What Is A Normal Hemoglobin A1C Level?

If you are living with diabetes, managing your A1c levels is critical to staying healthy and reducing your risk for diabetes-related complications. What is a normal A1c level, and how can you effectively lower it to an a1c normal range? Knowing the answers to these questions and where to find an A1c test can empower you to manage and improve your condition.

What is hemoglobin?

Hemoglobin is a protein in red blood cells that transports oxygen from your lungs to the rest of your body, including cells and organs. According to the National Institutes of Health (NIH), hemoglobin levels that fall outside of the normal range could indicate that you have a blood disorder. However, in the context of diabetes, doctors evaluate hemoglobin differently to help you manage your blood sugar levels.

Glucose (sugar) binds to hemoglobin in blood cells. If too much glucose is binding to hemoglobin in your blood cells, this may indicate you have either prediabetes, diabetes, or that your diabetes is not being properly managed.

A test called the hemoglobin A1c (HbA1c) test, or the A1c test for short, measures the amount of glucose that binds to hemoglobin. The NIH states that your doctor may have you take an A1c test regularly to determine whether you have normal A1c levels or whether it’s time to change your current diabetes treatment plan.

How the test works

According to the NIH, the A1c test is performed as a blood test. During the test, your doctor or a lab technician will draw a small sample of blood from a vein in your arm using a small, fine needle. Your blood will be drawn into one or more test tubes or vials, which are then sent to the lab for analysis.

Results from the A1c test reveal what the average amount of glucose attached to hemoglobin has been over the last 90 days. According to the NIH, the test uses a 90-day average because 90 days is the typical lifespan of a red blood cell.

After your results are ready, your doctor will review them and contact you to discuss your A1c levels in more detail. The NIH reports that the A1c test is most commonly used to diagnose prediabetes and diabetes and to determine whether your treatment plan needs to be changed if you are already living with diabetes.

A1c/average blood sugar chart

A1c test results come out as percentages. According to the NIH, normal A1c levels are at or below 5.7%. An A1c level between 5.7% and 6.4% may indicate prediabetes, and an A1c level of 6.5% or higher may indicate diabetes. For example, if hemoglobin A1c 5.9% is your percentage, your doctor may diagnose you with prediabetes.

The NIH adds that your A1c level should be kept below 7% if you have diabetes. Your doctor will work closely with you to reduce your A1c to normal levels if they are too high and may recommend eating healthier foods and exercising regularly to help regulate your blood sugar.

Ways to lower your A1c

You can reduce your A1c and achieve normal A1c levels. The NIH recommends practicing a series of healthy lifestyle behaviors to lower your A1c, including eating healthy foods, staying active, and using your diabetes medication responsibly and as directed.

Your doctor can help you develop a healthy diabetes meal plan that can reduce your blood sugar levels. Eat a higher amount of fruits, vegetables, whole grains, and a lower amount of sugar, salt, and saturated and trans fats. The NIH also recommends drinking more water, as many sodas and fruit juices are prone to containing high amounts of sugar.

Exercise can naturally reduce your blood sugar levels and regulate other hormones, including those related to stress. The NIH advises to start slow by taking 10-minute walks three times a day, gradually working your way up to higher intensity exercises.

Other steps you can take to lower your A1c, according to the NIH, include quitting smoking, reducing your alcohol intake, and managing your blood pressure level. Your doctor may provide you with other ways to lower your A1c based on your lifestyle and personal health situation.

How often do you need the test?

You should take an A1c lab test as often as your doctor recommends, which is based on factors including your age and whether or not you currently have diabetes.

The CDC recommends taking an A1c lab test two times a year if you are currently living with diabetes.

If you are over the age of 45, meet diabetes risk factors, or have ever been diagnosed with gestational diabetes, the CDC recommends getting an A1c test every three years.

If results from the A1c test show you have prediabetes, your doctor may recommend having the test every one to two years. Ask your doctor how often you should have the A1c test based on previous A1c results and medical history.

Frequently asked questions

• What is a normal hemoglobin A1c level?

  A normal hemoglobin A1c level is at or below 5.7%, according to the NIH. However, it’s important to have your A1c checked regularly if you have diabetes or have been diagnosed with prediabetes or gestational diabetes.

