What is HbA1c? recommended levels

HbA1c is also referred to as hemoglobin A1c or simply A1c. It forms when hemoglobin joins with glucose in the blood. It is a technical term commonly used with reference to diabetes mellitus. People who have diabetes need this test regularly to see if their blood glucose levels are keeping within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes.

What is HbA1c?

HbA1c or glycated hemoglobin develops when hemoglobin joins with the glucose in our blood. Hemoglobin is found in the red blood cells and carries oxygen throughout your body. As it joins with glucose in the blood, becoming ‘glycated’. Measurement of this glycated hemoglobin gives the clinicians an overall picture of what our average blood sugar levels have been over a certain period of weeks/months.

What is Hemoglobin?

Hemoglobin is a protein present in red blood cells. It imparts blood its red color and helps to carry oxygen throughout your body. Functionally, it carries oxygen from the lungs to the cells and returns carbon dioxide from the cells back to the lungs. The maximum life of the red blood cells is 120 days.


How does the HbA1c Test work?

The sugar in our blood is glucose. When glucose builds up in your blood, it binds to the hemoglobin in the red blood cells. How much glucose is bound to the RBCs, is measured by the HbA1c test. Since the red blood cells live for about 3 months, the test shows the average level of glucose in your blood for the past 3 months.

If your glucose levels have remained high for the recent weeks, your Hb A1c test will be higher. For individuals with diabetes, this test is very important. Higher the HbA1c result, the greater is the risk of developing diabetes-related complications.

What are the Recommended Levels of Hemoglobin A1c?

The American Diabetes Association has given the range of HbA1c test for diabetic and non-diabetic people. For people without diabetes, the normal range recommended for the HbA1c is between 4% and 5.6%. If HbA1c levels ranges between 5.7% and 6.4% mean you are more likely to develop diabetes. HbA1c levels of 6.5% or higher mean that you have diabetes.

What are Goals for A1c Levels?

The target HbA1c level for diabetic people is usually less than 6.5%. The higher the HbA1c, the higher you are at risk of having complications related to diabetes. A combination of well-planned diet, exercise, and medication can bring your HbA1c levels down.


People with diabetes should have an HbA1c test every 3 months to ensure that their blood sugar is within their target range. If your diabetes, or more precisely the blood glucose level is under good control. You may be able to decrease the frequency of the blood tests. But even then, healthcare experts recommend checking at least twice a year.

When Should you get HbA1c Levels Be, Tested?

For people having type 1 or type 2 diabetes. HbA1c recommended in addition to random fasting blood glucose levels.  HbA1c levels routinely, measured for the monitoring of diabetes in such cases. Levels of HbA1c are not, affected by daily fluctuations in the blood glucose concentration but show the average glucose levels over the prior period of six to eight weeks. Therefore, we can say that HbA1c indicates how well the blood glucose level, controlled in the recent past two to three months. This used to keep a watch on the effects of diet, exercise, and drug therapy on blood glucose in the diabetes patients.

What Are the Limitations of HbA1c tests?

Since HbA1c is not, influenced by daily blood glucose fluctuations, it cannot be, used to monitor day-to-day blood glucose concentrations and thus not appropriate, used for adjusting insulin doses. It can neither detect the day-to-day presence or absence of hypoglycemia or hyperglycemia.

People with diseases affecting hemoglobin, such as anemia sickle cell disease and thalassemia, are likely to get misleading results with this test. Other things that, affect the results of the A1c test include intake of supplements such as vitamins C and E and high cholesterol levels. HbA1c increased falsely in certain medical conditions. These conditions include kidney failure (uremia), chronic intake of excessive alcohol, hypertriglyceridemia. Medical conditions like chronic or acute loss of blood may falsely decrease HbA1c.


HbA1, along with fasting blood glucose and postprandial blood glucose gives the perfect test for blood glucose level. While the HbA1c gives you the record of blood glucose maintained for the past 3 months, the latter ones help to measure sugar level before and after a meal.  Experts now look for the combined result of all three tests for prescribing the right healthcare chart for a diabetic individual so that one can live slightly comfortably, and probably manage this sugary epidemic as much as possible.

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