What is HbA1c and why is it important for diabetes management. How is the HbA1c test performed and what do the results mean. What are the target levels for HbA1c and how can you lower them.

The Importance of HbA1c in Diabetes Management

Hemoglobin A1C (HbA1c) is a crucial indicator of blood glucose control over time. This test provides valuable insights into a person’s average blood sugar levels over the past two to three months, making it an essential tool for diagnosing and managing diabetes.

HbA1c is formed when glucose in the bloodstream attaches to hemoglobin, the oxygen-carrying protein in red blood cells. As red blood cells typically have a lifespan of about 120 days, the HbA1c test offers a more comprehensive view of blood sugar control compared to daily glucose monitoring.

Why is HbA1c testing so important?

• Provides a long-term view of blood sugar control
• Helps predict the risk of developing diabetes complications
• Guides treatment decisions and medication adjustments
• Assists in diagnosing diabetes and prediabetes
• Monitors the effectiveness of diabetes management strategies

Regular HbA1c testing is crucial for individuals with diabetes or those at risk of developing the condition. It allows healthcare providers to assess the effectiveness of current treatments and make necessary adjustments to prevent complications.

Understanding HbA1c Levels and Target Ranges

HbA1c levels are typically expressed in two ways: as a percentage (%) or in millimoles per mole (mmol/mol). Understanding these measurements and their corresponding target ranges is essential for effective diabetes management.

What are the recommended HbA1c target levels?

• For people with diabetes: 48 mmol/mol (6.5%) or below
• For those at risk of developing type 2 diabetes: below 42 mmol/mol (6%)

It’s important to note that these are general guidelines, and individual target levels may vary based on factors such as age, overall health, and the presence of other medical conditions. Your healthcare provider will work with you to determine the most appropriate target range for your specific situation.

Maintaining HbA1c levels within the target range is crucial for reducing the risk of diabetes-related complications, including eye problems, kidney disease, and cardiovascular issues.

The HbA1c Test Procedure and Frequency

The HbA1c test is a simple blood test that can be performed in a healthcare setting or, in some cases, at home using specialized kits. Unlike daily blood glucose monitoring, which requires frequent finger pricks, the HbA1c test provides a broader perspective on blood sugar control.

How is the HbA1c test performed?

1. A small blood sample is taken, usually from a vein in your arm
2. The sample is sent to a laboratory for analysis
3. Results are typically available within a few days

The frequency of HbA1c testing depends on various factors, including your current diabetes management and overall health status. Most people with diabetes undergo HbA1c testing every three to six months. However, more frequent testing may be necessary in certain situations, such as when adjusting medication or during pregnancy.

If you haven’t had an HbA1c test in over a year, it’s essential to contact your healthcare team to schedule one. Regular testing is crucial for maintaining optimal diabetes management and preventing complications.

Interpreting HbA1c Results and Their Significance

Understanding your HbA1c results is crucial for effective diabetes management. These results provide valuable insights into your long-term blood sugar control and can help guide treatment decisions.

How do you interpret HbA1c results?

• Normal (non-diabetic) range: below 42 mmol/mol (6.0%)
• Prediabetes range: 42-47 mmol/mol (6.0-6.4%)
• Diabetes range: 48 mmol/mol (6.5%) or above

It’s important to remember that a single HbA1c result doesn’t tell the whole story. Your healthcare provider will consider your individual circumstances, including your overall health, age, and other risk factors, when interpreting your results.

Higher HbA1c levels indicate poorer blood sugar control and an increased risk of diabetes-related complications. Even slightly elevated levels can significantly impact your long-term health, making it crucial to work closely with your healthcare team to achieve and maintain your target range.

Factors Influencing HbA1c Levels

While HbA1c is primarily influenced by blood glucose levels, several other factors can affect the test results. Understanding these influences can help you and your healthcare provider interpret your results more accurately.

What factors can impact HbA1c levels?

• Illness or infection
• Certain medications, such as corticosteroids
• Changes in lifestyle, including diet and exercise habits
• Stress and depression
• Anemia or other blood disorders
• Pregnancy
• Genetic factors affecting hemoglobin structure

It’s essential to discuss any recent changes in your health or lifestyle with your healthcare provider when reviewing your HbA1c results. This information can help provide context for unexpected changes in your levels and guide appropriate treatment adjustments.

