What is HbA1c? | Blood Test | Target Levels

HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below.

If you’re at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol (6%).

On this page we’ll go through what HbA1c means, and why aiming for your target level is so important. We’ll also explain the HbA1c test in more detail, and show you what you can do to lower your HbA1c levels if they’re too high. Plus, you can use our HbA1c converter tool if you’re looking to find out your level in % or mmol/mol. 

What does HbA1c mean?

HbA1c is what’s known as glycated haemoglobin. This is something that’s made when the glucose (sugar) in your body sticks to your red blood cells. Your body can’t use the sugar properly, so more of it sticks to your blood cells and builds up in your blood. Red blood cells are active for around 2-3 months, which is why the reading is taken quarterly.

A high HbA1c means you have too much sugar in your blood. This means you’re more likely to develop diabetes complications, like serious problems with your eyes and feet.

Knowing your HbA1c level and what you can do to lower it will help you reduce your risk of devastating complications. This means getting your HbA1c checked regularly. It’s a vital check and part of your annual review. You’re entitled to get this test at least once a year. But if your HbA1c is high or needs a little more attention, it’ll be done every three to six months. It’s really important not to skip these tests, so if you haven’t had one in over a year contact your healthcare team.

Once you know your HbA1c level, it’s important that you understand what the results mean and how to stop them from getting too high. Even a slightly raised HbA1c level makes you more at risk of serious complications, so get all the facts here and be in the know about HbA1c.

What is a HbA1c test?

The hemoglobin A1c (HbA1c) test measures the amount of blood sugar (glucose) attached to your hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body. It is an important blood test that gives a good indication of how well your diabetes is being controlled.

You can check these average blood sugar levels yourself, but you’ll have to buy a kit, whereas your healthcare professional will do it for free. It’s different from a finger-prick test, which is a snapshot of your blood sugar levels at a particular time, on a particular day.

You find out your HbA1c level by getting a blood test by a doctor or nurse. Your healthcare team will arrange this for you, but chase it up with your GP if you haven’t had one for a few months. 

Most people will have the test every three to six months. But you may need it more often if you’re planning for a baby, your treatment has recently changed, or you’re having problems managing your blood sugar levels.

And some people will need the test less often, usually later on during pregnancy. Or need a different test altogether, like with some types of anaemia. A fructosamine test can be used instead, but it’s very rare.

An HbA1c test is also used to diagnose diabetes, and to keep an eye on your levels if you’re at risk of developing diabetes (you have prediabetes).

The test is sometimes called haemoglobin A1c or just A1c.

Your HbA1c results

You should get the results quickly. The result of the HbA1c test lets your healthcare team know if they need to change your treatment or medication to help you manage your levels better. But it also tells you a number and it’s important you understand what this means. Some people find it helps to write their results down in a diary, to keep track of them and see if they can spot any trends.

And your HbA1c can change for lots of reasons, including:

• if you’re unwell
• if you’re taking other medicines, like steroids
• changes in lifestyle
• if you’re feeling very stressed or you’re depressed.

You’ll talk to your healthcare team about a target level that you need to aim for. We know this isn’t as easy as it sounds, but it’s important you do everything you can to keep in your target range. The longer your HbA1c level is even slightly high, the more you’re at risk of developing life-threatening complications.

We have lots of information and tools to help you lower your HbA1c.

What is a normal range for an HbA1c test?

If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below.

HbA1c levels and targets

But everyone’s different. So your healthcare team may give you an individual target level that takes into account your current level and when your next test is. So you can bring it down in stages and isn’t a sudden big drop.

And we’re not saying it’s easy to get to and stay at this level. We know it’s difficult, and we’re here to give you advice and information to help.

If you’re at risk of type 2 diabetes

There are different target HbA1c levels for people at risk of developing type 2 diabetes. If you’ve been told you’re at risk, your target level should be below 42mmol/mol (6%). We have lots more information for you if you’re at risk of type 2.

Type 2 diabetes remission

Remission is when a person with type 2 diabetes has healthy blood glucose (also called sugar) levels for the long-term, without taking any diabetes medications. We’re working with international experts to agree this, but our researchers used an HbA1c level of 48mmol/mol (6.5%) or less to define remission.

