Make the most of your A1c results

Some sugar, or glucose, travels in the blood by binding to hemoglobin, the part of a red blood cell that carries oxygen. The glucose remains attached for the life of the red blood cell—about 4 months. The hemoglobin A1c value determined in testing reflects average levels of glucose in the blood for approximately half that time, the previous 2 to 3 months.

The normal A1c level for people without diabetes is in the range of 4% to 6%, meaning glucose is attached to 4% to 6% of the blood’s hemoglobin. For most people with diabetes, the American Diabetes Association (ADA) sets an A1c target of less than 7%. A reading of 10% or greater puts the person at high risk of diabetes complications such as eye, nerve, kidney, or heart disease. In general, a reading higher than 7% presents additional risk.

A very valuable test—if you know about it

Since its introduction about 25 years ago, the A1c test has been the best indicator of a person’s general blood glucose control. However, many people with diabetes don’t fully understand A1c testing and how it can help them manage their disease. They’re more familiar with self-monitoring blood glucose—testing themselves at various times throughout the day, every day, to learn their glucose level at that moment.

In contrast, the A1c test provides a bigger, overall picture of glucose control over the previous few months. The results reflect how well medications and/or other efforts, such as dietary changes, are controlling glucose levels. The A1c test is performed by a doctor or other healthcare provider, usually 2 to 4 times a year.

Immediate feedback is the way to go

A1c tests usually take a few days to process, so the person is long gone from the doctor’s office or clinic by the time the results come in. This can make it difficult to sit down with a healthcare provider and discuss changes in diabetes care that might be required based on the test results.

A recent development, however, may fix this problem. A new bench-top analyzer can provide results during the clinic visit. In one study of 201 people with type 1 or type 2 diabetes (all insulin users), some individuals received their A1c test results immediately while others had to wait for a phone call or letter. Those who got their A1c results right away had much better glucose control 6 and 12 months later than the delayed-response group.

From Clinical Diabetes