Diabetes and the Significance of the A1c Test: Part 2 in a Series

Person Taking Blood from Personfor A1c Test

Taking Blood for A1c Test (The A1C Test & Diabetes | NIDDK (nih.gov))

Editor’s note:  For National Diabetes Month, this is the 2nd in a series of posts about managing diabetes written by Audrey Demmitt, RN, BSN, a Diabetes Nurse Educator and APH VisionAware Peer Advisor.

In Part 1 of the series, Audrey discussed how diabetes education can help lower your blood sugars and reduce the risk of diabetic retinopathy. In Part 2, she emphasizes the significance of the A1c test in the effective diagnosis, treatment, and management of diabetes. By making daily efforts to stick to your treatment plan and by making healthy lifestyle changes, you can achieve your A1c goal, avoid long-term complications, and live well with diabetes.

How Diabetes Is Diagnosed  

Diabetes is a complex condition to diagnose and manage. In the early stages, there are no symptoms; in the long term, there can be devastating effects on every system in the body. Prevention, early detection, and vigilant management are key factors in reducing diabetes complications, such as blindness and blood vessel disease. 

When teaching people with diabetes, I encourage them to “know their numbers” and use them to better manage their diabetes. Let’s take a look at the A1c and why it is an important number. 

A1c Blood Test

The A1c blood test is used to diagnose diabetes and pre-diabetes and to monitor blood glucose control in people with type 1 and type 2 diabetes. The test reflects a person’s average blood glucose – or sugar in the blood – for the past three months. When glucose enters the bloodstream, it attaches itself to hemoglobin, a protein in red blood cells. The A1c test measures what percentage of your hemoglobin is coated with sugar or “glycated.” 

A normal A1c is below 5.7%. This number represents an average of all the ups and downs in blood glucose levels as if recorded on a video camera over the past many weeks. The higher the A1c, the higher the blood glucose levels have been over time and the higher your risk is for diabetes complications. The Alc level for prediabetes is 5.7-6.4% and for diabetes 6.5% or higher.(American Diabetes Association)

How Often Should my A1c Be Tested? 

The American Diabetes Association (ADA) recommends you have the A1c test twice a year if your blood sugars are stable and you are meeting your treatment goals. Healthcare providers may repeat the A1c test as often as four times a year if there are changes in treatments or you are not meeting your A1c target. The A1c is like a report card on how well you are managing your diabetes. 

What Should My Target A1c Be? 

Everyone will not have the same A1c target. It will depend on your individual diabetes history and general health. You and your doctor need to discuss this and set goals that are appropriate for your situation. 

How Can I Meet My A1c Target? 

Managing diabetes requires a lifestyle of healthy self-care practices. The keys to bringing down A1C levels are the same as for bringing down blood sugar levels. The essentials are: 

  1. Taking the right medications at the right times and in the proper doses. Work with your doctor to evaluate your medications periodically so they can be adjusted when needed. Since diabetes is a progressive disease, it is likely that you will need to increase and/or add to your glucose-lowering medications over time. 
  2. Eating the right portions of fruits, vegetables, whole grains, low-fat dairy, and healthy fats. A diet rich in fiber has been linked to lower blood sugar levels. You may want to learn more about counting carbohydrates and portion control. Eat about the same amount of carbs at each meal and at the same times each day. Ask a dietician to help you create a meal plan that will help control your weight and A1c. 
  3. Increasing daily physical activity. Engage in at least 30 minutes of moderate exercise, such as brisk walking, five days per week and strength training two days per week. Find ways to move more and incorporate activities you enjoy into your day. 
  4. Managing stress and depression. Negative emotions, depression, and diabetes burnout can make following your treatment plan difficult. If you are finding it hard to cope with diabetes, let your doctor know and enlist the support of a loved one. There are many resources to help you. 

More About A1c and Achieving Your A1c Goals