• How often do you need an A1c test?

  The CDC recommends having an A1c test twice a year if you have diabetes, or every three years if you meet diabetes risk factors, are over the age of 45, or have ever been diagnosed with gestational diabetes. If previous A1c test results show you have prediabetes, your doctor may recommend repeating the test every one or two years.

• Where can I get an A1c test?

  A1c tests are available from many healthcare providers including hospitals, urgent care centers, walk-in clinics, and general physicians. This lab test is also available from providers that specialize in various lab testing, including COVID testing.

  One of the easiest ways to find an A1c test provider is to use Solv. Solv can provide you with a list of highly-rated healthcare facilities in your area that offer the A1c test. Use Solv to find an A1c test provider, then book a same-day or next-day appointment directly from the website. Solv is devoted to connecting families with convenient, hassle-free healthcare services.

Written by Michael Barber|Nov 08, 2021

Michael is an experienced healthcare marketer and father of two. He has worked alongside healthcare leaders at Johns Hopkins, Cleveland Clinic, St. Luke’s, Baylor Scott and White, HCA, and many more, and currently leads growth marketing at Solv.

Medically reviewed by Dr. Rob Rohatsch, MD|Updated on Apr 28, 2022

Dr. Rob Rohatsch currently serves as Chief Medical Officer for Solv Health. Dr. Rohatsch brings his extensive background in multi-site ambulatory medicine operations, on-demand healthcare, and consumerism to Solv, where he helps drive strategic initiatives in a cross functional executive role. He brings comprehensive healthcare expertise ranging from medical group operations to revenue cycle management and clinical expertise. 

Dr. Rohatsch completed his military service in the US Air Force and earned his MD from Jefferson Medical College of Thomas Jefferson University. Dr. Rohatsch served on the Yale School of Medicine faculty teaching at the medical school and is currently on faculty at the Haslam School of Business at the University of Tennessee teaching in the Executive MBA Program. He also serves on several boards and chairs The TJ Lobraico Foundation.

• Hemoglobin Test (July 31, 2020)
  https://medlineplus.gov/lab-tests/hemoglobin-test/
• The A1C Test & Diabetes (April 2018)
  https://www.niddk.nih.gov/health-information/diagnostic-tests/a1c-test#different
• Hemoglobin A1C (HbA1c) Test (September 15, 2021)
  https://medlineplus.gov/lab-tests/hemoglobin-a1c-hba1c-test/
• 4 Steps to Manage Your Diabetes for Life (January 2016)
  https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/4-steps
• All About Your A1C (August 10, 2021)
  https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a1c.html

• A1C Test
• blood test
• lab testing
• diabetes
• diet
• nutrition

What are the Normal Hemoglobin A1c Levels?

Many people have diabetes globally. The American Diabetes Association has recommended glycated hemoglobin (HbA1c) as a diagnostic test for diabetes. It is considered a reliable measure of blood sugar as it reflects the cumulative glycemic history of the past two to three months.

Hemoglobin is the iron-containing molecule within the red blood cells. They are responsible for carrying oxygen to the body tissues. A small percentage of hemoglobin gets attached to sugar or glucose molecules; this type of hemoglobin molecule is known as hemoglobin A1c. This hemoglobin A1c depends on the blood glucose levels; the highe the glucose level, the higher the A1c molecules in the blood. 

This article helps you to understand more about the hemoglobin A1c test, normal A1c levels, and more. 

What is Hemoglobin A1c? 

Hemoglobin protein molecules are present inside red blood cells; it helps to carry oxygen to the cells of your body. When sugar enters your bloodstream, it gets attached to the hemoglobin in your red blood cells. Everybody has glucose molecules attached to the hemoglobin, but people with diabetes have more such molecules. Hence hemoglobin gets glycosylated, and it is known as hemoglobin A1c or HbA1c (1).

Hemoglobin A1c can help to measure blood glucose levels. If a person’s blood glucose level is higher, then he will have more hemoglobin A1c molecules. As red blood cells live for an average of 3 months these glucose molecules reflect in the bloodstream for about 2 to 3months. 