Type 2 diabetes is still a serious condition. It can be lifelong and get worse over time for many, but it doesn’t have to be like this for everyone. This can be life-changing. Find out more about type 2 diabetes remission.

HbA1c converter

If you’re wondering how to convert HbA1c mmol/mol to %, or vice versa, our tool can help you. 

Mmol/mol stands for millimoles per mole. A mole is a scientific unit often used to measure chemicals, and it has been the standard measurement for glucose levels since 2009. Before that, a percentage was used. That’s why measurements often have a percentage as well.

If you’re more used to the percentage system, use our converter tool below to find out your level in millimoles.

How to lower your HbA1c levels

If your levels have gone above your target since your last check, it’s understandable to be worried. Even a slightly high HbA1c level puts you more at risk of developing serious complications in your body. But knowing your numbers and what that means is an important and good first step – now you need to know how to lower them.

Lots of things can cause your HbA1c levels to change and there’s action you and your healthcare team can take to bring them down to your target level:

• Your diabetes team may need to review your medication and increase the dose or try a new one.
• Ask them about local diabetes education courses – there’s always more to learn with diabetes and a course will help you take practical steps to lower your HbA1c.
• Get more active – moving more is good for everyone, but it can specifically help to bring down your HbA1c levels.
• Get advice on balanced, healthy eating.
• Stop smoking – smoking makes it harder for blood to flow around your body. 

And if you want to hear from others who are experiencing this too, think about joining our online forum. It’s a place where you can chat to others or just read other people’s stories.

And don’t forget, get advice from your healthcare team. They’re here to help.

HbA1c test and finger-prick test – what’s the difference?

Get more information on checking your own blood sugars using a finger-prick test.

HbA1c test	Finger-prick test
Measures your average blood sugar levels over last 2 to 3 months	Snapshot of blood sugar levels at the time
Everyone with diabetes should have this test	Only people taking certain medicines need to do this test, like insulin and sulphonylureas
Usually done every 3 to 6 months	Done a number of times a day, usually ranging from twice to 10 times
Blood is taken from arm or finger	Tiny drop of blood taken from the finger
A healthcare professional should do this for you, though you can pay for a kit and do it yourself. These aren’t available on prescription.	You can do this yourself, using a testing kit
Doctors can use this test to find out how someone is managing their diabetes, to diagnose diabetes and find out if someone is at risk of type 2 diabetes	This test is mainly used for people living with diabetes

Reduce your risk of type 2 diabetes

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You’ve just found out that you’re at risk of developing type 2 diabetes. But you don’t have it yet.

That’s the really good news. It means that you can now get support and find out about programmes that can delay or prevent type 2 diabetes. On this page you will learn how the risk of type 2 diabetes can be reduced. 

About half of all cases of type 2 diabetes could be prevented or delayed

Take action now and it will make all the difference to your health in the years ahead.

Where to start?

The reasons people are at risk can be different and some people are more at risk than others. But research has shown that, for some people, getting support to make changes to your lifestyle, including healthy eating, moving more and losing weight, can help reduce your risk by about 50%. 

You can reduce your risk of developing type 2 diabetes by:

• eating well
• moving more
• getting support to lose weight if you need to.

Simple, right? We know it’s not that simple and we’re here to help you get started. What can be difficult is knowing how to do it – especially long-lasting changes.

Remember, if you enjoy something, you’re more likely to stick to it.

Here are some tips to get you inspired:

• Don’t forget, you’re not alone in this – there’s lots of support out there to help you.
• Set goals which are realistic and work for you.
• Change one thing at a time and make the changes part of your everyday.

“I’ve always felt diabetes was inevitable for me and I’m learning that I have a say in this by the lifestyle choices I make. My goal is to fundraise and help Diabetes UK help others realise the same, so I started by taking part in Swim22.”

Tracy, who has a family history of type 2 diabetes

Get support

Make the most of all the support and services available in your area. Ask your GP about:

• a weight-loss programme or group – there are Prevention Programmes available in England
• a registered dietitian or exercise specialist
• a type 2 diabetes prevention programme
• other local services to help you move more and eat better.

It can also help to talk to family and friends – ask them to get involved too. It will help if they understand what you’re doing and why it’s so important. Plus, eating better and moving more is good for everyone, so you can do this together.

