A1C & Diabetes: How This Simple Blood Test Helps Doctors Diagnose Diabetes
If you’re one of the 34 million Americans currently living with diabetes, testing your glucose (or blood sugar) levels is nothing new. While those daily glucose tests are absolutely critical to managing diabetes and living a healthy life, there’s another test your doctor is likely to include as part of your diabetes care plan – the A1C test.
What is the A1C Test?
Glucose meters and test strips only tell you what your blood sugar level is at the moment. The A1C test (also called the hemoglobin A1C test), on the other hand, is a simple blood test that can tell your doctor and diabetes care team what your average blood sugar levels have been over the past two or three months. The A1C test provides a long-term, big-picture look at your glucose levels and that’s important because prolonged levels of high blood sugar can lead to serious diabetes complications, including heart disease, kidney disease, eye problems, nerve damage, and other diabetes-related health issues. Your physician will tell you how often your diabetes care plan calls for an A1C test, but for most people living with diabetes, it makes sense to get this test at least twice a year.
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How does the A1C test work?
The A1C test can be administered in either a doctor’s office or an authorized lab by drawing a standard sample of blood from your fingertip or arm. The blood is then analyzed to calculate your personal A1C level, often referred to as an A1C score, which is defined as the percentage of your red blood cells that have sugar-coated hemoglobin attached to them.
When sugar enters the bloodstream, it attaches to hemoglobin, a protein found in your red blood cells. Everyone has some sugar attached to their hemoglobin. For people without diabetes, the normal A1C range is below 5.7%. Those with diabetes, however, have a difficult time maintaining these healthy A1C levels, which can lead to those serious heart and health consequences mentioned earlier.
What is a healthy A1C for someone with diabetes?
There is no one-size-fits-all answer to this question. People with diabetes live with the disease in very different ways. They have different natural blood sugar levels, as well as insulin and other medication requirements. They eat and exercise at different levels. Additionally, age can play a big role in determining an ideal A1C target level for someone with diabetes.
All this being said, the general rule for most adults living with diabetes is to try and maintain an A1C level that is less than 7%.
Unfortunately, for a lot of diabetics this can be a difficult target number to hit. Nevertheless, it is important to try because the lower the A1C level, the lower the risk is for developing serious complications due to diabetes and elevated blood sugar.
A1C and Prediabetes
Getting an A1C test is also an effective way to diagnose prediabetes. As with most diseases, the earlier you can identify the warning signs of diabetes, the better your chances of limiting its severity.
According to the American Diabetes Association, A1C results correlate with a diabetes diagnosis as follows:
A1C Level Category
5.7% - 6.4%
6.5% and Above
If you test in the prediabetes range (5.7% - 6.4%), the closer you are to the high end, the more likely you are to develop Type 2 diabetes in the future. In other words, you find yourself at that critical juncture where making dietary and lifestyle changes just might prevent you from becoming diabetic.
Who should get an A1C test?
It’s a good idea for most adults over the age of 45 to get a baseline A1C test. However, if you possess one or more of the following risk factors for Type 2 diabetes, don’t wait until 45. Get your A1C test as soon as possible.
Diabetes Risk Factors
– Family history of diabetes or prediabetes
– You were once diagnosed with gestational diabetes
– You are physically inactive (active less than three times a week)
– African American, Hispanic/Latino American, Native American, and Native Alaskan groups are at higher risk of developing diabetes.
The good news is you can often prevent diabetes and reverse prediabetes with proven lifestyle changes and healthier eating habits. Getting your A1C score is the first step to knowing where you stand. Ask your doctor if an A1C test is right for you.
A1C tests do not replace daily glucose testing
A1C tests tell doctors and care teams what your average blood sugar levels have been over an extended period of time. But it’s not a replacement for daily glucose testing or insulin treatments. In fact, it’s possible for a person with diabetes to have wide fluctuations in blood sugar on a daily basis, but still have relatively low A1C scores when you average out blood sugar levels over two or three months. Those short fluctuations can lead to severe health complications, too, which is why daily glucose monitoring and A1C tests work together as part of an effective diabetes treatment plan.
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Lowering your A1C Score
Determining your A1C level and establishing a good target A1C are critical components to controlling your diabetes. It will help your diabetes physician and team better understand your specific disease, and help you better manage treatment. Still, the goal for everyone with diabetes is to manage blood sugar as effectively as possible through healthy living. With this in mind, here are a few ways you can improve your daily routine, which can also help lower your A1C.
- Get moving and make it something you enjoy.
Daily activity can lower your A1C by making the body more sensitive to insulin, which is why exercise is a key part of any good diabetes health program. However, sticking to a regimen can be hard - so do something you like! Play a sport with a friend. Take a long walk. Go for a morning bike ride. The point is to make something you enjoy part of your routine. You don’t need to go out and run a triathlon. You just need some quality moderate exercise. Try not to go more than two days without doing some form of exercise. Of course, like with any new diabetes regimen, it’s important to consult your physician before beginning any exercise routine.
- Eat balanced and properly proportioned meals.
Everyone with diabetes has their own dietary needs and restrictions. Again, it’s a good idea to talk with your doctor or a nutritionist who specializes in diet for diabetes to formulate an individual plan. That being said, a good rule is to follow the ‘Diabetes Plate Method’, which calls for you to fill one half of your plate with vegetables, one quarter with protein, and the final quarter with whole grains. Steer clear of sugary sodas and juices, as well as processed foods, which are high in carbs and can spike your blood sugar level, not to mention lead to unwanted pounds.
- Create a dining schedule and try your best to live by it.
Life can’t be entirely regimented and that wouldn’t be much fun anyway. However, for those living with diabetes, it’s important to eat meals and snacks at regular intervals. Skipping meals or eating too often can cause fluctuations in blood sugar levels, particularly if you’re taking insulin or other drug treatments for diabetes. Create a meal schedule and try your best to stick to it, knowing it’s okay to deviate once and awhile when life calls for it.
- Follow your individual diabetes treatment plan.
Your doctor and diabetic care team will help determine the best treatment plan for you. Remember, their goal is to make your diabetes program as easy and effective as possible. Once you’ve got it down, stick to it and don’t make any changes, particularly to your insulin dosage or other medications, without talking to your doctor first.
Measuring your A1C is an important part of building an optimal diabetes treatment plan. Should you have any questions regarding your A1C score, or, whether it’s time to get an A1C test, consult your personal diabetic physician.
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