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What is HbA1c and how is it used to measure diabetes?206,210

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A HbA1c or A1c test is used by doctors and healthcare professionals to measure your average blood sugar level over the last 2-3 months. The test result is used to diagnose, monitor, and manage treatment decisions for diabetes.  HbA1c is measured as a percentage(%). 

Why is HbA1c important?210

In general, a higher HbA1c indicates a higher risk of long-term diabetes complications. If you have either type 1 or type 2 diabetes, your doctor will check your HbA1c levels to decide on the best treatment plan for you, and help you set a target to lower your HbA1c.

What is considered a normal HbA1c range?211

Non-diabetes HbA1c range

Non-diabetes

A healthy HbA1c is below 5.7%

Prediabetes HbA1c range

Prediabetes

HbA1c between 5.7-6.4% indicates prediabetes. This means you are at risk of developing diabetes

Diabetes HbA1c range

Diabetes

HbA1c of 6.5% or above indicates diabetes

Gestational HbA1c range

Gestational diabetes

If you do not have diabetes, HbA1c of 5.9% in the first 15 weeks of pregnancy may mean you are at higher risk for gestational diabetes.

HbA1c on its own does not tell the full story

HbA1c does not give a full picture of your blood sugar levels. It does not account for the ups and downs of your blood sugar within a day or show patterns in your blood sugar over time. HbA1c also can't tell you whether you experience hypoglycemia. Gaining insight into what's affecting your blood sugar can help customize a diabetes management plan suited to your individual needs and routine.

Time in Range (TlR) is increasingly being used to assess blood sugar in combination with HbA1c. TIR is a measurement of how much of the day your blood sugar spends within your target range.
It is measured as a percentage (%) 211. The higher the TIR, the better the glucose control.

People can have similar HbA1c but different TIR⁠210⁠

Inforgraphic to compare the Time in Range of 3 patients
Inforgraphic to compare the Time in Range of 3 patients
Inforgraphic to compare the Time in Range of 3 patients

Why is continuous glucose monitoring important to managing glucose levels?212

What is recommended Time In Range (TIR) if I have diabetes?⁠210⁠

Recommended time in range for type 1 and type2 diabetes

Type 1 & type 2

At least 70% of the day:
3.9 - 10 mmol/L⁠

Recommended time in range for older of high-risk type 1 and type 2 diabetes

Older or high-risk type 1 & type 2

At least 50% of the day:
3.9 - 10 mmol/L⁠

Recommended time in range for type 1 during pregnancy

Type 1 during pregnancy

At least 70% of the day:
3.5 - 7.8 mmol/L⁠

Libre can help you increase your Time in Range (TIR) and reduce HbA1c27,216⁠

FreeStyle Libre can show you the Time In Target you had in the last 7/14/30/90 days.⁠
Decrease in HbA1c in Type 1 patients

Type 1

HbA1c reduced by 0.53% on average, after 12-16 weeks using FreeStyle Libre 216⁠

Decrease in HbA1c in Type 1 patients

Type 2

HbA1c reduced by 1.1% on average, after 22 weeks using FreeStyle Libre 216⁠

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