What is a good A1C reading. How does A1C reflect average blood sugar levels. Why is A1C used as a diabetes management tool. What factors can impact A1C results. How does age affect A1C goals.

What is A1C and Its Significance in Diabetes Management

Hemoglobin A1C, commonly referred to as HbA1c or simply A1C, is a crucial metric in assessing blood sugar management for individuals with diabetes. This test provides invaluable insights into a person’s average blood glucose levels over a 2-3 month period, making it an essential tool for both patients and healthcare providers.

How does A1C work? The test measures the percentage of hemoglobin proteins in red blood cells that are coated with sugar (glycated). As blood sugar levels rise, more hemoglobin becomes glycated, resulting in a higher A1C percentage.

The Importance of A1C in Diabetes Care

A1C testing has become the gold standard in diabetes management for several reasons:

• It provides a long-term view of blood sugar control
• Higher A1C levels are associated with increased risk of diabetes complications
• A1C results can guide treatment decisions and medication adjustments
• Regular A1C testing helps track progress in diabetes management over time

Studies like the Diabetes Control and Complications Trial (DCCT) and the UK Prospective Diabetes Study (UKPDS) have demonstrated a clear link between elevated A1C levels and the risk of diabetes-related complications, particularly those affecting the eyes, kidneys, and nerves.

Interpreting A1C Results: What’s Considered Normal?

Understanding A1C results is crucial for both individuals with diabetes and those at risk of developing the condition. The American Diabetes Association (ADA) has established guidelines for interpreting A1C levels:

• Below 5.7%: Normal (minimal risk for Type 2 Diabetes)
• 5.7% to 6.4%: Prediabetes (increased risk for developing Type 2 Diabetes)
• 6.5% or higher: Diagnosed diabetes

For those already diagnosed with diabetes, what is considered a good A1C reading? While individual goals may vary, many healthcare providers aim for an A1C below 7% for optimal diabetes management. However, it’s essential to work with your healthcare team to establish personalized targets based on your unique circumstances.

Factors Influencing A1C Goals

Several factors can influence what’s considered a “good” A1C reading for an individual:

• Age
• Duration of diabetes
• Presence of other health conditions
• Risk of hypoglycemia
• Overall health and life expectancy

Can A1C goals change over time? Yes, they can. As you age or your health status changes, your healthcare provider may adjust your A1C targets to balance the benefits of tight blood sugar control with the risks of hypoglycemia and other factors.

The Relationship Between A1C and Average Blood Glucose Levels

A1C results provide valuable information about average blood glucose levels over time. But how do A1C percentages translate to daily blood sugar readings?

Here’s a general guideline for the correlation between A1C and estimated average glucose (eAG):

• A1C 6% = eAG 126 mg/dL (7.0 mmol/L)
• A1C 7% = eAG 154 mg/dL (8.6 mmol/L)
• A1C 8% = eAG 183 mg/dL (10.2 mmol/L)
• A1C 9% = eAG 212 mg/dL (11.8 mmol/L)

Why is understanding this relationship important? It helps individuals with diabetes connect their day-to-day blood glucose monitoring with their overall glycemic control, providing a more comprehensive picture of their diabetes management.

Limitations of A1C Testing: When It May Not Tell the Whole Story

While A1C is a valuable tool in diabetes management, it’s not without limitations. In some cases, A1C results may not accurately reflect an individual’s true glycemic control.

Conditions That Can Affect A1C Accuracy

Several factors can lead to misleadingly high or low A1C results:

• Anemia or other blood disorders
• Kidney or liver disease
• Certain medications
• Pregnancy
• Genetic variants of hemoglobin

How can you determine if your A1C result is accurate? If you have any of these conditions or suspect your A1C may not be reflective of your blood sugar control, discuss alternative testing methods with your healthcare provider.

Beyond A1C: Other Important Metrics in Diabetes Management

While A1C provides valuable information about long-term glycemic control, it doesn’t capture the full picture of diabetes management. Other important metrics to consider include:

• Time in Range (TIR): The percentage of time blood glucose levels stay within target range
• Glycemic variability: The degree of blood sugar fluctuations throughout the day
• Frequency of hypoglycemic events: Episodes of dangerously low blood sugar

Why are these additional metrics important? They provide a more comprehensive view of glycemic control, helping to identify patterns and potential areas for improvement in diabetes management that A1C alone might miss.

Strategies for Improving A1C Levels

For individuals looking to lower their A1C, several strategies can be effective:

1. Regular blood glucose monitoring
2. Consistent medication adherence
3. Balanced diet and carbohydrate management
4. Regular physical activity
5. Stress management
6. Adequate sleep
7. Working closely with a diabetes care team

How quickly can A1C levels improve? With consistent effort and appropriate interventions, many individuals can see significant improvements in their A1C within 3-6 months. However, it’s important to remember that sustainable, long-term changes are more beneficial than rapid, short-term improvements.

The Role of Technology in A1C Management

Advancements in diabetes technology have revolutionized A1C management and overall glycemic control. Some key innovations include:

• Continuous Glucose Monitoring (CGM) systems
• Insulin pumps with automated dosing features
• Diabetes management apps and digital platforms
• Telemedicine for remote diabetes care

How can these technologies improve A1C levels? By providing real-time data, automating insulin delivery, and facilitating better communication with healthcare providers, these tools can help individuals make more informed decisions about their diabetes management, potentially leading to improved A1C results.

The Future of Glycemic Control Assessment

As our understanding of diabetes and glycemic control evolves, so too do the methods for assessing and managing blood sugar levels. Emerging areas of research and development include:

• More accurate and convenient A1C testing methods
• Advanced data analytics for personalized diabetes management
• Integration of artificial intelligence in diabetes care
• Development of novel biomarkers for glycemic control

What might the future hold for A1C testing and diabetes management? While A1C is likely to remain an important metric, we may see a shift towards more comprehensive, personalized approaches that take into account a wider range of factors affecting glycemic control.

In conclusion, understanding A1C levels and their significance is crucial for effective diabetes management. By working closely with healthcare providers, utilizing available tools and technologies, and staying informed about advancements in diabetes care, individuals can strive for optimal glycemic control and reduce their risk of diabetes-related complications.

Defining Normal A1C Levels | diaTribe.org

By Adithi Gandhi and Jeemin Kwon

Why we use A1c, what values are recommended, and what impacts A1c – everything from anemia to vitamins

Want more information just like this?

Sign Up Now!

Hemoglobin A1c (“HbA1c” or just “A1c”) is the standard for measuring blood sugar management in people with diabetes. A1c reflects average blood sugars over 2 to 3 months, and through studies like DCCT and UKPDS, higher A1c levels have been shown to be associated with the risk of certain diabetes complications (eye, kidney, and nerve disease). For every 1% decrease in A1c, there is significant pretection against those complications.

However, as an average over a period of months, A1c cannot capture critical information such as time spent in a target range (70-180 mg/dl) and hypoglycemia (less than 70 mg/dl).

This article describes why A1c is used in the first place, as well as factors that can lead to misleadingly high or low values. In a follow-up piece, we will discuss time-in-range, hypoglycemia, hyperglycemia, blood sugar variability, and how to measure and interpret them.

Click to jump down to a section:

1. What is A1c and why is it used?

2. What tools are available if an A1c test is not accurate or sufficient?

3. What’s important to keep in mind about A1c?

4. Conditions and factors that impact A1c

What is A1c and why is it used?

A1c estimates a person’s average blood sugar levels over a 2 to 3-month span. It is the best measure we have of how well blood glucose is controlled and an indicator of diabetes management.

Though A1c doesn’t provide day-to-day information, keeping A1c low has been proven to lower the risk of “microvascular” complications like kidney disease (nephropathy), vision loss (retinopathy), and nerve damage (neuropathy). The relationship between A1c and “macrovascular” complications like heart disease is harder to show in clinical trials, but having high blood sugar is a major risk factor for heart disease.

A1c is usually measured in a lab with routine blood work, or with a countertop machine in a doctor’s office (and some pharmacies) using a fingerstick.

A1c measures the quantity of “glycated hemoglobin,” which refers to sugar attached to a red blood cell protein called hemoglobin. The number is reported as a percentage of the total hemoglobin in the blood. If a person consistently has higher blood glucose levels over time, A1c levels go up because more red blood cells are coated with sugar. The test is representative of a 2 to 3-month average because once a red blood cell becomes coated with sugar, the link is irreversible. It is only when the red blood cell is “recycled” (happens every 2 to 3 months) that the sugar coating disappears. 

What are “normal” A1c levels for people who don’t have diabetes?

Generally, high A1c values indicate high average blood sugar levels and that a person might be at risk for or may have diabetes. The American Diabetes Association (ADA) has established the following cutoffs: 

Make sure you get a regular A1c test, especially if you think you might be at risk for diabetes.

What is an A1c goal for those with diagnosed diabetes?

An A1c of less than 6.5% or 7% is the goal for many people with diabetes. Since each person with diabetes is unique, however, healthcare providers are recommended to set individual A1c goals. For instance, goals may differ depending on age and other health conditions.  

How does age affect A1c?

A1c is a measure of diabetes management, so your A1c won’t naturally shift as you get older. However, as you age your diabetes management strategies and A1c goals may change – for example, younger people may be more focused on reducing long-term health complications, while older people may concentrate on avoiding severe lows. Talk with your healthcare professional if you’re curious about how your age may affect your A1c levels.

Where is A1c misleading or potentially inaccurate?

Much progress has been made in standardizing and improving the accuracy of the A1c test thanks to the National Glycohemoglobin Standardization Program (NGSP). Results from a non-NGSP certified lab may not be as reliable. Depending on the machine, a single A1c test can have up to a 0.5% margin of error, which means the “true” value might be 0.5% higher or lower than the measured A1c. For example, if a lab report shows an A1c value of 7.0%, the actual A1c value might range from 6.5% and 7.5%.

