With Type 2 diabetes, the A1C test is your litmus test. Not only does it give you a snapshot of how you’re doing, but it can serve as a wake-up call.
I can recall a doctor telling me about one of his patients who got very angry with him over an A1C test. It turned out that this patient only tested his fasting blood sugar in the morning and his blood sugar was usually OK. So the patient was very upset with his A1C test results and argued that the results were wrong.
But what the A1C test uncovered was that his blood sugar was consistently high throughout the day after meals. Very high. And since he didn’t test his blood sugar after meals he would have never known.
So he was being misled by the fasting blood sugar levels. And the A1C test showed that his blood sugar was averaging very high over a 3 month period.
An A1C test is important for several reasons. But the main two reasons in my opinion:
- It tells you if your current treatment is working. If your current treatment is working your doctor will usually tell you to do more of the same. But if things aren’t working, it may be time to make some changes.
- It tells you if diabetes is progressing. If diabetes is progressing, usually your A1C will start to increase. And sometimes this can be disheartening. There are several ways to stop diabetes in its tracks. And as it progresses this is a crucial time period. Aggressive action is usually necessary to improve beta cell function and reduce insulin resistance.
Most doctors will test at least twice per year. And it probably isn’t a bad idea to test on your own at home every 3 months.
The A1C Test Explained
The A1C, HBA1C test, or in clinical terms the hemoglobin A1C measures glycosolated hemoglobin which is high when your blood sugar is high. What this means is it measures the amount of hemoglobin that attaches to blood glucose to form hemoglobin A1C.
Let me explain. Red blood cells live for 120 days (4 months) in circulation. And hemoglobin in the red blood cells bind to elevated blood glucose to form hemoglobin A1C in the red blood cells. For this reason, a hemoglobin A1C test may not be as accurate if you have any hemoglobin abnormalities or conditions. But other than that, it is a very effective way to track if your blood sugar is elevated in the long-term (a 2-3 month period), not really for the short term.
The American Diabetes Association recommends an A1C goal of <7%. For many this goal is too high, but their main concern is low blood sugar or hypoglycemia, which can happen with diabetes treatment that is too aggressive.
Prior to using any of this information, please consult with your physician.