In some cases, alternative tests may be necessary to accurately assess blood sugar control. For example, individuals with certain types of anemia may require a fructosamine test instead of the standard HbA1c test.

Strategies for Lowering HbA1c Levels

If your HbA1c levels are higher than your target range, there are several strategies you can employ to bring them down. Lowering your HbA1c is crucial for reducing your risk of diabetes-related complications and improving your overall health.

How can you lower your HbA1c levels?

1. Maintain a balanced, diabetes-friendly diet
2. Engage in regular physical activity
3. Take medications as prescribed by your healthcare provider
4. Monitor your blood glucose levels regularly
5. Manage stress through relaxation techniques or counseling
6. Get adequate sleep
7. Avoid smoking and limit alcohol consumption

It’s important to work closely with your healthcare team when making changes to your diabetes management plan. They can provide personalized advice and support to help you achieve your HbA1c goals safely and effectively.

Remember that lowering your HbA1c is a gradual process. It may take several months to see significant changes in your levels, so be patient and consistent with your efforts.

The Role of HbA1c in Diabetes Prevention and Early Detection

HbA1c testing plays a crucial role not only in managing existing diabetes but also in preventing the development of type 2 diabetes and detecting the condition in its early stages. By identifying individuals at risk, healthcare providers can implement preventive measures and interventions to delay or prevent the onset of diabetes.

How is HbA1c used in diabetes prevention and early detection?

• Screening for prediabetes in at-risk individuals
• Monitoring those with prediabetes to prevent progression to type 2 diabetes
• Diagnosing diabetes in its early stages
• Guiding lifestyle interventions and preventive treatments

For individuals identified as having prediabetes (HbA1c levels between 42-47 mmol/mol or 6.0-6.4%), lifestyle modifications such as improved diet, increased physical activity, and weight management can significantly reduce the risk of developing type 2 diabetes.

Regular HbA1c testing in at-risk populations allows for early detection and intervention, potentially preventing or delaying the onset of diabetes and its associated complications.

Advanced HbA1c Monitoring Technologies and Future Developments

As technology continues to advance, new methods for monitoring HbA1c and managing diabetes are emerging. These innovations aim to make blood sugar monitoring more convenient, accurate, and accessible for individuals with diabetes.

What are some emerging technologies for HbA1c monitoring?

• Continuous glucose monitoring (CGM) systems that estimate HbA1c levels
• At-home HbA1c testing kits for more frequent monitoring
• Non-invasive HbA1c measurement devices using spectroscopy
• Artificial intelligence-powered apps for predicting HbA1c trends
• Integration of HbA1c data with electronic health records for improved care coordination

While many of these technologies are still in development or early stages of implementation, they hold promise for improving diabetes management and making HbA1c monitoring more convenient and accessible for patients.

As these advancements continue to evolve, it’s important to stay informed about new options that may become available for managing your diabetes and monitoring your HbA1c levels. Always consult with your healthcare provider before incorporating new technologies or methods into your diabetes management plan.

The Psychological Impact of HbA1c Results and Diabetes Management

Managing diabetes and striving to maintain target HbA1c levels can have significant psychological impacts on individuals. It’s important to acknowledge and address the emotional aspects of diabetes care to ensure overall well-being and successful long-term management.

How does HbA1c monitoring affect mental health?

• Anxiety about test results and potential complications
• Frustration when unable to achieve target levels despite efforts
• Feelings of guilt or failure when HbA1c levels are high
• Burnout from constant self-monitoring and management
• Depression related to the challenges of living with a chronic condition

It’s crucial to recognize that managing diabetes is a complex process, and fluctuations in HbA1c levels are normal. If you’re struggling with the emotional aspects of diabetes management, don’t hesitate to seek support from your healthcare team, a mental health professional, or diabetes support groups.

Remember that your HbA1c level is just one aspect of your overall health. While it’s important to strive for your target range, it’s equally important to maintain a balanced approach to diabetes management that prioritizes your mental and emotional well-being.

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

Savefor later Page saved! You can go back to this later in your Diabetes and Me Close

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).