What is A1c and Why Does It Matter?

What is A1c and why does it matter?

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A1c is a measurement of your average glucose levels over the past two to three months. It’s used by healthcare professionals to measure how well your diabetes is being managed and is given as a percentage²¹².

The goal for most people with type 1 or type 2 diabetes is an A1c below 7%².

What is a normal blood sugar?

Recommended blood sugar levels for most people with diabetes²¹⁴

This table provides general recommendations on blood sugar targets and may not be the same as the targets your healthcare team  has set for you. Your targets should be personalized to you.

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Doctors also use different blood sugar tests to diagnose diabetes. In addition to A1c, doctors will do a Fasting Blood Sugar Test (measures blood sugar levels after an overnight fast) and a Glucose Tolerance Test (measures blood sugar levels before and after drinking a sugary liquid)²¹⁵.

Diabetes is diagnosed when²¹⁵

A1c is 6.5% or above
Blood sugar level is 7 mmol/L or higher after fasting
Blood sugar level is 11.1 mmol/L or higher after a glucose tolerance test

Prediabetes is diagnosed when²¹⁵

A1c is 6.0-6.4%
Blood sugar level is 6.1-6.9 mmol/L after fasting
Blood sugar level is 7.8-11.0 mmol/L after a glucose tolerance test

How A1c is measured

When glucose is in your bloodstream,  it enters your red blood cells and attaches  to a protein called “hemoglobin”. A1c is a measurement of the percentage of hemoglobin in your blood that’s attached  to glucose²¹⁷.

A1c and glucose variability

Whatever your A1c, it’s possible to spend a significant amount of time outside of your target glucose range. Your target glucose range is where you and your diabetes care team would like your glucose levels to be²¹⁸. This is why Time in Range should be considered in addition to your A1c.

Consider the following example. These three people all have an A1c of 7%. Person A has spent 100% of the time in their target glucose range while persons B and C have not. Persons B and C have a good A1c, but they’re experiencing glucose variability.

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What is A1c and why does it matter?

What is a normal blood sugar?