A blood test can measure the amount of hemoglobin A1c in the blood. This test shows the person’s average blood sugar levels for 2 to 3 months before the test; hence, this test would help the physician understand how well a person’s diabetes is being controlled. 

What is an A1c Test?

Usually, people with diabetes depend on urine tests or daily finger-prick tests to measure their blood sugar levels. Although this test is accurate, it would be momentary. This is because your blood glucose keeps changing based on your diet, physical activity, and hormonal changes. For example, your blood sugar would be high in the middle of the night, and you will be unaware of it. 

The A1c test was available from the 1980s and is playing a vital role in monitoring diabetes and in helping to control it. A1c measures the average blood glucose for 2- 3months, so it helps to track if you have a high fasting blood glucose or after food blood glucose, even when your overall blood glucose is normal (2).

A1c test is the most recommended test for pre-diabetics and diabetics because it doesn’t require fasting, and this test can be done any time as a part of overall blood screening. It is also known as the HbA1c test, hemoglobin test, glycohemoglobin test, or glycated hemoglobin test (3).

Who Should Get an A1C test?

A1c test is recommended :

 1. To diagnose prediabetes

If you have prediabetes, regular monitoring of your glucose level is essential because you are at high risk of developing diabetes and cardiovascular diseases.

 2. To diagnose type 1 and type 2 diabetes

Your doctor may recommend an A1c test if you have type 1 or 2 diabetes; it is advised to monitor the average blood glucose levels. 

The initial test results of A1C will act as a baseline for the treatment plan; the subsequent or the regular A1C test helps to monitor your diabetes progress and review the treatment plan.  

Your healthcare provider can recommend A1C tests based on the type of diabetes, your treatment plan, how well your blood glucose level is controlled and maintained. For example, your healthcare provider may suggest A1C test : 

• Once every year for  prediabetes patients 
• Twice a year for type 1 and 2 diabetes if your blood sugar level is consistently within the target range
• Four times a year for patients under the administration of insulin;  if their blood sugar levels are varying abruptly or not in the target range
• If there is any change in your diabetes treatment plan or planning new medications
• If you are aged 45 and above, even if your results are normal. If you have any risk factors or if you have gestational diabetes then repeat the A1C test every 3 years (4)

How Is Hemoglobin A1c Measured?

The hemoglobin A1c test depends on the chemical charge on the molecule; because  HbA1c has a charge that differs from the charge on the other hemoglobin molecules.   The HbA1C molecule also differs in size from the other components.

When you give your blood sample for analysis, HPLC (High-pressure liquid chromatography) is performed to separate the HbA1C molecules from normal hemoglobin molecules based on charge and size (5).

The advantage of the HbA1C test is that it is not affected by short-term fluctuations in blood glucose concentrations, for example, due to diet, and hence you can have blood anytime. Fasting for the blood test is not necessary for the HbA1c test. 

What Are Normal Levels of Hemoglobin A1c (Chart)?

The HbA1C levels are less than 5.7% of total hemoglobin in healthy individuals. A level of 6.5% of total hemoglobin implies that diabetes is present. Many studies suggest that if you maintain the blood glucose levels below 7%, it can reduce the risk associated with diabetes and can be delayed or prevented.

Chart for normal diabetes and prediabetes HbA1C levels.

	HbA1C levels
Normal	Below 5. 7%
Prediabetes	5.7% to 6.4%
Diabetes	6.5% or above

 HbA1c chart

There are no guidelines to use hemoglobin A1c test levels as a screening tool. However, it helps the physician and healthcare providers to get a good idea of a patient’s diabetic graph. 

The table explains to you the average blood glucose and A1c levels:

According to the American Diabetes Association, your HbA1c levels should be less than 7. 0%, whereas the American Association of Clinical Endocrinologists suggests that it should be less than 6.5%. In 2016, the ADA advised that if your A1c level is 6.5% and above then you are diagnosed with diabetes (6).

Experts suggest that there is a 10% decrease in the microvascular complications for every 1% decrease in A1c levels. Hence it is crucial to monitor your HbA1c levels. 

What Can Affect Your A1C Results?

You can get an A1C test done additionally to the regular blood sugar self-test if you already have diabetes, but you cannot rely only on the A1c test because several factors influence increase or decrease levels in A1c.

