The A1C test is a common blood test that provides insights into average blood sugar levels over a period of time. This measurement helps healthcare professionals assess long-term blood sugar control.
Understanding A1C
The A1C test, also known as glycated hemoglobin or HbA1c, measures the percentage of hemoglobin in red blood cells that is coated with glucose. Hemoglobin is a protein found in red blood cells that carries oxygen throughout the body. When glucose enters the bloodstream, it attaches to hemoglobin, a process called glycation. The more glucose present in the blood, the more it binds to hemoglobin.
Red blood cells live for about three months. This allows the A1C test to reflect an average of blood sugar levels over the preceding two to three months. Unlike a single blood sugar measurement, which provides a snapshot at one moment, the A1C test offers a broader picture of blood sugar control over time.
A1C Levels and Diabetes Diagnosis
A1C levels are reported as a percentage, with higher percentages indicating higher average blood sugar levels. These percentages serve as standard diagnostic criteria for medical professionals to classify blood sugar status. A normal A1C level, indicating no diabetes, is below 5.7% (or 39 mmol/mol).
If an individual’s A1C falls between 5.7% and 6.4% (or 39-47 mmol/mol), they are considered to have prediabetes. This range indicates blood sugar levels are higher than normal but not yet high enough to be diagnosed as diabetes. A diagnosis of diabetes is made when the A1C level is 6.5% (or 48 mmol/mol) or higher, often confirmed by two separate tests.
Achieving and Maintaining a Non-Diabetic A1C
For individuals diagnosed with diabetes, achieving a non-diabetic A1C level often refers to entering a state of diabetes remission. Remission for type 2 diabetes means blood sugar levels fall below the diabetes threshold and remain there for at least three months without glucose-lowering medication. While a common target for most adults with diabetes is an A1C below 7%, aiming for the non-diabetic range below 5.7% (or 39 mmol/mol) is often the goal for remission.
Sustaining a non-diabetic A1C, especially after a diabetes diagnosis, requires ongoing management and lifestyle adjustments. Dietary changes play a significant role. Focusing on whole, nutrient-dense foods, such as lean proteins, whole grains, and a variety of fruits and vegetables, helps stabilize blood sugar. Reducing the intake of sugary drinks and processed foods, which can cause rapid blood sugar spikes, is also beneficial. Incorporating fiber-rich foods, like whole oats and legumes, can help decrease the absorption of simple sugars.
Regular physical activity is another important component. Engaging in at least 150 minutes of moderate-intensity exercise per week, such as brisk walking or cycling, improves the body’s ability to use insulin effectively. Both aerobic exercise and strength training contribute to better blood sugar control. Consistent exercise can help lower blood glucose and improve A1C levels over time.
Weight management, if applicable, can also significantly impact A1C levels. Losing even a small amount of body weight can improve insulin sensitivity and contribute to better blood sugar control. Some studies suggest that losing around 15kg of weight can increase the chances of type 2 diabetes remission. Additionally, managing stress through relaxation techniques can be beneficial, as chronic stress can influence blood sugar levels. Regular monitoring and follow-up with healthcare providers are important to track progress and adjust strategies as needed.