What is an A1C test?

The A1C test, also called the glycosylated hemoglobin, glycated hemoglobin, hemoglobin A1C, or HbA1c test, is a blood test that diagnoses type 1 and type 2 diabetes and assesses how well patients are managing their type 2 diabetes.

The A1C test provides a broader overview of diabetes management than a daily home blood sugar test. Though daily tests give a good snapshot, the A1C test measures the average blood sugar level of a patient for the past 2 or 3 months. The test tells patients and doctors what percentage of hemoglobin is glycated, which means covered with sugar. The A1C test is performed in a doctor’s office.

Why get an A1C test?

The results of an A1C test can help your doctor assess your health and diabetes status in the following ways:

  • Detect prediabetes – patients with prediabetes have a higher risk of developing cardiovascular disease and diabetes. It is important to monitor these patients to prevent diseases from developing.
  • Diagnose diabetes – the A1C test can diagnose type 1 and type 2 diabetes. To confirm the diagnosis, a doctor will administer two blood tests on two separate occasions. This either consists of two A1C tests or one A1C test and another blood test.
  • Monitor diabetes management plan – the results of the first A1C test serve as a patient’s baseline A1C level. The test is then repeated to monitor the patient’s treatment plan and assess whether it is working to lower blood sugar levels.

How often should you get an A1C test?

A1C test frequency depends on whether a patient has type 1 or type 2 diabetes and how well they are monitoring their blood sugar. It also depends on their diabetes treatment plan. The amount of times an A1C test should be administered by diagnosis is as follows:

  • Prediabetes – once per year, every year.
  • type 2 diabetes, with no insulin use and blood sugar levels consistently in the target range – twice per year, every year.
  • type 2 diabetes, with insulin use or if blood sugar levels are not consistently in the target range – 4 times per year, or every 2 or 3 months.
  • type 1 diabetes – 4 times per year, or every 2 or 3 months.

Understanding A1C test results

The ideal A1C level is low – higher results mean higher blood sugar levels, which lend themselves to a higher risk of diabetes complications.

To help you understand your A1C test results in relation to your home monitoring tests, here is how A1C relates to estimated average blood sugar levels:

  • 6 percent = 126 mg/dL (7 mmol/L)
  • 7 percent = 154 mg/dL (8.6 mmol/L)
  • 8 percent = 183 mg/dL (10.2 mmol/L)
  • 9 percent = 212 mg/dL (11.8 mmol/L)
  • 10 percent = 240 mg/dL (13.4 mmol/L)
  • 11 percent = 269 mg/dL (14.9 mmol/L)
  • 12 percent = 298 mg/dL (16.5 mmol/L)

A normal A1C level for someone without diabetes is 5.7 percent or lower. A percentage between 5.7 and 6.4 qualifies a patient for prediabetes, also known as impaired fasting glucose. At this level, patients are at a high risk of developing diabetes without intervention.

If a patient receives an A1C level of 6.5 percent or higher on two separate tests, then they are diagnosed with diabetes. For adults with diabetes, the common treatment target is 7 percent or lower. However, higher or lower targets may be suitable for some patients. If your A1C test result is higher than your target, then your doctor may recommend changing your treatment plan.

An A1C result of 8 percent and above is an indication that the patient’s blood sugar levels are not well-controlled. This means they may be at higher risk of developing complications related to diabetes.

How to lower A1C

Diabetes can be a very difficult condition to manage. However, there are many things patients can do to help live a healthier lifestyle and lower their A1C. Here are a few ways that patients can improve blood sugar management and lower their A1C:

  1. Exercise more – exercise for at least 30 minutes a day, 5 days a week. This does not have to be strenuous exercise, but could simply mean taking a walk, participating in a sport, or going for a bike ride.
  2. Eat proper portions and a balanced diet – be mindful of serving sizes, especially when eating fats, fruits, lean proteins, and complex carbohydrates like potatoes and bread. Avoid sugary drinks and processed foods and stick to a healthy diabetes diet.
  3. Establish a meal schedule – eating too often, skipping meals, or letting large amounts of time pass between meals can make it difficult to regulate your blood sugar levels. A doctor or dietitian can help you create a meal schedule suitable to your lifestyle.
  4. Follow your treatment plan – no matter what you read online or hear from your friends, the person most familiar with your individual needs is your doctor. Always consult your doctor when making changes to your diet or treatment plan.
  5. Check your blood sugar at home, as directed – speak to your doctor about if, or how often, you need to monitor your blood sugar.

A1C tests play an important role in managing diabetes and improving blood sugar levels. If you have type 2 diabetes or are worried about prediabetes, then speak to your doctor about A1C testing today.


—Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.