If you have any chronic kidney disorders, anemia, blood loss, blood transfusion, early or late pregnancy, and liver problems, your A1c values will increase and give us a false result. If you have sickle cell anemia, chronic blood loss, or thalassemia, it will decrease your A1C levels. 

When Should Hemoglobin A1c Levels be Tested?

In addition to the random fasting blood glucose levels, HbA1c levels monitoring is advised for type 1 and type 2 diabetes people. Higher the concentration of the HbA1c levels, the higher the blood glucose concentration. Your healthcare provider may suggest taking an HbA1c test to analyze your diet, exercise, and drug therapy on blood glucose with diabetes people. 

How can HbA1c Help to Prevent or Control Diabetes? 

The following tips may help you maintain your HbA1c levels and prevent diabetes in pre-diabetes. It helps to control type 1 and type 2 diabetes by;

• following the right diet,
• physical activity such as exercise, yoga,
• medications,
• And a combination of these

A normal or slight elevation in the HbA1c levels is a clear indication that your blood glucose level is under control. If your HbA1c increases despite your dietary plans and treatment, you must seek medical help. Your healthcare provider may suggest changing your treatment plan. 

Final Words 

Tracking your HbA1c levels helps you and your healthcare provider determine how well you can control your blood sugar levels over time. Although this cannot substitute your daily glucose monitoring methods,  it helps you track your blood glucose levels for an average of 3 months. HbA1c test is a valuable tool that can help fight against diabetes and other blood glucose-related disorders. 

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C give an analysis of Glycosylated hemoglobin (HbA1c), the price of Glycosylated hemoglobin (HbA1c) in MEDIX LAB Ivanovo.

Description

Glycosylated or glycated hemoglobin is an indicator that allows you to estimate the average amount of glucose in the blood over the past 2-3 months.
There are several types of normal hemoglobin, and many abnormal varieties have been identified, although the predominant form is hemoglobin A, which is 95-98% of total hemoglobin. Hemoglobin A is divided into several components, one of which is A1c. Part of the glucose circulating in the blood spontaneously binds to hemoglobin, forming the so-called glycated hemoglobin. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Having combined with hemoglobin, glucose remains “in conjunction” with it until the very end of the life of the erythrocyte, that is, 120 days. The combination of glucose with hemoglobin A is called HbA1c or A1c. Glycated hemoglobin is formed in the blood and disappears from it every day, as old red blood cells die, and young (not yet glycated) take their place.
Three forms of glycated hemoglobin are known:
HbA1a
HbA1b
HbA1c
Glycated hemoglobin is the last form, HbA1c, formed in the largest quantities. The higher the concentration of glucose in the blood, the more HbA1c is formed. Thus, the HbA1c indicator makes it possible to adequately assess the degree of diabetes mellitus (DM), its course and control.
After the formation of glycosylated hemoglobin, it remains in erythrocytes throughout the life of red blood cells, which is approximately 120 days. Therefore, by determining the level of HbA1c, it seems possible to estimate the amount of glucose in the blood throughout the life of erythrocytes.

Synonyms

Glycosylated Hemoglobin, Biochemistry, Glycosylated Hemoglobin, Glycohemoglobin, Glycated Hemoglobin, GHB, Fast Hemoglobins

Indications

blood levels as close to normal as possible important. This helps to minimize complications to the kidneys, eyes, cardiovascular and nervous systems.
To determine the patient’s average blood glucose over the last few months.
To confirm the correctness of the measures taken for the treatment of diabetes and to find out if they need to be adjusted.
To determine in patients with newly diagnosed diabetes mellitus uncontrolled rises in blood glucose. Moreover, the test may be prescribed several times until the desired glucose level is detected, then it needs to be repeated several times a year to make sure that the normal level is maintained.
For preventive purposes, to diagnose diabetes at an early stage.

Deadline

1 day. The specified period does not include the day of taking the biomaterial.

Type of biomaterial and collection methods

Blood

In the center

at home

On one’s own

“Children under the age of 1 year should not eat for 30-40 minutes before the test.
Children aged 1 to 5 years do not eat for 2-3 hours before the study.