HbA1c (Hemoglobin A1c)

What is HbA1c?

HbA1c measures the percentage of hemoglobin with glucose attached. It reflects average blood sugar over the past 2-3 months.

Why is this test performed?

HbA1c testing helps:

• Diagnose diabetes and prediabetes
• Monitor diabetes control over time
• Adjust diabetes medications
• Assess risk of complications
• Guide treatment decisions

Interpreting Your Results

Diagnostic Categories

Normal:

• ＜5.7%: Normal blood sugar regulation

Prediabetes:

• 5.7-6.4%: Increased diabetes risk, lifestyle changes needed

Diabetes:

• ≥6.5%: Diabetes diagnosis (if confirmed)

For Diabetes Management

Treatment Goals (varies by individual):

• ＜7%: General goal for most diabetics
• ＜6.5%: Stricter goal for young, healthy patients
• ＜8%: Relaxed goal for elderly or complicated cases

Risk Assessment:

• ＞9%: High risk of complications
• 7-9%: Moderate control
• ＜7%: Good control

Estimated Average Glucose (eAG)

Your HbA1c correlates to average blood sugar:

• 5% ≈ 97 mg/dL
• 6% ≈ 126 mg/dL
• 7% ≈ 154 mg/dL
• 8% ≈ 183 mg/dL
• 9% ≈ 212 mg/dL
• 10% ≈ 240 mg/dL

Factors Affecting HbA1c

May Falsely Elevate:

• Iron deficiency anemia
• Vitamin B12 deficiency
• Kidney disease
• Alcoholism

May Falsely Lower:

• Hemolytic anemia
• Recent blood loss or transfusion
• Erythropoietin therapy
• Hemoglobin variants

Advantages Over Fasting Glucose

• No fasting required
• Reflects long-term control
• Less affected by daily fluctuations
• More convenient for patients

Action Steps

If Prediabetic (5.7-6.4%):

• Lose 5-7% body weight
• Exercise 150 min/week
• Reduce refined carbs
• Recheck in 6-12 months

If Diabetic (≥6.5%):

• Start or adjust medications
• Blood sugar monitoring
• Diabetes education
• Check every 3-6 months

Related Tests

• Fasting Glucose: Confirms diagnosis
• Fructosamine: 2-3 week average (alternative)
• Continuous Glucose Monitoring: Real-time tracking