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A1C: One of the Most Important Tests You Should Do

The hemoglobin A1C test, or simply A1C test, is a common laboratory investigation done to determine if you are diabetic or not. It is also an important test diabetics undergo to monitor how well they’re managing their diabetes.

In diabetes, the body loses its ability to regulate sugar, and this occurs in two ways. In type 1 diabetes, the body does not produce enough insulin – a hormone that regulates blood sugar levels – so blood sugar rises abnormally. In type 2 diabetes, the body may produce adequate amounts of insulin, but the body is insensitive to its effects. In both types of diabetes, therefore, blood sugar levels increase unrestrained, causing damage to nearly all tissues and organs of the body.  The A1C test gives an accurate measure of your blood sugar levels.

The A1C test measures your average blood sugar level over the last three months, giving a more accurate impression of how your body regulates sugar. More specifically, the A1C test – also known as glycated hemoglobin or glycosylated hemoglobin – measures the proportion of hemoglobin, the blood’s oxygen-carrying molecule, that is coated with sugar. The higher this percentage, the poorer your blood sugar control.

Why is A1C Done?

Your hemoglobin A1C results helps in three ways: it helps to identify prediabetes, diagnose diabetes, and monitor diabetes treatment progress.


AIC should be checked in persons who are older than 40 years and are overweight, obese, or have other risk factors for diabetes. Normal A1C level is below 5.7 percent. If your result shows any value below this, it means your body regulates sugar optimally, while a value between 5.7 and 6.4 percent suggests that you may be on the verge of developing diabetes. This range is called prediabetes or impaired glucose tolerance.

In prediabetes, your body still regulates sugar, but not optimally. Consequently, blood sugar may be elevated, but not as much as in diabetes. If you have prediabetes, you also have a high risk of developing heart disease and other complications of diabetes. People with prediabetes need to work to get their AIC under 5.7 to avoid deteriorating to full blown diabetes.

Diagnose Diabetes

Hemoglobin A1C diagnoses both types 1 and 2 diabetes and is detected with elevated readings on two different occasions. If you have an A1C level of 6.5 percent or greater on both checks, you have diabetes. If your A1C level is above 8, it means you have poorly-controlled diabetes and may be at a higher risk of complications.

Monitor Treatment Response

If you have diabetes, your doctor could order routine A1C tests to monitor how well your body is responding to treatment. Since the A1C test indicates the blood sugar level in the last three months, it gives an accurate measure of how well your body has been regulating sugar.

Your doctor may set lower or higher A1C targets for you depending on your baseline A1C level, your medications, and other factors such as co-existing diseases.  If your A1C is higher than the recommended target, your doctor may need to increase your dosage or change your medications.

How Often Should I do A1C Test?

How often you should do this test depends on if you have prediabetes or not, and also on the type of diabetes you have:

  • Do the A1C test annually if you have prediabetes.
  • Do the test twice a year if you have type 2 diabetes and four times a year if you have type 1 diabetes. This is because if you have type 1 diabetes, your doctor may place you on the drug, insulin, to help control your blood sugar, and this drug has a potential to cause your blood sugar to drop to dangerously low levels. Frequent monitoring of A1C levels is important to titrate the dosage of the drug and to determine when to discontinue it.
  • Do the test four times a year also if you have type 2 diabetes and use insulin or if your blood sugar has been difficult to control.
  • More frequent checks may be necessary if your doctor changes your diabetes treatment plan or adds a new medication to your treatment.
  • If you do not have prediabetes or diabetes, your doctor can advise you on how often to get tested.