A1C test

Definition

The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you’re managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c.

The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control. And if you have previously diagnosed diabetes, the higher the A1C level, the higher your risk of diabetes complications.

Why it’s done

An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation recommends that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes.

After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a point in time, it is a better reflection of how well your diabetes treatment plan is working overall.

Your doctor will likely use the A1C test when you’re first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you’re learning to control your blood sugar.

Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you’re managing your blood sugar. For example, the A1C test may be recommended:

• Twice a year if you have type 2 diabetes, you don’t use insulin, and your blood sugar level is consistently within your target range
• Three to four times a year if you have type 1 diabetes
• Four times a year if you have type 2 diabetes, you use insulin to manage your diabetes, or you have trouble keeping your blood sugar level within your target range

You may need more frequent A1C tests if your doctor changes your diabetes treatment plan or you begin taking a new diabetes

How you prepare

The A1C test is a simple blood test. You can eat and drink normally before the test.