Glycated hemoglobin. Try saying that three times fast! Don’t worry, you can actually abbreviate this complicated term as “A1c”. Unfortunately, for many diabetics, the information surrounding A1c levels can be just as confusing as the tongue-twisting medical term.

Let’s simplify things: A1c levels are a measurement of the percentage of hemoglobin (the oxygen-carrying protein in red blood cells) that is connected to sugar (glucose) in the bloodstream. When there is a high amount glucose floating around in the body, the A1c level will also be high.

Unlike the glucose self-monitoring that most diabetics use on a daily basis, the A1c test shows the average of glucose levels over a three-month period of time. This is because red blood cells regenerate every 8-12 weeks. Because of this, the A1c levels change very slowly. Sudden changes or “instant” readings are not possible with this test.

The test is quite convenient since it does not require the patient to be fasting. A1c tests can be used to diagnose Type 1 or Type 2 Diabetes, or to track a diabetic’s progress. In diagnosing diabetes, the following guidelines are recommended by the World Health Organization (WHO):

  • Non-diabetic:    5.6% and below
  • Pre-diabetic:     5.7 to 6.4%
  • Diabetic:           6.5% and above

*Note: hemoglobin variants, anemia, heavy bleeding, iron deficiency, kidney or liver disease may cause inaccurate results.

For most diabetic patients, A1c levels below seven percent show that the disease is well controlled. Patients with levels above seven or eight percent are at risk for severe complications like stroke, heart attack, nerve damage, and kidney disease.

Experts recommend that diabetics have their levels tested two to four times per year. Studies show that a person with Type 2 Diabetes who reduces the A1c level by just one percent has the following health outcomes:

  • 19 percent reduction in cataract extractions
  • 16 percent decrease in heart failure
  • 43 percent reduction in amputation or death due to peripheral vascular disease

If your A1c level is above normal, your health care provider may suggest lifestyle changes in order to better control your blood glucose levels. You may need to lose weight, exercise more, or change your diet. You may also need to adjust your insulin dosage and other medications.

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