We’re here to help too, with lots of tools and stories to keep you motivated. Think about sharing your story – it could really help motivate others. And remember, the trained counsellors on our helpline are ready to support you if you have questions or just need a chat.

Set realistic goals

Like everything in life, you’ll have good days and bad days, but don’t let a bad day put you off.

Set yourself realistic goals that fit in with how you live your life. Choose the healthy food and activities that you like best. This will really help you stay on track.

And think ahead about anything that could stop you from achieving your goal, and plan how you could overcome this.

Weight-loss planner

“I keep a daily diary and log my weight and activity. It keeps me accountable and focused.”

Edward Morrison, who lost over four stone – read his story.

You can download My weight-loss planner (PDF, 534KB) to set goals and track your progress. By putting a plan in place and noting down your progress, you’ll be able to see the positive changes you’re making.  

Make changes part of your every day

Changing too many things at the same time can make them difficult to stick to in the long run. Start with small things you can change about your everyday routine and build up to more.

We know it can be hard to stay motivated, but remember you’re in this for the long run. Your risk of developing diabetes is serious and you can’t reduce your risk by eating better or moving more for just a couple of weeks.

By building healthy meals into family life and moving more to help you get from A to B, you can maintain these changes and look forward to a healthy future.

Glycated hemoglobin up to 50% off

Test description

Index

Glycated hemoglobin is a complex formed from glucose combined with hemoglobin. An analysis of glycated hemoglobin shows the content of glucose in the blood in dynamics, that is, for a period of up to three months.

Applications

Thanks to the study, you can find out the degree of development of diabetes and the effectiveness of the prescribed treatment.

Specialist

It is prescribed by a therapist or endocrinologist.

Important

An HbA1c test does not reflect sudden changes in blood glucose levels. Glucose fluctuations in patients with labile diabetes will also not be detected by this test.

Test Method – High Performance Liquid Chromatography

Test Material
— Venous blood with EDTA

Deadline

The analysis will be ready in
within 1 day, excluding Saturday, Sunday and the day of collection.
The term can be extended by 1 day if necessary.
You will receive results by email. email as soon as it’s ready.

Deadline: within 1 day, excluding Saturday, Sunday and the day of sampling, excluding Saturday and Sunday (except for the day of taking the biomaterial)

How to prepare

In advance

Talk to your doctor about taking your medications the night before and on the day of your blood test, and any additional preparations you might need.

Do not take a blood test immediately after X-ray, fluorography, ultrasound, physiotherapy.

The day before

24 hours before blood sampling:

• Limit fatty and fried foods, do not take alcohol.

From 8 to 14 hours before donating blood, do not eat, drink only clean still water.

On the day of donation

Before blood sampling

• Do not smoke for 60 minutes,
• 15-30 minutes to be in a calm state.

Result

Analysis result example.pdf

Explanation of

Interpretation of test results is for informational purposes only and does not constitute a diagnosis or
replaces medical advice. Reference values ​​may differ from those indicated in
depending on the equipment used, the actual values ​​will be indicated on the form
results.

Unit: % (NGSP)

Reference values: 4.4 – 6.0%

Increase:

• Diabetes mellitus.
• Hyperglycemia, in some diseases (CNS trauma, CNS tumors, severe liver disease, thyrotoxicosis, Itsenko-Cushing’s disease).

Reduction:

• Active synthesis of hemoglobin.
• Regeneration of erythropoiesis after blood loss.
• Hemolytic conditions.
• Hypoglycemia in certain diseases (hyperinsulinism, hypothyroidism).

Quality Assurance

Test performed by Bio-Rad VARIANT II TURBO Glycated Hemoglobin Analyzer from Bio-Rad, USA

Based on the clinically reference HEFA method

Glycated hemoglobin

Learn more about popular analyses:

Do’s and don’ts before a blood test?

How to decipher the general and biochemical blood tests?

Biochemical blood tests – meaning and importance

The main task of the doctor in the treatment of diabetes is to normalize the level of glucose in the blood. The patient can control this metabolite in the blood either independently (with portable glucometers) or in the laboratory. By a single determination of blood glucose, it is possible to judge only the concentration of glucose at the time of taking, therefore, it is not possible to assume the state of the patient’s carbohydrate metabolism between measurements. To assess the patient’s carbohydrate metabolism over a longer period of time, it is necessary to conduct a test for the content of glycated hemoglobin (HbA1c) in the blood.