A1c is based on a person’s red blood cell turnover (the lifespan of a red blood cell) and the quantity of sugar attached to each cell. Certain conditions, such as kidney disease, hemoglobin variants, certain types of anemia, and certain drugs and vitamins, impact red blood cell turnover, leading to misleading A1c values. Click here to jump down to a list of factors that impact A1c. 

According to Dr. Irl Hirsch, in a typical diabetes practice, an estimated 14%-25% of A1c measurements are misleading.

The relationship between A1c values and average blood sugar levels can also vary markedly from person to person. In studies using continuous glucose monitoring (CGM), 24/7 blood sugar levels can be compared to a measured A1c. These studies reveal considerable variation from person to person. For instance, an 8% A1c value in one person could reflect an average blood sugar of 140 mg/dl, while in another it could be 220 mg/dl. This variation relates to individual differences in how red blood cells and blood sugars bind or the lifespan of red blood cells.

“An A1c of 8% can correspond to an average blood sugar of 140 mg/dl in one person, while in another it could be 220 mg/dl. “

For looking at an individual’s glucose values, CGM is a better tool for measuring average sugar levels, time-in-range, and hypoglycemia. Learn more in our previous beyond A1c article here. 

What tools are available if an A1c test is not accurate or sufficient?

Besides A1c tests, the most common measures of blood sugar are the oral glucose tolerance test (OGTT), CGM, and self-monitored blood glucose tests.

The OGTT is a diagnostic tool diabetes and prediabetes, assessing a person’s response to consuming a fixed amount of sugar. After taking the sugar drink, blood sugar levels are measured two hours later. Below 140 mg/dl is considered “normal,” between 140 mg/dl and 200 mg/dl points to prediabetes or impaired glucose tolerance, and above 200 mg/dl indicates diabetes. It is not useful for tracking diabetes management.

For those with established diabetes, CGM has the advantage of monitoring blood sugar levels consistently throughout the day (every 5-15 minutes), providing more detailed insight into time spent in-range, low blood sugars, and high blood sugars. Examples of CGM include:

If CGM is not available, taking frequent fingersticks with a blood glucose meter – when waking up, before and after meals, and before bed – can also indicate when blood sugar levels are going low, high, and staying in range. 

What’s important to keep in mind about A1c?

If you have diabetes, it’s also important to take the perspective that A1c is not a “grade” on diabetes management, but rather a helpful measurement tool that you and your healthcare providers can use to guide decisions and assess the risk of complications.

Non-glycemic factors that can affect A1c:

While there are many unsuspecting factors that can impact A1c, the information in the table below is not meant to invalidate the A1c test. Rather, knowing how certain conditions and factors can change A1c levels is a key part of using A1c as one measure of diabetes management.

Many of the conditions that affect A1c results are related to changes in the turnover of red blood cells, and thus notably, types of anemia.   Correction of anemia by treatment can also affect A1c results.

Why should my A1C be 7 per cent or less? — Mount Sinai Hospital

Over the last several years a significant amount of research has proven that control matters, and good control is now defined as an A1C of < 7 per cent.

What is an A1C?

An A1C test shows your blood glucose control over the last 2 or 3 months.

Diabetes Control & Complications Trial (DCCT) 1982-1993

Research from both the Diabetes Control & Complications Trial (DCCT) and its follow up study (EDIC) proves that having an A1C of 7 per cent is definitely worthwhile for persons with type 1 diabetes.

Exactly 1441 volunteers aged 13 to 39, all with type 1 diabetes, took part. These people agreed to randomly be assigned to either conventional treatment – taking about two insulin injections a day – or to intensive treatment (IT) – taking either multiple dose insulin (MDI, about 4 injections a day) or an insulin pump.

During the study the A1C of each group was compared:

• 
  the conventional therapy group had an average A1C of 9.1 per cent (normal 4-6 per cent)
• 
  the intensive therapy group had an average A1C of 7.2 per cent

The purpose was to finally demonstrate whether or not good blood sugar control was really important to prevent the complications of diabetes. And indeed it is – as you can see below, complications developed at a much lower rate in the intensively treated group compared to the conventional group.

The reduction in risk for eye disease (the primary outcome) was so great that the study was stopped early – and intensive therapy to achieve an A1C of 7 per cent or less became the standard of practice worldwide!

But what do these results mean for you?

For you, a person with type 1 diabetes, lowering your A1C by 1 per cent means a 45 per cent less risk you will develop the chronic complications of diabetes! That’s 45 per cent for each 1 per cent lower! The closer to normal (<6 per cent) the A1C is the better!

The results also mean that an A1C of <7 per cent will also be good for you if you already have some signs of chronic complications. For example, kidney and eye disease may stay stable for years!

At the end of the original DCCT trial, all the people in the conventional group changed to intensive therapy and their A1C lowered. Then both groups went back to their usual diabetes care teams, coming back to the study centre for a once yearly assessment.

This same group of volunteers has remained in the DCCT follow up study called Epidemiology of Diabetes Interventions & Complications (EDIC) since 1993. Now that’s commitment to a research study!

Over time the A1C of the original intensive therapy and the former conventional therapy groups evened out at an average of 8%, but the benefits of intensive therapy remained – much to everyone’s surprise. And for the first time, the benefits of good control on heart/cardiovascular disease were clearly shown.

 

 

DCCT/EDIC Results 1993-2005 (NEJM 2005)

Original Intensive vs. Conventional Therapy Groups: Comparison of Complications Status	EDIC 11 yrs of A1C~ 8% Both testing 4 x per day
Eyes (retinopathy)	75% less progression
Kidney	86% risk reduction in onset of new microalbuminuria
Heart/ Cardiovascular	57% less risk of heart attack (MI), stroke or CV death Intensive group: 31 people with 46 events Conventional group: 52 people with 98 events

  

The latest results (2005) continue to support the earliest possible adoption of intensive therapy to achieve an A1C of <7 per cent. Early and optimal blood glucose control has long term benefits.

That’s why we believe so passionately in using the IT system, and why we want to help you find the best way for you to do this. We know it isn’t easy to act like a pancreas day in and day out. It‘s hard work – and we want to help!

How to Maintain a Healthy A1c Level

Understanding A1c Tests

An A1c test helps doctors see the amount of glucose in a person’s blood (blood sugar) over a three-month period. When glucose builds up in your blood, it binds to a protein called hemoglobin—this molecule is responsible for the red color of your blood and carrying oxygen throughout your body.

A1c tests measure what percentage of hemoglobin is coated by glucose. The higher your percentage, the higher your risk of diabetes and diabetes complications.

Doctors use A1c tests to diagnose type 1 and type 2 diabetes and monitor patients who are already diagnosed with diabetes. If you have diabetes, you should get an A1c test regularly to evaluate how well you are managing your blood sugar.

What is a Healthy A1c Level?

The normal A1c range for a non-diabetic person of average health is below 5. 7 percent, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). If your levels are between 5.7 to 6.4 percent, you may be prediabetic. A level of 6.5 percent or higher indicates diabetes.

Patients with diabetes should aim for an A1c level below 7 percent. It may seem like a lofty goal, especially if your levels are high, but it’s important to remember that lowering your A1c levels reduces your risk of developing diabetes complications like kidney and nerve damage, cardiovascular disease, cataracts, etc.

How Often Should I Get Tested?

If you are at risk for diabetes or prediabetes and have not been diagnosed, an A1c test can help you determine whether you have the condition or are likely to develop diabetes. Because prediabetes usually does not present any signs or symptoms, it’s important to identify your risk factors and notify your doctor.

How often you get tested depends on your diagnosis and your treatment plan. Here are some general recommendations:

• If you are prediabetic, you should get tested annually to monitor your risk of progressing to diabetes.
• Patients with type 2 diabetes who do not use insulin and whose A1c levels are consistently in the target range may only need the test twice a year.
• If you have type 1 diabetes, you should be tested three to four times per year.
• Patients with type 2 diabetes who use insulin for diabetes management or have difficulty keeping their blood sugar in their target range should be tested four times a year.

Tips to Reduce Your A1c Levels

Reducing your A1c levels can reduce your likelihood of developing diabetes if you are prediabetic or are at risk, but it can also improve the quality of life of those with type 1 or type 2 diabetes and prevent further complications. Tips to lower your levels include:

1: Exercise

Increasing your activity level can have a positive effect on your A1c levels. Aim for 30 minutes a day, five days a week. Exercise can be overwhelming for someone who is not used to being active—starting with something as simple as taking your dog for a walk can help ease you into an exercise routine. Discuss your routine with your doctor before increasing your activity level.

2: Follow your treatment plan

Successful management of chronic conditions is all about making a plan and sticking to it. Work with your doctor to set goals for your health and create a plan that will work for you. It you have a hard time following your plan, you may want to write it down or post your goals in a place where you will see them frequently. The NIDDK offers a diabetes planning worksheet to help you get started.

3: Eat a diabetes-friendly diet

Some eating habits can worsen symptoms of diabetes. Create a diet plan that emphasizes healthy carbs—like whole grains, low-fat dairy, fruits and vegetables—and foods high in fiber. Be sure to watch your portion sizes to prevent overeating, and beware of sugary drinks, processed foods, and foods high in cholesterol and sodium. Try using an online tool to document your goals, recipes and shopping lists, and track your progress over time.

4: Take medications as directed

Medications for diabetes can assist you in your efforts to lower your A1c levels, and you should take them as directed in order to get the most benefit out of them. Because your needs may change over time, it’s good to visit your doctor if you notice your levels changing. A simple schedule change or tweak in dosage may be all you need to get back on track.

5: Get organized

Being organized can help you feel less overwhelmed as you try to manage your diabetes and lower your A1c levels. Practice writing down your schedule for the week on Sundays; include your doctors appointments, medication reminders, exercise plan, to do lists and anything else that will help you get into a routine and focus on your health. You may want to organize all of your supplies in one place or keep glucose tablets in your purse or car to help you prepare for unexpected lows.

