, lower A1Cs are correlated with a lower risk of “microvascular” complications, such as kidney disease (nephropathy), vision loss (retinopathy), and nerve damage (neuropathy). It is one measure we have of how well blood glucose is controlled and an indicator of diabetes management. What is A1C and why is it used?Ī1C estimates a person’s average blood sugar levels over a 2 to 3-month span. In a follow-up piece, we will discuss time-in-range, blood sugar variability, and how to measure and interpret them. This article describes why A1C is used in the first place, as well as factors that can lead to misleadingly high or low values. However, as an average over a period of months, A1C cannot capture critical information such as time spent in a target range (70-180 mg/dl) and below range (less than 70 mg/dl). For every 1% decrease in A1C, there is significant protection against those complications. A1C reflects average blood sugars over 2 to 3 months, and through studies like DCCT and UKPDS, higher A1C levels have been shown to be associated with the risk of diabetes complications (kidney and nerve disease). Hemoglobin A1C (“HbA1c” or just “A1c”) is the standard for measuring blood sugar management in people with diabetes. Why we use A1C, what values are recommended, and what impacts A1C – everything from anemia to vitamins
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