Endocrinology
HbA1c: The Gold Standard for Long-Term Blood Sugar Monitoring
HbA1c reflects your average blood sugar over the past 3 months. Understanding its role in diabetes diagnosis, longevity optimization, and metabolic health assessment.
Reference: 4.0 - 5.6% (optimal for longevity) %
Key Takeaway
HbA1c is a "memory" of your blood sugar over the past 2-3 months. Unlike fasting glucose which only captures a moment, HbA1c reveals your long-term glucose control patterns.
What is HbA1c?
Hemoglobin A1c (HbA1c) is formed when glucose binds to hemoglobin in red blood cells. Since red blood cells live approximately 120 days, HbA1c provides a window into your average blood sugar over the past 3 months.
Why HbA1c Matters More Than Fasting Glucose
- Fasting glucose only measures your blood sugar at one point in time
- HbA1c captures the cumulative effect of post-meal spikes, overnight dips, and daily fluctuations
- Research shows HbA1c predicts complications better than single glucose measurements
- Optimal (＜ 5.4%): Associated with lowest mortality and longest lifespan in studies
- Normal (5.4 - 5.6%): Standard healthy range
- Prediabetes (5.7 - 6.4%): Early warning sign - reversible window
- Diabetes (≥ 6.5%): Diagnostic threshold - requires intervention
Factors That Affect HbA1c Accuracy
- Anemia: Can cause falsely low HbA1c
- Iron deficiency: May elevate HbA1c independently of blood sugar
- Ethnicity: Some populations naturally have higher HbA1c
- Pregnancy: Lower targets are recommended
Related Testing
- Fasting Insulin: Detect insulin resistance earlier than HbA1c
- Homocysteine: Associated with diabetic complications
- Omega-3 Index: May improve insulin sensitivity
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