(C) Daily Kos This story was originally published by Daily Kos and is unaltered. . . . . . . . . . . Kos Diabetes Group: A1c [1] ['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.', 'Backgroundurl Avatar_Large', 'Nickname', 'Joined', 'Created_At', 'Story Count', 'N_Stories', 'Comment Count', 'N_Comments', 'Popular Tags'] Date: 2023-02-10 Home blood glucose testing can be an important and useful tool for managing blood sugar on a day-to-day basis, but it only provides a snapshot of what’s happening in the moment. The A1c blood test also known as the hemoglobin A1C or HbA1c test is a simple blood test that measures the percentage of your red blood cells that have sugar-coated hemoglobin. Everybody has some sugar attached to their hemoglobin, but people with higher blood glucose levels have more. The A1c is a good indicator of your average glucose level over the last three months and it’s one of the most commonly used tests to diagnose prediabetes and diabetes. It is also the main test to help you and your health care team manage your diabetes. The higher the levels, the greater your risk of developing diabetes complications, so reaching and maintaining your individual A1c goal is really important if you have diabetes. It can be stressful to see an abnormal or higher-than-you-expected A1C result. Know that having an elevated A1c for the first time doesn’t necessarily mean you have diabetes. Several factors can falsely increase or decrease your A1c result, including: Kidney failure, liver disease, or severe anemia. A less common type of hemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anemia or thalassemia) may have. Certain medicines, including opioids and some HIV medications. Blood loss or blood transfusions. Early or late pregnancy. When should A1c testing begin? Everyone over the age of 45 should get a baseline A1c test. You should be screened earlier if you’re under 45 and are overweight or have one or more risk factors for prediabetes or Type 2 diabetes. If your results are normal, you can repeat the test every three years. If the results show you have prediabetes you should start taking steps like changing your eating and exercise habits to avoid becoming diabetic. The test should be repeated every one to two years. If the test shows you are diabetic, you will need to begin management right away. Management may involve taking oral medications, using insulin, monitoring blood sugar levels and/or making lifestyle changes, such as changes to your diet and exercise level. Future A1c tests can help you and your provider determine if you should adjust any part of your management plan. You may also need an A1c test to screen for Type 2 diabetes if you’re over the age of 35 and at risk for the condition. Risk factors include: Family history of Type 2 diabetes. Personal history of gestational diabetes. Obesity Lack of activity or exercise. How often should I have an A1c test done? Every three years if your results are normal Once every year if you have prediabetes Twice a year if you don't use insulin and your blood sugar level is consistently within your target range Four times a year if you take insulin or have trouble keeping your blood sugar level within your target range Interpreting Your A1C Results Normal Below 5.7% Prediabetes 5.7% to 6.4% Diabetes 6.5% or above Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your glucose meter: A1C % eAG mg/dL 7 154 8 183 9 212 10 240 The goal for most people with diabetes is 7% or less. However, your personal goal will depend on many things such as your age and any other medical conditions. Work with your doctor to set your own individual A1C goal. Your A1C goals may be above 7% if you have: Limited life expectancy. Severe low blood sugar (hypoglycemia) episodes or are unable to sense these episodes (hypoglycemia unawareness). Advanced diabetes complications, such as chronic kidney disease, nerve problems or cardiovascular disease. If you have an elevated A1c (above 6.5%) for the first time, it doesn’t always mean that you have diabetes, especially if you have no other common symptoms of diabetes. Other factors, such as certain medications (like steroids) or sickness can temporarily increase your blood glucose levels. Anemia and other conditions can cause a falsely high A1c result, as well. There also could’ve been an error in the collection, transport or processing of the test. Healthcare providers rely on more than one test to diagnose diabetes, so they may order a glucose tolerance test or another A1c test. It’s important to remember that your A1c (if you have diabetes) is just a temporary average of your blood glucose levels. It’s not the ultimate determiner of whether you’re living a healthy life. Remember that your A1c will change over your lifetime and that there are steps you can take to improve your diabetes management and A1c level, if needed. Some of the actions you can take include: Start an exercise plan you enjoy and do it regularly. Eat a balanced diet with proper portion sizes. Stick to a regular schedule so you can more easily avoid skipping meals or eating junk. Follow the treatment plan your healthcare provider recommends and take your medications as directed. Your A1c score is a helpful tool, but it is not the only indicator of how healthy you are. For example, you could hit your A1c goal but still have wide fluctuations in your glucose levels, which is more common among people who take insulin. These fluctuations need to be leveled out since they can lower quality of life and increase risk of complications. Now that continuous glucose monitoring systems are becoming more common, providers and people with diabetes have found time in range (TIR) to be a more helpful and accurate representation of their overall diabetes management. Time in range is the amount of time your glucose levels are in a recommended target range. TIR is measured as a percentage. Blood glucose range goals can vary for each person, but a typical target range is between 70 and 180 mg/dL. For most adults with Type 1 or Type 2 diabetes, providers recommend aiming to have a TIR above 70% (about 17 hours out of a 24-hour day). Whether you only use the A1c or also use the TIR. Please make sure you are tested regularly by your healthcare provider. 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