Are both blood sugar testing and A1C testing necessary?
The American Diabetes Association (ADA) recommends both blood sugar testing and A1C testing for good diabetes management. A blood sugar test that you conduct at home with a meter tells you how much sugar is in your blood at that moment. Research studies show that improving blood sugar levels benefits patients with diabetes. The blood sugar reading on your meter is given in milligrams per deciliter (mg/dl) or millimoles per liter (mmol/L), depending on what country you live in. An A1C test measures your average blood sugar level over the past three months. Research studies show that improving your blood sugar levels and A1C levels benefits patients with diabetes.
Why is the A1C test important for managing blood sugar?
The measurement of percent A1C is recognized and well established by the American Diabetes Association (ADA) as a way to determine a patient's historical glycemic control profile. Results of the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) established the relationship between A1C levels and the risk of diabetic complications in patients with type 1 and type 2 diabetes, respectively. A strong relationship exists between A1C and blood sugar – an increase in A1C equates to an increase in average blood sugar.
What does the A1C test measure?
The A1C test is also called glycated hemoglobin, HbA1c, or hemoglobin A1C. A1C provides an indication of average blood glucose control for the past 2-3 months. Hemoglobin is part of the red blood cells and binds to glucose. The A1C complex is formed when the glucose in the blood binds irreversibly (glycates) to hemoglobin. The higher the glucose level in the blood, the more that binds to the hemoglobin. Therefore, A1C values are proportional to the amount of glucose in the blood. The A1C result is in percentage (%) units in the United States or mmol/mol units in other countries. A1C reflects the amount of the hemoglobin that is glycated. Hemoglobin remains glycated for the lifespan of the red blood cell, about 90-120 days. Therefore, the A1C test reflects an average blood glucose control for the past 2-3 months.
What is the ideal range for the A1C result?
According to the American Diabetes Association, the A1C goal for most people with diabetes is less than 7%. Healthcare providers may suggest an even lower A1C goal than the general goal of <7% if this can be achieved without significant hypoglycemia or other adverse effects. If patients can lower their A1C numbers by any amount, they will improve their chances of staying healthy.
How often should the A1C test be done?
For patients whose therapy has changed or who are not meeting blood sugar goals, the A1C test should be performed every three months. The A1C test should be performed at least two times a year in patients who are meeting treatment goals and who have stable blood sugar control.
Is there proof that lowering the A1C levels can reduce the risk of complications?
Both the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) showed that the lower the A1C number, the greater the chances that people with diabetes will slow or prevent the development of serious eye, kidney and nerve disease. The studies also showed that if people with diabetes can lower their A1C number by any amount, they will likely reduce their risk of developing complications. It’s been shown that a 1% reduction in A1C lowers risk of complications such as eye, kidney and nerve disease by 40%.