A1c levels are blood test results of a test known as A1c, HbA1c or glycosylated hemoglobin. This test is usually performed to confirm diagnosis of diabetes in addition to a useful tool for doctors to manage diabetes therapy.
The A1c levels are measurement of percentage of excess sugar in the blood which managed to attach to hemoglobin in red blood cells. Under normal circumstances, the A1c level is approximately 5%, meaning about 5% of the sugar is bound or glycated to the hemoglobin. The official or generally accepted definition of diabetes is more than 7% on more than one occasion.
Some consider A1c levels of 5.7 to 6.5% as pre diabetes. People with these A1c levels are at higher risk of developing into diabetes. Vigilant lifestyle changes for those with pre diabetes can slow the progression to diabetes when diabetes therapy will need to be initiated. Exercise and diet control are two very fundamental principles for treating pre diabetes, with emphasis on reducing waist circumferences and sugar intake.
The A1c levels should be checked prior to starting any diabetes therapy and subsequently every quarter until steady A1c levels achieved. Knowing the baseline A1c level will allow setting goals and targets by endocrinologists. Due to the irreversible nature of sugar binding to hemoglobin in red blood cells, the HbA1c test reflects more accurate results when performed at life span of red blood cells, namely about 90days.
In another word, the A1c levels indicate how well sugar or diabetes is managed over the past two to three months. Keeping a record of the A1c results give an idea if the diabetes therapy is effective. The doctor may amend therapy according to the results, either by adding new medication or starting insulin therapy.
To check how the blood sugar is doing on day to day basis, it is recommended to use blood glucose meter rather than the HbA1c test. The A1c levels only tells retrospectively the average control of the blood sugar, not the blood sugar level at real time. These A1c levels are not meant for titration of insulin doses. Proper frequent blood sugar level using blood glucose meter is still the preferred method to adjust insulin doses.
Sometimes, doctor may choose to inform the result as estimated average glucose (eAG) which is calculated from the A1c levels. The eAG paints the picture of average overall blood sugar levels from the A1c levels.
Range of A1C Levels
Keeping A1c levels below 7% is recommended for all with diabetes. This has been shown to reduce heart attack risks, kidney failure, loss of vision as well as numbness of limbs. Uncontrolled diabetes can be reflected in routine A1c levels of more than 9%. Intensive therapy in combination with drastic lifestyle changes will be necessary to combat the high A1c levels.
There should be some understanding that A1c levels are a lagging indicator of the diabetes control. Hence, those with very high A1c levels, it will take some time, possibly up to months before improvement on A1c levels can be accomplished. Take the time to fully execute all the right advices for diet and lifestyle changes and not get disheartened by the slow improvement. Perseverance will help reach the goal A1c level of less than 7%.
Why You Need To Keep Track Of A1c Levels
A1c levels help both doctor and diabetes patients to set targets and review progression of diabetes therapy. The diabetes A1c tests are necessary as part of the diabetes management to ensure minimal diabetes complications.