What can an HbA1c test tell you?
An HbA1c test can estimate your average blood sugar levels over the past few months, which healthcare providers use to assess your risk for prediabetes, diabetes, and related health complications. Prediabetes is a condition where your blood sugar levels are higher than normal but not high enough to be considered type 2 diabetes, and it raises your risk for developing diabetes as well as other health problems, such as stroke or heart disease.
The Centers for Disease Control and Prevention (CDC) recommends getting an A1C test if you’re older than 45, or if you’re younger and have risk factors for prediabetes or type 2 diabetes, such as obesity, a sedentary lifestyle, or a family history of type 2 diabetes.
The American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists also recommend screening all adults older than 45 for prediabetes and diabetes, as your risk for these conditions increases with age, and testing adults at any age who are at higher risk. This could include an A1C test or other types of blood sugar tests. If your results are normal, both organizations suggest re-testing every three years. If your results indicate prediabetes, your provider may recommend re-testing every year or two.
For its part, the U.S. Preventive Services Task Force recommends screening adults with overweight or obesity for prediabetes and type 2 diabetes starting at age 35 because some data suggest the incidence of diabetes increases at this age. This screening may include an A1C test.
If you’re being treated for diabetes, your provider may use the A1C test to help monitor how well your treatment is working. The lower your numbers, the better-managed your diabetes generally is, and the lower your risk for diabetes-related complications like nerve damage or kidney disease.
What is being tested?
A Hemoglobin A1c test measures the amount of glycated hemoglobin in your blood, or how much of your hemoglobin has glucose attached to it. To understand why that’s an important health marker, let’s back up a bit.
Glucose is a type of simple sugar that gets into your body via the foods you eat. A hormone called insulin helps glucose get from your bloodstream into your cells, so they can use it as energy. Normally, a small amount of glucose may stay in your bloodstream, attaching itself to a protein called hemoglobin on your red blood cells.
But if your body doesn’t make enough insulin or can’t use it well, then glucose builds up in the bloodstream, sticking to more and more hemoglobin.
Once it sticks to hemoglobin, glucose holds on tight for the rest of the red blood cell’s life, which spans about three months. That’s why the Hemoglobin A1c test shows your average blood sugar level over that timeframe.
Where is the hemoglobin A1c test typically included?
The HbA1c test is not typically included in standard blood panels like the basic metabolic panel or comprehensive metabolic panel. Both of these look at current blood sugar levels, but not A1C.
However, this test may be added to either of these panels if your provider chooses. This would be called a basic metabolic panel with reflex to hemoglobin A1c or a comprehensive metabolic panel with reflex to hemoglobin A1c. The “with reflex” means the A1C test is only performed if the standard test comes back with a certain result, such as a high blood sugar level.
HbA1c testing is included as part of lab testing through Hers, which goes beyond standard lab tests to help you understand what’s really going on in your body and either address or get ahead of problem areas with a tailored action plan.
Who should get an HbA1c test?
Your healthcare provider may recommend A1C testing if you have certain risk factors or symptoms related to prediabetes or type 2 diabetes.
Risk factors for prediabetes and type 2 diabetes include:
A family history of the condition
Being mostly sedentary (physically active fewer than three times per week)
Having overweight or obesity
Having polycystic ovary syndrome (PCOS)
People with certain ethnic backgrounds are also at higher risk, including African Americans, Hispanic or Latin Americans, American Indians, Alaskan Natives, Pacific Islanders, and some Asian Americans.
Symptoms of type 2 diabetes include:
If you have diabetes, you may get the test twice a year (or more) to monitor how your treatment is going. Ultimately, your healthcare provider will determine how often you should be tested based on your individual health and risk factors.
