Hemoglobin A1C: what's all the fuss about?

Most people who have diabetes have probably heard the term “hemoglobin A1C” (or HbA1C). Our doctors say it’s important and our parents tend to get pretty worked up about it, but here’s my question: do you know what a HbA1c is? And why it matters? No need to be embarrassed if you don’t because many people have somewhere between a vague idea to none at all.

First, what is it? According to the Mayo Clinic, your A1C result reflects your average blood sugar level for the past 2-3 months. Specifically, the A1C measures what percentage of your hemoglobin—a protein in red blood cells that carries oxygen—is coated in sugar (glycated). Many doctors use the A1C to monitor your diabetes treatment plan because the A1C is supposed to reflect how you’re doing overall. Check out the chart to see how the A1C level corresponds to the average blood sugar in milligrams per deciliter (mg/dL). 

For those who do not have diabetes, your A1C level target is below 5.7 percent. 5.7 to 6.4 indicates prediabetes, and 6.5 and above means (you guessed it!) diabetes.

Some important things to note here: Not once in this post have I used the term “test”. Thinking about diabetes in terms of a test that you pass or fail is not helpful because it can quickly bring blame and shame into the mix (and let’s face it—we’ve already got enough of that in the diabetes world). The A1C provides information. It is an indicator of whether one’s diabetes is being managed safely or unsafely. It is also important to note that there is no “one size fits all” here. For instance, one person may have a higher A1C target due to hypo-unawareness (or when a person does receive the warning signs that many of us do for when their blood sugars are dropping). Your doctor will tell you the best range for you. If he or she does not, ask! I recently heard an analogy comparing an A1C number to the amount of money in a bank account. What would you do if you walked into a bank, asked the teller how much money you have in your account, and heard, “Don’t worry, you’re fine”? The same goes for your A1C. Owning your diabetes means knowing the specifics of what’s going on in your body and understanding what is needed in order to feel healthy. The A1C lets you know if you are in a safe or unsafe place with your diabetes. Remember, this is not a judgment. Blood sugars go wacky for all kinds of reasons (being sick, stressed, depressed or just burnt out) and the A1C is information that can give you and your health care team a better idea of what needs to be addressed so that you can feel your best. If your A1C is higher than you'd like it to be but you've having trouble doing what you need to do or feeling stuck in negative thought patterns, consider reaching out. I help people rediscover hope and work through that stuckness towards a healthier, more joyful life.