6: Take advantage of tech

There are lots of apps out there to help patients manage their diabetes. What may work for one person may not work for another—try out a few to find a good fit. You may want to talk to your doctor about getting a continuous glucose monitor (CGM) to help you track your progress. These tiny sensors, which are inserted under the skin, are a great way to see your glucose levels in real time—some can even send your results to your tablet or smartphone.

7: Take a deep breath

Stress hormones can cause blood sugar levels to spike. Whether your stress is mental, emotional or physical, finding ways to reduce your stress can help you better control your A1c levels. Practicing mindfulness or breathing exercises, for example, can be a great way to manage your stress and A1c levels.

Complications of diabetes can dramatically increase your out-of-pocket medical costs. Regularly consult your doctor about your condition and which management methods are best for you.

Our Utah County Endocrinologist helps diagnose and treat endocrine system disorders—including complex cases. As trained specialists, our providers know the latest treatments and technologies to treat a variety of disorders.

Sources:

“CT scan (How you prepare).” The Mayo Clinic. http://www.mayoclinic.org/tests-procedures/ct-scan/basics/how-you-prepare/prc-20014610

“Positron emission tomography scan (How you prepare).” The Mayo Clinic. http://www.mayoclinic.org/tests-procedures/pet-scan/details/how-you-prepare/ppc-20319717

“MRI (How you prepare).” The Mayo Clinic. http://www.mayoclinic.org/tests-procedures/mri/details/how-you-prepare/ppc-20235719

A1c: Why This Critical Blood Measurement Is Significant

If you have diabetes or you’re at risk for developing diabetes, your doctor might recommend a hemoglobin A1c test. It’s a blood test that gives you an estimate of your blood sugar levels over the last three months. Mark Bridenstine, MD, an endocrinologist at Banner Health in Loveland, CO, answers some key questions about this important health marker.

Who needs a hemoglobin A1c test?

Your doctor might want to check your A1c levels if you:

• Are at higher risk of developing diabetes/have prediabetes
• Could be diagnosed with diabetes
• Have diabetes and need to see how well your blood sugar is controlled

How is my hemoglobin A1c tested?

Most of the time you’ll have blood drawn in a lab. It’s also possible to do an A1c test from a finger-stick drop of blood.

What information can I learn from my A1c test?

In your body, glucose attaches to the hemoglobin in your red blood cells. The hemoglobin A1c test measures how much of your hemoglobin has glucose attached to it.

So, if your reading is 7.0%, it means that 7.0% of your hemoglobin contains glucose. Your red blood cells live for around three months, so your reading is an estimate of your average blood sugar level for the past three months.

A1c is different from your blood glucose level, which tells you what your blood sugar level is at that moment in time. “If A1c is the birds-eye-view of the forest, then blood glucose is the hikers-eye-view,” Dr. Bridenstine said. Both blood measurements give you valuable information.

What should my A1c level be?

For most people, a good target A1c level is 7.0% or less. But your target hemoglobin A1c level depends on a lot of factors:

• Your age
• How long you’ve had diabetes
• Your risk of complications from diabetes
• Other medical conditions
• Your risk of hypoglycemia (low blood sugar)
• Your ability to manage your diabetes with medication

Your doctor can help determine the best target A1c level for you.

How can I improve my A1c level?

There are steps you can take to lower your hemoglobin A1c levels and help keep your diabetes well controlled. “Lifestyle efforts are paramount,” Dr. Bridenstine said.

• You can make changes to your diet. Dr. Bridenstine recommends limiting highly processed foods, avoiding sugary drinks, and choosing smaller portions of foods that are high in calories and carbohydrates.
• You can exercise more. Dr. Bridenstine said to find activities that you enjoy, so you keep doing them. And he pointed out that even short bursts of exercise are useful. “Walking for 10 minutes after a meal can help your body process and manage blood sugars,” he said.
• You can take medication if your doctor recommends it. “Even with optimizing lifestyle, some people are going to need more help with diabetes drug therapy,” he said.

What can happen if my A1c levels are high?

High A1c levels mean your diabetes isn’t controlled very well. That can increase your risk for complications, so you may need to be screened for kidney damage, nerve damage, eye damage, and heart disease. Additionally, according to the American Diabetes Association, diabetes is the seventh-leading cause of death in the United States. “It’s worth mentioning that the top six causes of death are all influenced and/or worsened by diabetes, too,” Dr. Bridenstine said.

Got more questions? Whether you’re at risk for developing diabetes or already have it, discuss with your doctor if an A1c test is right for you. To find a doctor in your area, visit bannerhealth.com.

You may also like:

Join the Conversation

A1C: What It Is, Why It Matters to Contain Diabetes Costs – Welldoc

What is A1C?

Hemoglobin A1C, also called A1c, HbA1C, or glycated hemoglobin, is the part of red blood cells that have glucose attached.¹ It gets reported as a percentage.

What does the A1C test measure?

The A1C test measures the average glucose level over the past three months. Think of it as a 24/7 video of all of the ups, downs and in between of glucose levels. It gives you an idea of how well your body is managing glucose.

The A1C test is different than a blood glucose monitor check or continuous glucose monitors. These devices give you the glucose level at that exact moment in time.

Using A1C, along with day-to-day glucose results is a good way of measuring how well diabetes is being managed.

What’s the recommended A1C for people with diabetes?

The American Diabetes Association (ADA) recommends an A1C goal of <7% in most adults (not pregnant). Some healthcare providers may recommend an A1C of <6.5%, if they can maintain it without adverse effects or events, such as frequent hypoglycemia.²

An A1C of <8% is also thought to be appropriate for people:

• with a history of hypoglycemia (low glucose levels)
• limited life expectancy
• advanced complications
• or other complexities of life.²

We recommend that you discuss your personal target goals with your care team.

How often should I measure A1C?

ADA’s recommendation for measuring A1C is at least two times a year. This recommendation is for those that are currently meeting their treatment goals. If you’re not meeting treatment goals, A1C should be checked quarterly.²

Is there a relationship between A1C and glucose control?

Yes, you can convert A1C to glucose levels.

In the chart below, the first column is the A1C result. The second column shows what the average glucose level was over the past three months. The third column shows the range of glucose levels.

Relate A1C Results to Glucose Levels

For example, an A1C of 8% would mean your average glucose over the past three months was 183 mg/dL. And likely over that three month period, your glucose levels would have ranged from 147 mg/dL to 217 mg/dL.

Is the A1C test accurate for everyone?

Since the A1C test has been made available (about 40 years), is has become a common way to measure glucose control. However, in the last several years some questions have been raised about potential limitations of A1C:

• Is the A1C accurate for everyone?
  • It may not be accurate for some people, including people of African-American descent, people with liver and kidney disease, or with some anemias and sickle cell disease.
• How much detail does the test give?
  • It doesn’t give a detailed perspective. The test shows overall trends but does not give same level of details as daily glucose checking.

Can A1C be used to diagnose prediabetes and diabetes?

Yes, in 2010, the ADA endorsed the use of the A1C test as a way to diagnose prediabetes and diabetes. ⁴

The table below provides the A1C levels at which prediabetes and diabetes can be diagnosed.¹

Why is keeping A1C in a healthy range so important in diabetes care?

Numerous studies conclude that keeping A1C in the desired range can help reduce complications of diabetes.

Diabetes complications that can be delayed or prevented are:²

• high blood pressure
• decreased blood circulation
• heart attacks
• strokes
• diminished eyesight or blindness
• nerve damage

What is the cost benefit of lowering A1C?

Recently the ADA published analysis diabetes costs. They showed total estimated costs of $327 billion with $237 billion on direct costs and $90 billion in indirect costs. ⁵ Economic costs of diabetes continues to rise.

Data from numerous studies show that better A1C results in lower total healthcare costs.⁶ A study using claims data from a large health maintenance organization showed that the group of mainly type 2 patients whose A1C was lowered by 1% experienced lower total health care costs in the range of $685 to $950 less per year compared to people who had no A1C improvement.

Another analysis from a large managed care organization showed that total diabetes-related costs for people whose A1C was greater than 7% was $1,540 per patient during the 1-year follow-up. This was 32% higher than the total diabetes-related costs for people whose A1C was at or below 7%.

References

1. Section 1 The A1C Test & Diabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test
2. Section 2 American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes -2018. Diabetes Care.2018;41(Supp 1):S55-S64.
3. Section 3 National Glycohemoglobin Standardization Program (NGSP). Harmonizing Hemoglobin A1c Testing. 2010 https://www.ngsp.org/A1ceAG.asp.
4. Section 4 American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes -2018. Diabetes Care.2018;41(Supp 1):S55-S64.
5. Section 5 American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.
6. Section 6 Hirsch JD, et al. Estimated Cost-Effectiveness, Cost Benefit, and Risk Reduction Associated with an Endocrinologist-Pharmacist Diabetes Intense Medical Management “Tune-Up” Clinic. J Manag Care Spec Pharm. 2017;23(3):318-326. https://www.jmcp.org/doi/full/10.18553/jmcp.2017.23.3.318.

What it Measures, Ranges, Tips & More

A1C is a blood test performed by a healthcare professional to measure an average of blood sugar levels over the past 2-3 months. If you have been diagnosed with prediabetes or diabetes, you have probably had your A1C tested. This is a helpful tool for understanding your overall blood sugar control, allowing you and your healthcare provider to see if there are trends between each visit and evaluate how your current diabetes treatment plan is working.

Since A1C is measured as a percentage, this value can be harder to interpret as compared to a blood sugar value, like the one you’re used to seeing on a blood glucose meter. You can use an A1C calculator to give you a sense of how an A1C percentage correlates to an average blood sugar value and vice versa. Before you use the calculator, it may be helpful to understand what A1C tells you and what affects it.

A1C calculator

Note: This calculator is not a replacement for an A1C lab test and should not be used to make treatment changes. Discuss this information and any questions with your healthcare provider, regarding your unique diabetes self-management plan.  The correlation between A1C and average glucose has been studied by Nathan, et al, 2008, 1473-1478.* 

What does A1C measure?

