The A1c test is a blood test that provides insight into long-term blood sugar control. Healthcare providers use it to assess average blood glucose levels over an extended period. Understanding your A1c result offers important information about your metabolic health, serving as a key tool for diagnosing conditions and monitoring their management.
What A1c Measures
The A1c test measures the percentage of hemoglobin in red blood cells that has sugar attached to it, a process known as glycation. Hemoglobin, a protein in red blood cells, carries oxygen throughout the body. Glucose in the bloodstream binds to this hemoglobin; more glucose means more binding.
Red blood cells live for about two to three months. This lifespan allows the A1c test to provide an average picture of your blood sugar levels over the preceding two to three months, unlike a single blood glucose measurement. The A1c result is reported as a percentage, indicating the proportion of glycated hemoglobin.
What Your A1c Number Means
An A1c result categorizes your average blood sugar levels over several months into specific health ranges. For individuals without diabetes, a healthy A1c level is below 5.7%. This indicates consistent blood glucose levels within a healthy spectrum.
An A1c result of 5.2% falls within this healthy range, indicating good long-term blood sugar control. This level is considered normal and suggests a low risk for developing diabetes-related complications.
An A1c result between 5.7% and 6.4% indicates prediabetes. This means blood sugar levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. Prediabetes suggests an increased risk of developing type 2 diabetes and cardiovascular disease. A diabetes diagnosis is made when the A1c level is 6.5% or higher, typically confirmed by two separate tests, indicating consistently high blood sugar.
Beyond Blood Sugar What Affects A1c
While A1c primarily reflects average blood sugar, other factors can influence its readings independently of glucose control. Certain medical conditions affect red blood cell lifespan or hemoglobin, leading to inaccurate A1c results. For example, anemia can cause falsely high A1c levels, while chronic kidney disease, liver disease, significant blood loss, or transfusions may result in falsely low readings.
Some medications also impact A1c results by affecting hemoglobin or red blood cell turnover, such as steroids or certain cancer treatments. Hormonal changes, like those during menstruation or menopause, and high stress levels can also influence A1c. Healthcare providers consider these variables when interpreting A1c results, especially if there’s a discrepancy with daily blood glucose measurements.
Strategies for a Healthy A1c
Maintaining a healthy A1c level involves consistent lifestyle practices supporting metabolic well-being. A balanced diet plays a significant role in managing blood sugar. This includes prioritizing whole foods, lean proteins, healthy fats, and fiber-rich fruits and vegetables, while limiting sugary beverages and processed foods. Mindful portion sizes and spreading carbohydrate intake throughout the day also contribute to stable blood glucose.
Regular physical activity is another important component. Engaging in at least 150 minutes of moderate-intensity aerobic exercise weekly, along with strength training, helps the body use insulin more effectively and muscles absorb glucose. Achieving and maintaining a healthy weight further contributes to better insulin sensitivity and helps keep A1c levels in a desirable range. Regular medical check-ups and open communication with your healthcare team are beneficial for personalized guidance and monitoring.