According to data obtained from a 10-year study called DCCT (The Diabetes Control and Complications Trial) conducted by the National Institute of Diabetes, Digestive and Kidney Diseases (USA) in the USA and Canada in 1983-1993, it was found that the control of the level glycemia, correlated by the level of HbA1c concentration, is directly related to the risk of developing long-term complications of type 1 diabetes and their progression. Specialists from the UK at 19In 1999, it was shown that a decrease in the patient’s serum glucose, as measured by the concentration of HbA1c, reduces the number of microangiopathies in type 2 diabetes mellitus.

Glycated hemoglobin is hemoglobin in which a glucose molecule is non-enzymatically linked to the β-terminal valine of the β-globin chains of hemoglobin A1 and is referred to as HbA1c. The content of HbA1c has a direct correlation with the level of blood glucose. Normally, the concentration of HbA1c is from 4.4 to 6.1%; in diabetic patients, its level depends on the degree of hyperglycemia and is usually 2-3 times higher than normal values. Glycated hemoglobin accumulates inside erythrocytes and persists throughout the entire period of erythrocyte circulation in the bloodstream, which is about 60 days. Thus, the concentration of HbA1c reflects the degree of glycemia for 60 – 90 days before study. Multiple studies of glucose measurement with traditional methods have confirmed the relationship between HbA1c and the patient’s glycemic level. The results of the DCCT studies conducted in the 1990s confirmed the hypothesis that the HbA1c level is directly related to the level of glucose in the blood and is the most appropriate criterion in monitoring the effectiveness of the treatment of patients with diabetes mellitus.

In the early 1990s, there was no unified international standardization for the measurement of glycated hemoglobin, which reduced the clinical effectiveness of this test. In order to achieve a single standard and overcome the problems associated with its development, the International Federation of Clinical Chemistry (IFCC) created in 1993 Working Group on Standardization of HbA1c Assessment. Her work resulted in the National Glycosylated Hemoglobin Standardization Program (NGSP). Most manufacturers of devices and kits for testing blood for glycosylated hemoglobin are required to be checked for compliance with the results obtained with reference methods. If the test result satisfies the reference data, the manufacturer is issued an “NGSP certificate of conformity”. The American Diabetes Association (ADA) recommends that all laboratories use NGSP certified glycosylated hemoglobin blood tests.

There are many analytical methods that allow the determination of HbA1c. These methods include electrophoresis, liquid chromatography, affinity chromatography, immunological techniques, column techniques. One of the main criteria when choosing an analyzer for performing a blood test for glycated hemoglobin is the availability of a reference NGSP method, which is liquid chromatography. When using standardized test methods, the laboratory has the ability to compare the results obtained with data obtained using reference methods. Such a comparison maximizes the reliability of the research results.

Of undoubted importance is the use in the work of the attending physician only of such research results that are obtained in laboratories using tests for blood analysis for glycated hemoglobin certified by the NGSP.

Glycated hemoglobin (HbA1с) – get tested in St. Petersburg

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What is glycated hemoglobin in a blood test?

Hemoglobin is a protein found in red blood cells that carries oxygen. The most common form of this protein is called hemoglobin A. It makes up about 95% of all types of hemoglobin. When hemoglobin A combines with glucose, a structure called HbA1c is formed, where A1c is glucose.

An HbA1c test provides information on the average blood glucose level over a period of two to three months.

The analysis is necessary for patients who have a suspicion of the development of diabetes mellitus or an established diagnosis. Also, the analysis can be taken for preventive purposes.

How to test for glycated hemoglobin? It is advisable for patients with diabetes to do this analysis 2-4 times a year. In some cases, based on the results of the analysis, the doctor may recommend that you take it again (for example, to confirm the results if diabetes is diagnosed for the first time).

Method of determination

Ion exchange high performance liquid chromatography.

Test material

Deoxygenated blood.

Due date

During the day.

Readings

1. Suspicion of diabetes mellitus (thirst, fatigue, frequent urination).

2. Controlling the level of glucose in the blood.

3. Adjustment of treatment for diabetes mellitus (if required).