You may be wondering what makes this test different, especially if you already check your blood sugar multiple times a day. The A1C test goes by a few names, including glycosylated hemoglobin, glycated hemoglobin, or hemoglobin A1C (HbA1c). All of these names hint at what is being measured — the amount of sugar (glucose) attached to hemoglobin.

Hemoglobin is a protein found inside red blood cells, and its job is to carry oxygen to the lungs and all of the cells in your body. Glucose enters your blood stream and sticks, or “glycates,” with the hemoglobin. The higher your blood glucose, the more sugar-coated or “glycated” the hemoglobin becomes.

Since the lifecycle of a red blood cell is about four months, the A1C percentage reflects average blood sugar levels detected on hemoglobin cells of varying ages — days, weeks, or months old. If your blood glucose control has generally been steady, your hemoglobin cells will not be highly sugar-coated, or “glycated,” leading to a lower A1C value.

How often should you have an A1C lab test?

Your healthcare provider may order an A1C test every three months to monitor diabetes treatment changes, such as adjustments to medications, insulin pump settings, or other areas of diabetes self-management. If your blood glucose is within range and stable, your healthcare provider may only order the test every six months.

If you have not been diagnosed with diabetes, sometimes A1C is used along with other measures to help diagnose diabetes. It may also be used as a baseline measurement for people with a strong family history of diabetes or other risk factors to see if levels are increasing over time.

What are A1C ranges and goals?

The lower the A1C value, the less glucose there is coating the hemoglobin. The higher the A1C value, the more glucose there is on the hemoglobin. So higher A1C levels typically correlate with higher circulating blood glucose levels.

A1C ranges

According to the CDC, a normal A1C level is below 5.7%. This is what would typically be expected for someone who does not have diabetes. If your body becomes less efficient at moving glucose into your cells to be used for energy, or insulin resistant, then levels may increase from 5.7% to 6.4%, which is considered prediabetes. Those with levels from 6.5% and above are considered to have diabetes.

If you’ve been diagnosed with diabetes and an A1C test is used to help monitor your diabetes management, not everyone agrees on the ideal number to aim for:

A1C goals

Your healthcare provider can advise you on an individualized A1C goal that takes into consideration factors such as:

• Your age
• Risk of hypoglycemia
• Willingness to spend time working on diabetes self-management
• Financial access to tools such as test strips, medications, insulin, insulin pumps, and CGMs
• Any other current health issues as well as your personal goals

There are some conditions that can affect A1C levels, which your healthcare professional will be aware of, including anemia and sickle cell disease.

A1C results are not good or bad, they are information. Living with diabetes brings many challenges, and some aspects of controlling blood glucose can be out of your control, such as pain from an injury, stress, not being able to eat on time, and more. Don’t be afraid to look at your A1C number — in fact, you should ask about your lab result at each office visit. When it comes to diabetes self-management, the more information you have, the better.

How does A1C relate to glucose averages?

Average from a glucose meter

Although an A1C level gives you a sense of average glucose levels over the past few months, a person with type 1 or type 2 diabetes needs a blood glucose meter to check blood sugar and make treatment decisions on a day-to-day basis.

If you test often during the day — like before and after meals and other times that your blood sugar can vary — and use an accurate glucose meter, this can give you valuable information on daily variations in blood sugar levels. Many blood glucose meters are also equipped to provide 7, 14, 30, or 90-day averages. A 90-day average on your meter can be used in the calculator above to estimate how it may correlate to an A1C.

Glucose meter averages are based on the frequency that you have tested per day, so if you do not have many data points (i.e. testing infrequently or not during high or low blood sugar swings) or are unable to test at certain times (i.e. like while you’re sleeping), it probably won’t give you a full picture of your blood sugar levels and may skew lower than an A1C test result.

Estimated average glucose (EAG)

The American Diabetes Association (ADA) recommends using an estimated average glucose (EAG) for correlating your A1C percentage into an average that’s a more familiar unit of measure. The ADA has studied how A1C and EAG are related, which is the basis for the A1C to EAG calculator above. The EAG value from the A1C calculator tells you how your blood glucose numbers are averaging in a unit of measure that is familiar, like on a blood glucose meter.

This value should not be used for treatment decisions, but rather for helping you correlate A1C to an estimated average glucose to give you a better idea of how close you are to your target ranges. If your A1C is higher, your EAG is also going to be higher. Or if your A1C is lower, your EAG is going to be lower, so these two numbers will track similarly.

What can you do to improve your A1C levels?

• Partner with your healthcare provider. Ask if you need changes to your medication, insulin or insulin pump settings. If you haven’t had a recent visit with a Certified Diabetes Educator, ask for a referral so that he/she can recommend small changes that can make a big difference.
• Create routines. Try to test with a blood glucose meter, take medications or insulin, and exercise at about the same time each day. This helps create habits so that you don’t forget your self-care activities and helps your healthcare provider identify patterns in your blood sugars.
• Get more data. Test blood glucose more frequently and make sure to check two hours after the start of a meal as often as possible, not just before meals. These after-meal readings are most closely linked with your A1C number and tell how well your body handled the meal.
• Make course corrections quickly. If you find that you are always having a low blood sugar before dinner, add an afternoon snack. If your blood sugar is high, drink lots of water and take a walk (as long as your number is below 250mg/dL, if higher, do not exercise). If you have two readings over 250mg/dL in a row, notify your healthcare provider. Taking action while you are out of range can help you find your way back in target faster.
• Tighten up your carbohydrate counting. Use a kitchen scale to help measure accurate portions of carbohydrate foods. Read labels and use tools that help you carb count, not carb guess. Using an app like Calorie King to look up the exact carb content of foods, and visiting a Registered Dietitian Nutritionist for an individualized meal plan and carb counting review can be great steps to help you get on track.
• Reduce stress. Stress can raise blood sugar, so find ways to relax. Take a walk, read a book, laugh with a friend, find a yoga and/or mindfulness class, or visit a therapist for support. This is all part of self-care, especially when you are living with diabetes.
• Increase activity, even in small amounts. Walking for ten minutes after each meal has been shown to improve blood glucose. Be active and keep moving even by walking the dog or cleaning the house.

People often wonder how long it will take to improve their A1C number. By following your diabetes self-care plan, you can improve your A1C by your next three-month check. Your A1C may continue to go down at each visit if you continue to partner with your healthcare provider and follow the tips above.

It’s not helpful to test your A1C more frequently than every three months, and more frequent testing is not always covered by insurance. If you feel like you have followed your healthcare provider’s recommendations but your A1C level is high, don’t take it personally. Again, there are many factors that make diabetes management difficult, and if you continue to work on it, your number will come down.

In summary, the A1C test gives you a picture of your overall glucose levels. There is no bad or good number, just information that helps you and your healthcare provider understand how well your diabetes management plan is working.

Using an A1C calculator can give you an idea of how your A1C translates into an EAG number that you can recognize, using the same unit of measurement as shown on a blood glucose meter. However, remember that A1C goals can be different for each person based on age, treatment goals, access to diabetes supplies, and other health issues present, so don’t be afraid to talk with your healthcare professional about setting your unique goals to lead to better diabetes management.

*Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. “Translating the A1C assay into estimated average glucose values. ” Diabetes Care. 2008;31(8): 1473-1478. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742903/

How to Lower A1C Levels Naturally

Call it what you will: hemoglobin A1C, glycosylated hemoglobin, HbA1c or just “A1C,” these numbers, known as A1C levels, play a huge role in how your diabetes is managed. It’s also used to diagnose diabetes, as well as prediabetes. Your A1C is a blood test that provides information about your average blood sugar levels over the past three months. Your provider and diabetes care team use this number to gauge how things are going and if and how to tweak your diabetes treatment plan. For most people who have diabetes, the American Diabetes Association (ADA) recommends an A1C of less than 7%. The American Association of Clinical Endocrinologists (AACE) advises a tighter goal of 6.5% or lower. Your goal may be completely different, and that’s OK (just make sure you know what it is!).

Why lower your A1C?

A1C goals aren’t decided upon out of thin air. The targets that the ADA, AACE or your provider advise for you are based on clinical research, as well as other factors, such as your age, your overall health and your risk of hypoglycemia. Landmark clinical trials, such as the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC), for example, have correlated lowering A1C with a decrease in diabetes-related complications. So, for every one point that you lower your A1C, you’ll lower your complication risk as follows:

• Eye disease by 76%
• Nerve damage by 60%
• Heart attack or stroke by 57%
• Kidney disease by 50%

It’s important to realize that your A1C levels reflects an average of your blood sugar numbers. Your A1C levels might be 6.7%, but that may be because you’re having a lot of low blood sugars, for example. For this reason, your A1C levels should be viewed as part of the picture, and not in isolation. Your blood sugar readings, frequency of highs and lows, and quality of life need to be considered as part of your overall diabetes management plan.

How long does it take to lower your A1C levels?

Is it possible to lower A1C levels overnight? Well, the short answer is no. Unlike your blood sugars, which can go up or down in a matter of minutes, your A1C will take some time to change. Remember what your A1C measures: your average blood sugars over the past three months. The good news is that if your A1C is on the high side, say, 10% or higher, it will likely start to drop within two to three months (in other words, the higher it is, the faster it comes down). On the other hand, if your A1C is 7.5%, it may take a little longer to lower A1C levels. 

Seven ways to lower your A1C levels

There are a number of ways to get your A1C down. Taking medication is one way (and the reality is that many people with diabetes need to take medication), but lifestyle measures are effective, too. Here’s a rundown of what can work.

