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Average blood glucose and the A1C test

The A1C test (also known as HbA1C or glycated hemoglobin) provides a good general indication of diabetes control. It is used to indicate a person’s average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you test blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target recommended by the American Diabetes Association (ADA).2

A1C calculator*

The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C result. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management.

See how average daily blood sugar may correlate to A1C levels.1 Enter your average blood sugar reading and click Calculate.

Average Blood Sugar
(from 100-300 mg/dL)

Calculate
 

A1C

Please use a number between 100 and 300.

Please use a number between 5 and 12.

*Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes.

What is A1C?

Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a sample of hemoglobin A1C cells—a specific component of your red blood cells. This important clinical laboratory test gives you and your doctor a look at your long-term blood sugar control.

Here's how it works. Some blood sugar (or glucose) naturally attaches itself to A1C cells as they move through your bloodstream. When this happens, the cell is considered "glycated." The more sugar in your blood, the higher the percentage of glycated A1C cells you'll have.3

Once a cell has been glycated, it stays that way. And since each A1C cell has a lifespan of about 4 months, your A1C sample will include cells that are a few days, a few weeks and a few months old. As a result, the test covers a span of about 2 to 3 months.

Self-monitoring and A1C

As important as the A1C is, however, it's not a substitute for frequent self-monitoring. Only regular blood sugar checks show you how meals, activity, medications and stress affect your blood sugar at a single moment in time, as well as over the course of a day or week.

In fact, without regular self-testing to provide day-to-day insights, an A1C result can be confusing. Because it gives a long-term view, a person with frequent highs and lows could have an in-range A1C result that looks quite healthy.2 The only way to get a complete picture of your blood sugar control is by reviewing your day-to-day self-checks along with your regular A1C tests, and working closely with your healthcare team to interpret the results.

How often do I need an A1C test?

This calculator only estimates how the A1C of someone who self-monitors quite frequently might correlate with their average meter readings. But many factors can affect blood glucose, so it's critical to have your A1C checked by your doctor regularly.

The ADA recommends an A1C test at least 2 times a year for those who are in good control. For those who have changed their therapy or who are not in good control and not meeting glycemic goals, an A1C test is recommended quarterly. Your doctor will help you decide what's right for you.2

To learn more about your A1C, visit the ADA Web site.

Using your blood glucose test results

A1C test goals

1 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. Available at http://care.diabetesjournals.org/content/31/8/1473.full.pdf. Accessed September 5, 2014.
2 American Diabetes Association. Standards of medical care in diabetes—2014 [position statement]. Diabetes Care. 2014;37(1): S14-S80. Available at: http://care.diabetesjournals.org/content/37/Supplement_1/S14.full.pdf+html. Accessed September 9, 2014.
3 American Diabetes Association. A1C and eAG. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/. Accessed September 5, 2014.

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The long-term measure of blood sugar control. The A1C test measures how many A1C hemoglobin cells (a specific part of red blood cells) have sugar attached to them. Because these cells live for about four months, this gives a picture of how well blood sugar has been controlled for the past few months. The American Diabetes Association recommends an A1C result of 7% or less to help reduce the risk of long-term complications of diabetes.*

 

*American Diabetes Association. Standards of medical care in diabetes–2011 [position statement]. Diabetes Care. 2011;34(1):S11-S61. Available at: http://care.
diabetesjournals.org/content/34/Supplement_1/S11.full Accessed November 15, 2011.