The A1C test (hemoglobin A1c or HbA1c) is a simple blood measure that provides a picture of your average blood glucose levels over the preceding two to three months. Glucose molecules attach to hemoglobin, the oxygen-carrying protein in red blood cells, in a process called glycation. Since red blood cells live for about 120 days, the A1C test measures the percentage of hemoglobin that has become sugar-coated, reflecting long-term blood sugar control. This measurement is used to screen for and diagnose prediabetes and diabetes, and to monitor treatment effectiveness.
Physician and Clinical Testing
The most reliable and common way to obtain an A1C test is through a healthcare provider, such as a primary care physician or an endocrinologist. The doctor orders a lab requisition, directing you to a specialized clinical laboratory for a blood draw. A medical professional will collect a sample of blood from a vein in your arm, which is then sent for analysis using standardized, certified methods. This procedure ensures the highest accuracy and is required for an official medical diagnosis.
Results from this clinical route are integrated directly into your medical record, providing a comprehensive history for your care team. Health insurance usually covers the cost of testing when it is ordered by a physician and deemed medically necessary for screening or monitoring. While some doctor’s offices have point-of-care devices for quick results, a diagnosis must be confirmed by a sample analyzed at a certified external laboratory. For individuals with a diagnosed condition, testing is often performed several times per year to track progress and guide medication adjustments.
Retail and Walk-In Options
For those seeking testing without a primary care appointment, convenient walk-in options are available, including urgent care centers and pharmacy-based minute clinics. These locations often provide A1C testing, sometimes using point-of-care devices that deliver quick results from a small finger-prick blood sample. While rapid, these immediate results are best used for monitoring treatment effectiveness, as they may not be accurate enough for a new diagnosis. If the sample needs to be sent to an outside laboratory for venous blood analysis, results may take one to two days.
The payment structure at these retail facilities may differ significantly from a routine physician visit. Testing may be offered on a self-pay basis, which is an option for people who lack comprehensive insurance coverage or who are simply curious about their current status. Results obtained outside of a primary care setting may not be automatically shared with your regular doctor. This lack of integration means the patient is responsible for following up with their provider to discuss the results and plan any necessary changes.
Direct-to-Consumer Home Kits
Direct-to-consumer A1C home kits, purchased online or at a pharmacy, are increasingly popular for monitoring blood sugar control. These kits require the user to perform a finger prick to collect a small blood spot onto a collection card. The sample is mailed to a designated laboratory for analysis, providing privacy and removing the need for an in-person visit. This method is primarily intended for monitoring existing conditions or tracking trends, not for establishing an initial medical diagnosis.
While convenient, the accuracy of home A1C kits can be more variable than clinical lab tests, and user error during collection is possible. Some kits correlate highly with lab-drawn samples, while others show significant discrepancies outside established accuracy benchmarks. Regulatory clearance for these products is generally for home measurement of A1C, which differs from the strict criteria for clinical diagnosis. These tests are usually not covered by insurance and are paid for out-of-pocket, which is a factor to consider.
What the A1C Results Indicate
The A1C test result is reported as a percentage, correlating to the average amount of glucose in your blood over the preceding months. Understanding these numerical ranges is essential for interpreting blood sugar control. A result below 5.7% is considered normal, indicating healthy blood sugar management.
A reading between 5.7% and 6.4% falls into the prediabetes range, signaling elevated blood sugar levels and a significantly increased risk of developing diabetes. If your A1C is in this category, providers advise immediate lifestyle changes, such as modifying diet and increasing physical activity, and recommend retesting regularly. A result of 6.5% or higher on two separate tests meets the standard criteria for a diagnosis of diabetes.
This higher percentage indicates that blood sugar levels have been consistently high enough to warrant medical treatment to prevent or delay serious long-term complications. Regardless of how the test was obtained, any result in the prediabetes or diabetes range requires consulting a doctor for a thorough evaluation and the development of a treatment strategy. Maintaining an A1C level at or near your personalized target is a primary goal for effective diabetes management.