Diet

What and how much you eat factors in to your blood sugar control and, in turn, affects your A1C. There’s so much controversy about the best “diet” for diabetes and there’s no shortage of arguments on this topic. However, realize that there is no one “diet” that will work for everyone. And despite popular belief, the American Diabetes Association does not prescribe any one type of eating plan. In actuality, they state that many different types of eating patterns, including lower carb, vegetarian, DASH and Mediterranean can be beneficial. One of the best ways to figure this all out is to meet with a registered dietitian, preferably one who has experience in working with people who have diabetes. Your doctor can provide you with a referral to meet with a dietitian. In the meantime, consider the following for lowering A1C levels:

1. Come up with a plan

Getting into the habit of eating three meals a day, and possibly some snacks, is a great way to get started on controlling A1C levels. In addition, aiming to eat your meals at about the same times each day will make it easier to stabilize your blood sugars. Try not to skip meals or delay eating your meals as much as possible.

2. Be carb choosey

Carb naysayers will proclaim that carb foods are evil and should be avoided as much as possible. But reality and research shows otherwise. It’s difficult for most people to cut out carbs and it’s not the smartest thing to do from a nutrition standpoint, as carb foods can and do provide important nutrients that you won’t get from eating just protein and fat. However, you do need to consider the types of carbs you eat. Refined carbs, such as white bread, white rice, chips, soda, cookies and other sweets have been stripped of their fiber and most of their vitamins and minerals; contain “empty” calories; and can cause “spikes” in blood sugars. Eating refined and processed carbs has been linked to an increase risk of diabetes, heart disease, inflammation and obesity. The carbs to focus on are unrefined, meaning, they retain their fiber, vitamins, minerals and other plant compounds that promote health. These carbs include whole grains, whole fruits and vegetables and legumes (beans and peas).

3. Be carb consistent

Along with eating healthy carb foods comes the concept of carb control for controlling A1C levels. Eating too much carb from any food source can mean higher blood sugars and a higher A1C. Aim to eat the same amount of carb at your meals and snacks each day. Many people count grams of carb and aim for a range at their meals — for example, 30–45 grams per meal. Doing so helps you keep your blood sugars steady, whether you take diabetes medicine or not. Because people do need different amounts of carb, it’s best to check with a dietitian as to what your carb goals should be.

4. Watch portions

Eating too much carb is one thing; eating too much protein or fat is another. Keep an eye on your portions of all of the foods that you eat, especially if you are trying to lose weight (losing weight, if you need to, can help lower your blood sugars and A1C). Using the plate method or sample menus are a couple of ways to help you get on track with an eating plan.

Being active

We’re all bombarded with messages to exercise or be physically active, and after a while, it’s easy to tune them out. But if your goal is to lower your A1C, it’s time to pay attention. Yes, carb counting and losing weight helps, but don’t overlook the power of physical activity, too. Exercise provides numerous health benefits, including a lower risk of heart disease, weight loss, increased energy and a lower risk of depression and stress. Add lower blood sugars to the list.

5. Come up with a plan

If you haven’t been active for a while, you might be wondering how to get started. The first step is to think about what you might like to do. One of the best ways to get moving is to start walking. All you need is a good pair of sneakers. However, bicycling, swimming, using an exercise video or taking a Zumba class, for example, are all great ways to be active.

6. Commit to 150 minutes each week

One reason why people don’t exercise is because they think they need to spend hours at the gym, huffing and puffing away. Not true. The goal is to aim for doing at least 150 minutes of physical activity each week, or 30 minutes, five days a week. And the good news is that you can break those 30 minutes into 10-minute segments, three times a day. If you haven’t been exercising, start slowly and build up, five minutes at a time. By the way, don’t forget to check with your doctor before starting any new exercise program.

7. Combine cardio and resistance

Exercises that strengthen your heart and lungs and that use large muscle groups are often called aerobic or cardio exercises. These include walking, swimming and bicycling. Ideally, your exercise routine should also include resistance, or strengthening, exercises, such as using hand weights, resistance bands, calisthenics or weight machines. Both types of exercise work in different ways to promote health, but they both lower blood sugars and A1C.

More on how to lower your A1C next week!

Want to learn more about A1C? Read “How to Lower Your A1C: More Steps You Can Take,” “What Does A1C Stand For?” and “H-B-A-1-C: What It Is and Why It Matters.”

En Español: Cómo Reducir los Niveles de A1C Naturalmente

Originally Published September 11, 2017

90,000 Everything you need to know about the A1C

test

A1C test is a diabetes test for measuring the average blood glucose level of a person for about 3 months. Doctors can use it to diagnose type 2 diabetes and to monitor people’s diabetes.

By analyzing the level of glucose in the blood, a person checks how much sugar – or glucose – is in his blood. They can do this at home with a finger stick or a monitor they can wear.

The A1C test provides an average estimate of blood sugar levels over a long period of time, usually 2-3 months.A person will do an A1C test at the doctor’s office.

An A1C test is essential for most people with diabetes. This article explains how this test works and how it helps control blood sugar levels.

What is the A1C test?

Share on Pinterest Achieving glucose targets can help a person reduce their risk of complications and maintain a good quality of life.

A1C test is a blood test that measures your average blood glucose level over a period of 2-3 months.

Doctors use the A1C test to determine how stable a person with diabetes is in blood sugar. Additionally, according to the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), doctors may use it in the initial diagnosis of type 2 diabetes, but not type 1 diabetes.

Other names for A1C test:

• hemoglobin test A1C
• test HbA1c
• test for glycated hemoglobin
• glycohemoglobin test

Hemoglobin is a protein in red blood cells that carries oxygen throughout the body.When blood glucose levels are high, some of the glucose binds to hemoglobin.

The type of hemoglobin to which glucose is attached is hemoglobin A. The name of the resulting combination is glycated hemoglobin (A1C).

Red blood cells live for about 120 days or 4 months, and during the test there will be a direct link between the A1C result and the average blood glucose level over the previous 12 weeks or so.

What to expect

A person can take the A1C test at any time.They do not need to fast before taking or make any other preparations. A doctor or other healthcare professional will take the blood and send it to a laboratory for evaluation.

Some doctors’ offices offer an on-site test, which means that they analyze the blood themselves. It may be useful for diabetes management, but NIDDK notes that it is not suitable for diagnosis.

Understanding the levels

The A1C blood test measures your blood glucose levels in about 3 months.

The A1C test result will be percentage. This refers to the amount of hemoglobin to which glucose is bound in a person’s blood.

For diagnostics, the test results can be as follows:

• Normal start : Below 5.7%
• Prediabetes : 5.7-6.4%
• Diabetes : 6.5% or more

A single A1C test result does not mean a person has diabetes. The doctor will also check the person’s blood glucose level.If a person’s blood glucose is 200 milligrams per deciliter (mg / dL), the doctor may confirm diabetes.

Various factors may slightly alter the result, and some medical conditions can also lead to a higher A1C result.

According to NIDDK, if the A1C test shows 6.8 percent, the actual reading can be anywhere between 6.4-7.2 percent.

Other conditions that can mislead the A1C for diabetes include:

• kidney disease
• liver disease
• Certain blood disorders such as sickle cell disease
• recent blood loss or transfusion
• low iron
• to be unhealthy
• stress

If a person has or may have any of these conditions, the doctor may suggest a different test or a different type of A1C test.

If A1C results, glucose readings, or both suggest diabetes but the person has no symptoms, the test may need to be repeated.

A doctor can diagnose prediabetes if the result is between 5.7 and 6.4 percent.

A person with prediabetes is more likely to develop type 2 diabetes in the future, but lifestyle changes such as quitting smoking, following a healthy diet, and exercising regularly can often prevent this.

The person may already have risk factors for type 2 diabetes such as:

• obesity
• high blood pressure
• high cholesterol or triglycerides in blood plasma
• Low High Density Lipoprotein (HDL)

The A1C test is useful for diagnostics, but also important for monitoring. Regular A1C and glucose testing can show the doctor if a person’s treatment is working well or needs some adjustment.

What is eAG?

Mean glucose or eAG is another way of reporting A1C test results. It means the same thing, but some people prefer this way of interpreting the results because it uses the unit mg / dl, which is similar to a blood glucose test.

Here is a comparison of the two estimates based on a calculator from the American Diabetes Association (ADA) website.

90 125 117 90 128

90 125 137 90 128

90 125 140 90 128

90 125 240 90 128

The eAG score provides an indication of a person’s average blood glucose levels over the previous 2–3 months, but does not show the highs and lows that continuous glucose monitoring or a routine finger prick test might indicate.

Target levels

A person who is not diagnosed with diabetes should have an A1C test result below 5.7 percent.

A person with a score of 6.5 percent or higher will be diagnosed with diabetes and will need to start treatment. This will include lifestyle changes such as dietary adjustments, additional exercise, and possibly medications.

During diabetes treatment, the person will strive to maintain their A1C score. below 7 percent.However, different people will have different goals, depending on factors such as their age and the medications they use.

Why is testing important?

People diagnosed with diabetes should get tested regularly, depending on their doctor’s advice.

Controlling blood sugar and A1C is essential because diabetes can lead to a number of complications such as cardiovascular disease.

As the percentage of A1C increases, so does the risk of progression to type 2 diabetes and complications in those who already have a diagnosis.

For example, one research group found that people with an A1C of 6.0–6.5% were often 20 times more likely to develop diabetes over 5 years when researchers compared them to people with an A1C of less than 5 percent.

A 2010 review reviewed 16 studies involving over 44,000 5.6 people that researchers studied over a period of XNUMX years.

Using A1C to prevent complications

People with diabetes need to control their blood sugar levels to keep them from getting too high.

Glucose control can reduce the risk of complications affecting small blood vessels, especially the eyes and kidneys, and coronary arteries.

This can help prevent many of the problems that can occur with diabetes, including:

• loss of vision
• cardiovascular disease
• stroke
• kidney disease

Achieving and maintaining an A1C of 7 percent or below can significantly reduce these risks.

However, a person will determine their blood sugar and A1C targets with their doctor or other healthcare provider as each person is different.

Pregnancy testing

A doctor may recommend taking an A1C test early in pregnancy to see if a person with risk factors for diabetes has a high score.

Later in pregnancy, they may test for gestational diabetes in other ways, since pregnancy may affect the A1C test result.

