The A1C is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you’re managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c.
The test result reflects your average blood sugar level for the past two months. Specifically, the A1C test measures what percentage of your hemoglobin – a protein in red blood cells that carries oxygen – is coat with coated with sugar (glycated). The higher the A1C level, the poorer the blood sugar control and the higher the risk of diabetes complications. Because red blood cells (RBCs) live approximately 120 days, the half life of an RBC is 60 days. So the test measures the saturation of sugar into RBCs over that 60 day average.
Recently an international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation recommended that the A1C test be the primary test used to diagnose prediabetes, type 1 and type 2 diabetes. Previously, the fasting glucose was the gold standard. However, in many cases the A1C elevates years prior to the fasting glucose. It is estimated that there are 35 million undiagnosed cases of type 2 diabetes in the United States alone.
The medical norm for the A1C test is less than 5.7%. That corresponds to an average blood sugar level, in milligram per deciliter (mg/dL) of 117. Research reveals anything above that level causes damage to the kidneys, small blood vessels, nerves and the eyes. A test result of 6.5%, the threshold for diabetes, reflects an average blood sugar level of 140.
A1C levels above 5.7 but below 6.5 are considered pre-diabetes. This is where many of my patients land, if they are not yet true diabetics. This is also where early treatment in the form of dietary improvements, regular exercise, and supplementation will easily reduce the A1C below 5.7% and allow patients to avoid Type 2 diabetes.