If a person has gestational diabetes, the doctor may also check within 12 weeks after giving birth, as gestational diabetes can subsequently develop into type 2 diabetes.

Test frequency

A large 1-year A2014C testing study found that testing once every 3 months can help people with diabetes maintain stable blood glucose levels, especially if their initial score was 7 percent or higher.

Researchers found that people who were tested four times a year had an average of 1 percent drop in A3.8C and were less likely to see an increase in blood sugar.

Meanwhile, in people who were tested only once a year, A1.5C results increased by an average of 1%.

ADA recommend A1C testing for people diagnosed with diabetes:

• At least twice a year for those with stable glucose levels and meeting treatment goals.
• More often when a person’s treatment plan changes or if they do not reach their target blood glucose levels.

For those who do not have diabetes, the ADA recommends taking a baseline test for anyone aged 45 and over or under 45 but with risk factors for diabetes, such as obesity. The person may need to undergo further testing, depending on the result of the baseline test.

People who have gestational diabetes during pregnancy may need to be screened every 3 years.

Outlook

The A1C test is useful for diagnosing type 2 diabetes and for monitoring blood glucose levels in a person with this condition.

It is also wise to have regular blood glucose tests at home and follow the correct diabetes management plan between tests.

It can also be helpful to connect with people who understand what it is like to live with type 2 diabetes. T2D Healthline is a free application that provides support through one-to-one messaging, real-time group discussions and expert resources on type 2 diabetes.Download the iPhone or Android app.

Read the article in Spanish.

90,000 Best Life Insurance Companies for Diabetics

Think diabetics can’t get life insurance? Think again. Companies are now adapting coverage for insurers with diabetes. I found nine insurance companies in advance.

Do you consider buying life insurance a diabetic? Three cheers for planning ahead! Life insurance is important for the financial security of your beneficiaries (and your peace of mind).

However, as you may know, life insurance companies take risks very carefully. For a candidate with a chronic medical condition, such as diabetes, it can be difficult to find coverage. And getting affordable coverage is another challenge. The higher your statistical risk of premature death, the higher the expected premiums.

Don’t let diabetes get in the way of protecting your family – get life insurance quotes from Policygenius

Fortunately, insurers understand that they need to provide diabetes insurance at a reasonable cost if they want to remain competitive in the market.Diabetes is a common condition; in 2015, 10% of the US population reported being diagnosed with type 1, type 2, or gestational diabetes. Since then, the numbers have only increased.

I have compiled some of the best companies for diabetics looking for life insurance. Everyone has different cases, but I’m sure you will find the one that works for you on my list.

Review of the best life insurance companies for diabetics

Political genius

When you start comparing purchasing policies, your first choice is Policygenius.It is an independent insurance broker that compares providers; they don’t sell insurance themselves. This means they can give you personalized advice without bias.

If you are a diabetic, there are many health variables that come into play, and Policygenius takes most of them into account when giving you quotes.

Policygenius does not provide information on every provider, so you may need to do more research. It was difficult to find a policy that covered both the first type and additional health problems.

Ethos

Ethos

creates a policy tailored to your situation and does not require a physical examination. You can get a quote in minutes by simply specifying your age, whether you are a smoker and your health status – Average, Excellent or Excellent.

Combining this basic information with data analytics, Ethos provides life insurance quotes. Policies under $ 1 million start at just a dollar a day, providing more insurance for your money than competing companies.

For diabetics, the best thing about Ethos is that political decisions are made on an individual basis. Regardless of how you answer the initial question about your health, the Ethos team will gather additional information and take into account all factors, including your finances and age.

Fabric

Built with parents in mind for life planning, Fabric is another insurance company that does not require a medical examination to qualify.This can be circumvented by asking general questions about your lifestyle, health, and having children. Your policy will be based on the information you provide.

Fabric divides its users into five classes, from Ultra Select to Tobacco User. Medium Plan – Select, which covers those who are in good health and low-risk lifestyles. If your health is acceptable, you are eligible for a standard plan that covers those who do not use tobacco products and lead a moderate-risk lifestyle.

In addition to life insurance, Fabric also provides a Voluntary Will and Family Vault, which stores all of your information in one place. If something happens, family members can access all the important information about your finances here.

Ladder

Ladder sells lifetime policies with coverage up to $ 1 million. And they will allow you to increase or decrease your coverage in the future if your needs change.

For example, you might want to buy less coverage because you will save more money over time. This can save you a lot of money, especially if your health needs change.

They also provide quotes very quickly. And they have some of the best customer service.

Unlike other companies on this list, Ladder does not have plans for diabetics. You may have to go through a medical exam before claiming coverage.

Health IQ

For health conscious diabetics who are actively in control of their condition, why not turn to a company that rewards you for your hard work?

Health IQ boasts that they rate applicants for their health literacy and overall lifestyle, not just their current health status. They even have a life insurance plan targeted at diabetics who make healthy lifestyle choices, such as exercising regularly.The plan is now for Type 2, but the company plans to expand its offerings to Type 1 in the future.

Because the Health IQ derives metrics based in part on fitness statistics, the process is difficult to track. If you prefer not to be monitored for your activity and fitness level, it is best to have a hands-off policy.

LeapLife

Another independent broker, LeapLife, is a company that checks if you have multiple health problems and want to compare your options side by side.They expand coverage for everyone between the ages of 18 and 75 who has lived in the United States for more than two years. Like Policygenius, they will receive your information and match you with a company that suits your needs.

They also offer competitive tailor-made terms or “riders” including a rider with a chronic illness who provides a steady income if you need long-term care in the future, and a “waiver of bonus” rider who exempts you from premiums if you contract. serious illness or complication.

Although LeapLife will do their best to find a policy for you, they do not provide coverage themselves.

Prudential

Prudential is one of the most recommended life insurers for diabetics, especially those with type 1, high A1C or additional health complications. They don’t shy away from high-risk candidates. Their approach is individual, they will carefully consider the specifics of your condition and adapt the plan to your needs.

If your diabetes is well controlled, you may even get your desired score, which is unheard of for other carriers. Even if you are insulin dependent, you can still get a policy, although your rates may be higher.

Prudential offers higher prices than some of the other options. Young diabetic candidates in excellent health may find cheaper coverage from another carrier.

Protective

Protective is another great choice for high risk candidates.Their no-exam or “guaranteed pass” policy is designed for those who fear that an exam could void their eligibility for coverage. The company is known for its fast underwriting process if you don’t want to wait weeks for coverage.

As a bonus, Protective believes that everyone should be able to get life insurance, and they have developed offerings aimed at insurers with diabetes who are committed to healthy lifestyles.

Although the company is competitively priced, I could not easily find a preliminary quote for Policygenius for complex diabetic conditions under Protective.

American Citizen (ANICO)

ANICO

insures more diabetics than any other company in the United States, so their experts are probably well aware of the condition. Their policies will also be less costly, even if you choose the no-exam option.

To get the best performance, you probably still need to be relatively healthy. However, ANICO doesn’t seem to have the set of options for the different terms that Protective and Policygenius offer, so make sure you pay attention to that when looking for a policy.

Summary of Best Life Insurance Companies for Diabetics

How I Compiled This List

Flexibility

I have highlighted companies with a reputation for offering coverage to candidates that others might refuse.No life insurance policy is universal, especially for people with persistent health problems. Many of the insurers on this list, such as Health IQ and Prudential, go out of their way to gauge the big picture when pricing.

Availability

While these options offer a wide range of monthly rates, none of them represent an outrageous cost.

Range of Capabilities

These companies offer different insurance terms, whether you want coverage for five, 20, or even 50 years.And I’ve looked for places that offer additional perks, such as better rates for healthier lifestyles, or the ability to increase or decrease coverage as we age.

Reliability

I was looking for a reputable company with an A or A + financial strength rating from AM Best. And I avoided insurers that received bad reviews from regulatory agencies.

Types of life insurance available to diabetics

Life insurance companies try to avoid paying out payments on their policies as long as possible.In this way, they keep an eye out for any illnesses that increase the likelihood of the applicant’s early death. These factors include age, gender, family history of certain medical conditions, addictions such as smoking, and more. Chronic health problems like diabetes top the list.

This means two things to you: You won’t have many companies to choose from as some of them won’t provide insurance for high-risk candidates.And you will pay a higher premium – the monthly or annual amount you pay to keep your policy active – than non-diabetes insurers.

Life insurance rates are divided into the following categories:

• Preferred Plus and Preferred – L vl rates for low risk candidates in good health. Diabetics are usually not eligible for these rates.
• Standard Plus and Standard – for decent health candidates with multiple factors preventing them from getting preferred rates.

Diabetics can get a standard grade (the “average” health rating that most people claim). You have a good chance if:

• You have type 2 diabetes (considered a lower risk than type 1 diabetes).

• Your condition is well monitored.

• For the rest, your health is good.

Some diabetics may be eligible for the Standard Plus rate, but this is often for those diagnosed at the end of life – think after 50 years.

Non-standard or tabular rating

For high risk candidates who pay the highest bonuses. At this rate, type 1 diabetics and people with other medical conditions are likely to follow. The tabular ratings use a scale of one to eight, from Table 1 (the cheapest option is only 25% above the standard rates) to Table eight (up to 200% above the standard rates). Your table category may differ depending on your insurer and the specifics of your condition.

The only factor that significantly increased my scores was type 1 diabetes as opposed to type 2 diabetes.Type 1 diabetics are considered more at risk for several reasons. They are most commonly diagnosed in childhood, while type 2 diabetics are usually diagnosed in adulthood. Type 2 diabetes is also much more common.

Gestational diabetes, a temporary condition that affects people during pregnancy, did not significantly affect my scores compared to standard type 2.

What Factors Affect Your Potential Bids?

Remember that insurers look at two main variables when assessing diabetes risk:

Severity

How long ago were you diagnosed with diabetes? Has your condition resulted in other mild or serious health complications? A short-term case of gestational diabetes will be considered a lower risk than a diagnosis of type 1 diabetes made decades ago.

Treatment

If you are currently under medical supervision and are managing your symptoms well, you will be eligible for much higher rates. Insurance companies want to know how diabetes will affect your future health and will be more optimistic if your condition is under control.

Insurers will also consider these factors:

• Age – the younger you are , the less you will pay.That is why I recommend purchasing life insurance as soon as possible.
• Pol. Women pay less than men in all respects, because statistically women live longer.
• Tobacco use – Non-smokers pay much less than smokers.
• Family history – If you have a family history of diabetes or other conditions such as cancer or heart disease, you are at increased risk.
• Type Diabetes – Type 1 diabetics will pay more than Type 2 diabetics.
• Date of diagnosis. The longer you have been diagnosed with diabetes, the more you will pay.
• A1C Levels – You’re probably more knowledgeable about A1C levels than you would like if you’ve had diabetes for a while, but here’s a quick rundown: Lower A1C levels (below 7.0) won’t improve your scores. Levels from 7.0 to 7.9 will increase your rates slightly. Levels 8.0 and higher will significantly increase your premiums. Insurers will likely look at your average A1C over a 12 month period.
• General Health – Non-smokers, people without other serious medical conditions, and those who routinely take care of themselves through diet and exercise can get better results.
• Treatment plan. Regular visits to the doctor, taking any medication, and regular self-monitoring are all items in your column. Insurers may want to know if your condition has been stable in the past six to 12 months.

How can diabetics get the best performance?

Unfortunately, many of the ranking factors are beyond your control, but some are not.Literally following your treatment plan, including taking your prescribed medications, starting a regular treatment plan if you don’t have one, quitting smoking or cutting back on smoking if you smoke … these are all good places to start.

Insurers really want to see you take proactive steps to control your diabetes with medication, insulin, a healthy lifestyle, or whatever plan you think will work best. You don’t need to be in great health to get a good grade, especially with some of the more flexible companies on our list, such as Prudential and LeapLife.

If you are type 1, there are some steps you can take to potentially reduce your premiums:

• Consult a diabetes healthcare professional to monitor your condition.
• If you are physically able to improve circulation, exercise regularly.
• Choose a policy with a medical examination. The more information the insurance companies have about your health, the more likely they are to make a competitive offer.

What can you expect during a medical examination?

When you apply for life insurance, you will answer tons of questions about your medical history. Respond honestly to all of them. You may also need to provide a medical record from your doctor.

The next step before buying a policy is a medical examination so that insurers can get all the facts about your health.

Your doctor may want to know:

• Average blood pressure.
• Average cholesterol value.

90,021 Your average A1C reading.

• Your age at the time of diagnosis.
• If you have a history of other diabetes-related diseases.
• Your exercise regimen, if any.
• Your general dietary habits.
• Your current medications and dosages, including any insulin use.
• Your weight and BMI (body mass index).

Do you need a medical examination to purchase a policy?

There are no health insurance policies for life insurance or policies without health insurance.In general, I don’t recommend them – they tend to be much more expensive and less comprehensive than other policies.

But it’s also important that you have as many options as possible. And if you’ve been suffering from diabetes for years, you’ve probably already visited your fair share of doctors. You may be able to calculate your health statistics while sleeping. Policies with a lower threshold for acceptance and a focus on general health may be more appropriate.

You can also get coverage much faster than with an exam-specific policy (think hours, not weeks or months).

Several of the companies on this list stand out for offering candidates competitive policies without mandatory medical examinations. You will still need to answer basic questions about your health and possibly provide additional medical records.

Exam waiver policy usually does not exceed $ 500,000 coverage, so if you need more, you can opt for an exam.

What if you have prediabetes?

People with prediabetes or at increased risk of developing diabetes in the future may be eligible for non-diabetic life insurance if they are not currently being treated with medication and are monitored by a doctor.

Insurance companies will consider you a diabetic if you take medication or insulin, even if you have prediabetes. As always, it’s best to submit your application honestly.

Summary

People with diabetes can get life insurance at an affordable price. A thorough treatment plan and smart lifestyle decisions make you an even better candidate for competitive coverage, even in difficult insurance conditions such as Type 1.

Shop around, be prepared for your medical records, and report your health honestly, and you’ll likely find a policy that works.

Read more:

Recording source: https://www.moneyunder30.com

90,000 Read more? But is there any use in fictional stories?

• Claudia Hammond
• BBC Future

June 22, 2019

Photo author, Getty Images

We hear from childhood: we need to read more. But does modern research confirm the positive impact of fiction on humans?

More than 1.8 million books are bought in the United States every day.In Great Britain – half a million. Despite the many distractions (and entertainment) of modern life, people still love to read.

Books teach us to understand the world around us, help expand vocabulary and correct spelling.

But can fiction make us better?

The influence of fiction is credited with many wonderful things, from the desire to participate in charity, civic engagement, to the gradual decline in the level of violence around the world over the centuries.

Masterfully written characters make us immerse ourselves in the story being told. As Aristotle said, when we look at a tragedy, two emotions prevail in us – pity (for the main character) and fear (for ourselves).

We imagine what it would be like to be the kind of person we read about, and compare the reaction of the character of the book in a given situation with how we would act in his place. Or imagine how we will behave if we find ourselves in such a situation in the future.

This exercise (seeing another person’s perspective) is like training in understanding other people.That is why Canadian psychologist Keith Outley calls fiction “the flight trainer of our consciousness.”

Photo Credit, Getty Images

Just as pilots learn to fly an airliner on the ground, people who regularly read fiction can improve their social skills by discovering a novel.

When the heroes of the book are in danger, our heart beats faster. It even happens that we choke with excitement.

However, the thought that all this is not happening to us is calming and even pleasurable.We are not overwhelmed by horror, we do not jump out of the window to be saved.

At the same time, some of the neural mechanisms used by our brain to understand what is happening in the book have much in common with those used in real life.

When we read that the hero has grabbed the end of a thin rope, the grasping region of the brain is active.

To follow the plot, we need to know which of the heroes know what they are feeling and what each of them thinks about the thoughts and plans of other characters.

To do this, you need to have an ability called mental state modeling. When people read about the thoughts in the hero’s head, the very areas in the brain that are responsible for this ability are activated.

Photo author, Getty Images

Photo caption,

Reading fiction activates certain areas of our brain

And since we learn to empathize with others through reading, is there any way to prove that those who read fiction, have better social skills than those who mostly read non-fiction or non-fiction, or do not read at all?

Here is one of the difficulties – people tend to exaggerate the number of books they read.To get around it, Oatley and colleagues handed out to students a list of authors of fiction and non-fiction and asked them to note which of them they had heard.

The participants were warned that the lists contain fictitious names – to check if the subjects were cheating.

The number of writers people have heard of is a good indicator of how much they read.

Photo author, Getty Images

Photo caption,

Many of us tend to exaggerate the number of books read

Then Oakley’s team conducted the Mind in the Eyes test with the participants, during which they offer photographs where on each has only a pair of eyes.

The task is to determine what emotion the person is experiencing in the picture by the expression of the eyes and the state of the mimic muscles surrounding them.

This gives a list of options – for example, shyness, guilt, dreaminess, anxiety …

The difference in the expression of the eyes is subtle, at first glance it may seem neutral, so the task is much more difficult than it might seem.

However, the fact remains: those who read more fiction scored higher on this test.As well as on the scale of interpersonal susceptibility.

Psychologist Diana Tamir of the Princeton Laboratory of Social Neuroscience has demonstrated that people who read fiction often have better social cognitive abilities.

In other words, they better understand how others are feeling or thinking.

Using brain scans, Tamir found that when reading fiction, increased brain activity is observed in areas of the brain that are usually excited when a person ponders what others are thinking.

Photo author, Getty Images

Photo caption,

Those who read more fiction tend to understand other people better

Those who read novels understand the emotions of others better than the average person. However, does this necessarily make them better?

To test this, the researchers used a method that everyone who has studied psychology is familiar with: It’s as if you accidentally drop a few pens or pencils on the floor and then watch who rushes to help you.

Before the participants were tested for their willingness to participate in the pencil selection, they were asked to complete a questionnaire, among other things, containing questions to help measure empathy.

Then they read the short story and answered a series of questions about how much they were captured by the story. Do they have a good idea of ​​the heroes? Do they want to know more about the characters after they finish reading the story?

The experimenters then said that they needed to bring something from another room and then – oh! – suddenly dropped six handles on the floor.

And it worked: those who were captured by the story just read, who sympathized with its heroes more, were more likely to come to the rescue and pick up pens from the floor.

You may ask: maybe these people were generally kinder and more sympathetic by nature – even before they read the story?

Photo author, Getty Images

Photo caption,

Those who are more attracted to reading are then less selfish read, behaved more altruistically.

Experiments are one thing, of course. It is quite possible that in real life the opposite is true: those who are more sympathetic to others are more interested in their inner life, and such an interest attracts them to reading novels and stories.

This subject is not easy to learn. Ideally, at different stages of life, you should measure the degree and levels of empathy of the participants, sometimes reading fiction, sometimes giving up – and so on over the years.

Several short studies were conducted instead. For example, Dutch scholars asked students to read either newspaper articles about riots in Greece and a holiday in the Netherlands, or a chapter from the novel “Blindness” by Nobel laureate Jose Saramago.

In this chapter, a man, sitting at the wheel of a car, is waiting for the green light to turn on, when he suddenly loses his sight. Those who rode with him take him home, and a passer-by who promised to drive a car to his house steals it instead.

Immediately after the students read this story, their level of empathy increased. But even a week later, those who were strongly attracted by the reading showed even higher results on the empathy scale.

Of course, you can say that it is not only works of art that affect our behavior and feelings.We can also have empathy for the people we read about in the news reports.

Photo author, Getty Images

Photo caption,

Reading fiction helps to become a good doctor. And, apparently, not only a doctor

But fiction has at least three advantages. We have access to the inner world of the hero – which we do not have in journalism. We tend to take on faith what we read about the people in the novel and what they say about themselves.

Finally, novels allow us to do something that we cannot do in real life – to trace the life of a character over the years.

So research suggests that perhaps reading fiction really makes people behave better.

And some educational institutions are already taking this serious influence into account – they are inserting humanitarian modules into their programs.

It looks like it’s time to abandon the stereotype that “bookworms” spend so much time reading because they are afraid of real relationships with real people.

Perhaps, in fact, these “worms” better than anyone else, understand other people and their feelings.And this is useful not only for future doctors.

To read the original of this article in English, visit BBC Future .

How to Encourage Children and Teens to Read

Parents are often worried about why their child does not read, and most importantly – how to change it? Which book to offer? Can you instill a love of reading? Ekaterina Asonova believes that reading for the sake of reading is not an option. She told The Matrons how to encourage children and teenagers to pick up a book.

Ekaterina Asonova – Candidate of Pedagogical Sciences, Head of the Laboratory of Socio-Cultural Educational Practices at Moscow State Pedagogical University, author and leader of the project “Children’s Books in the Circle of Adult Reading”.

Interviewed by Elena Barkovskaya.

Source: www.matrony.ru/ne-chitaet-i-ne-zastavite/

Ekaterina Asonova

One of your works is about family reading. What’s the point of reading with the whole family?

Joint reading is, first of all, a communicative practice.The book helps an adult and a child to interact, to experience something together, to be physically close. It is very important to understand that for a parent, after all, communication with a child is primary: if we forget this, making reading the main thing, then we get a woodcutter who prays to his ax.

How is family reading organized in your family?

My husband and I are both philologists. Reading fiction, reading special literature is our main professional activity.Since I am engaged in children’s reading, I have a very – no, not so – a LOT of children’s literature. I cannot say that we often read aloud to our children, but we seem to live “on books”.

Our children (now they are 11, 12 and 25 years old) in preschool age read a lot simply because they grew up in the conditions of book festivals, mother’s lectures, etc. They quickly and well learned to read children’s books, that is, to read not only text but also pictures. Until now, I am for them (as well as for many friends, acquaintances, close and distant relatives) a book “source” – I help to choose books, slip new items, answer questions.Another thing is that this practice is completely inseparable from my work, therefore it is not suitable as a model for another family.

At what age can you start reading together?

Everything that is commonly called nursery rhymes in children’s folklore is, in a sense, the beginning of family and children’s reading; this is where the perception of a speech image begins. The emotional speech of an adult (mom, dad, grandmother, grandfather, nanny) addressed to the baby is special, because the adult at this moment is a little bit an actor, a little bit a writer, a creator.

When emotionally colored statements are highlighted in the everyday speech of an adult, when intonation, tempo, rhythm change, dramatization occurs, this gives a positive result. A child gains experience of speech perception, imitating an adult, learns to create it himself. So, in a special, artistically organized sounding speech, this is also a kind of artistic work.

What did you read or tell your children in childhood?

A lot, not only and not so much I read, but spoke, performed a variety of things: funny songs that I remembered in childhood or in youth, poems, nursery rhymes.Without them, it is impossible to dress the child, without them it is boring to play, without them it is difficult to calm the baby down.

Then the time of Chukovsky and his company came – many poems by V. Levin, R. Mukha, V. Lunin, G. Sapgir, A. Givargizov, M. Yasnov, M. Boroditskaya, E. Moshkovskaya, Z. Alexandrova, M. Grozovsky, A. Timofeevsky and many, many others.

Then fairy tales and short stories were used. The former are taken by the plot, the latter by the likelihood and closeness of the depicted experiences.I remember that Annie Schmidt’s five-volume book about Sasha and Masha was read ten times. Among the favorite authors were Chukovsky, Dragunsky, Sedov, Usachev. And there are many, many picture books, among which there were books by Nordkvist, Jansson, Appelgren, Erlbruch, Gerasimova, Silverstein, Surova, Shmelkov, Stalfelt and others.

Let’s imagine a child about 8 years old who doesn’t want to read. Parents give him “Dunno on the Moon”, and he replies: “I’d better play the computer.” How to deal with this?

We need to understand why we want the child to read.And you also need to remember that he received the computer from you.

“To receive emotions, knowledge,” the adults will answer.

This means that he does not receive this from reading: he does not believe us, or he does not need knowledge. We return to the question of whether reading is necessary for the sake of reading. What do we want? So that the child just reads and our parental ego feels good? Give your child a phone book – let him read.

It is wrong to prioritize the thesis “reading is better than watching TV”, because you can also see something good on TV – it’s just better to get knowledge through activity, experience.As long as the parent gives the child “Dunno” and says: “Read, because I decided so,” reading is impossible in principle. Reading is about freedom, independence, opportunity, respect and self-esteem. If a child in an ultimatum form receives a book that did not interest him, which he did not take off the shelf, he will not read, he will not feel like a free person. Because this is not the exercise of a right, but an obligation. And a person should have reading only as an opportunity.

If a child had the right to choose and read the books he wanted, and this need was cultivated, he will continue to choose books himself. He will not read what mom considers useful. Books are not vitamins (but sometimes they can be very helpful, and they are much cheaper and healthier than pills for depression, but we are getting ahead of ourselves).

How can you get your child to choose books?

Trust the child and always remember that the main result is not to cram knowledge, but to direct it to them.For example, go to the library and give the opportunity to choose at that happy time when the child is still interested in everything, when for him books are part of the objective world that is interesting to learn. This happens in 3-5 years. It is necessary to make sure that he sees as many interesting books as possible, that he finds himself in a surplus book environment (libraries, good bookstores, exhibitions), so that he and his mother gather together the home library. So that he has an experience of choice, an experience of evaluation: he likes it, it does not like it, to be supported in this.Then there is a chance that at his next stage, gradually separating from you, he will acquire more independence and will designate this independence with books. But you need to remember that even then you will have to respect his choice. And this is not easy.

But this is not always the case, as you say?

Yes, it is difficult. There may be failures: any child can say: “I don’t want to read, I’m not interested,” because, for example, it is more important for him to “learn” something with his hands. There are children who are immune to complex imagery, and that’s okay.I have three children and they are different. Do my children read? Yes. Because they live in conditions of book redundancy and a constant search for new interesting books; I try to be sensitive to the child’s needs, try to guess what is interesting to him.

Today my daughter was left alone – she got sick. I brought her three different books and gave a description of each. She showed that there are many books and they are different: this one is older, and this one she can easily read now, and this one is just for a good mood. In this way, I give her signals by which she can try to feel herself: is she ready to read something serious or just wants to have fun? You need to understand that we read in very different ways, sometimes we read to kill time, and this is also normal, so I teach my children to take a book on the road.Yes, this is my function – to remind me to take books with me or grab something myself that I can give them on the road when they get bored. And yes, I select books for each of them specifically – according to their character, mood, and momentary needs.

That is, you need to catch the signals of children?

Of course. You need to be very sensitive to their needs. And in no case use the argument: “I liked it at your age.” This is insulting and demeaning. Especially if it’s a tough grandfather who says so to his grandson.The child understands the implication: “I was better than you.” Naturally, this cannot cause anything but rejection and resentment in a person of 7-10 years old.

Okay, but if we imagine that the 3-5 years stage that you mentioned is skipped? And when a child is already 12 years old, he does not read, at school everything is also lost, what to do?

First move (if it is available to you): we go to a very cozy reading place with the child and look for what might be interesting there. We go to a book festival, to an attractive library or shop.Next, you need to be puzzled which books may be of interest to your child. Like algebra in comics? Yes, yes, it may not be “The Captain’s Daughter” at all. We must be demand-driven. You can also look for someone to help. This may be the head of a theatrical, historical club – children very often begin to read when they get into an environment where it is customary. You can also just sign up for a library and ask your child to pick up an interesting book. If you failed to get carried away with books, this does not mean that the child cannot get carried away with them at all.

Is there a compulsory reading for a child of a certain age? What books can you recommend?

There are texts, images, plots around which popular culture revolves: “Winnie the Pooh”, “Alice in Wonderland”, “Peter Pan”, “The Little Prince”. This is a set of works, knowledge of which will allow you to evaluate, for example, the difference between the director’s variation of a film or play and the original text.

I sometimes advise parents or give private lessons in literature and language, and so, once I gave my student a wimmelbuch.This is a large drawing book, in which there is a lot of everything: for example, the life of a city street is depicted in the smallest detail. In this wimmelbuch, plots and heroes of fairy tales were mixed, and I asked to show who was drawn here. It turned out that the child had never heard half of these tales. My mom and I had to put together a reading list that we called “classic” to fill the gap. A person has a big life ahead, culture will offer him new films, books, starting from “eternal images”: name heroes, refer to plots.Therefore, we decided that we should read both “Little Red Riding Hood” and Andersen.

How necessary this reading is, I do not know. In the case I described, this was important for my mother, so a list appeared, that is, the ability to select works and read. There was no obligation for the student on this list. Therefore, returning to your question, I can only assume what would be more convenient for the child to read before school, and what later. So, for my children, I often made a list of what we will not read for now, so that they will read it on their own a little later.

If your children were to ask: “Mom, why read?”, What would you answer?

They often ask that. And this is a difficult question: in fact, I am not saying anything at this moment, because I cannot say why they should read. My middle son and I often argue about how much computer should be in his life and what he can do on it. Why is reading a book better than playing a computer game? From my point of view, reading is an opportunity to be in the rhythm that you yourself will set.This is an opportunity to be a subject, because a film, a computer game, and partly music (less, but also) “rule” us. Reading is a private process, in which everything depends on the reader.

And if the parents themselves do not read, can a child love to read? Does your own example work here?

May. And, perhaps, this is the most important thing to know about reading for teachers, librarians – those who, on duty, provide this opportunity to people. The phrase “everything comes from the family” is very dangerous – it means that we refuse to trust and help each other.Every child’s reading ability must be ensured.