How to Understand Your A1C Levels

October 10,2022 |
Woman getting an a1c test taken.

Diabetes is a common condition that affects adults of all ages. In fact, as of the start of 2022, there are about 1 in 10 Americans currently living with diabetes and 1 in 3 people with prediabetes. If you’re one of the individuals affected by this condition, you understand how important it is to take care of your health and keep track of your blood sugar levels. However, one thing that can continue to confuse people is the A1C test. This can also be referred to as the hemoglobin A1C, glycated hemoglobin, glycohemoglobin, or HbA1c test. Although the process is simple, analyzing the results can leave you feeling a little lost. To provide you with all of the tools you need to properly manage your diabetes and adjust your lifestyle, this article will explore how to understand your A1C levels.


What is an A1C Test?

When you eat something that contains sugar, the food travels through your digestive system, where nutrients enter the bloodstream. The sugar from food attaches to a protein in your red blood cells called hemoglobin. This is a normal process in any individual, regardless of if they have diabetes or not. Therefore, everyone will have some degree of sugar-coated hemoglobin floating throughout their veins and arteries. Those who have higher blood sugar levels will have more sugar-coated hemoglobin than individuals with low blood sugar levels.

An A1C test is a type of blood test that’s done to measure an individual’s average blood glucose level over the previous three months. This is done by determining what percentage of red blood cells throughout your body contain hemoglobin that’s coated with sugar. The higher the percentage, the higher your average blood sugar concentration.


Why A1C Tests Are Administered

There are several reasons your doctor may schedule an A1C test during your routine health check-ups. If you have recently had a major life change, have been diagnosed with diabetes, or show symptoms of prediabetes, an A1C test can provide your doctor with more information about your current blood sugar levels and risk of complications. Your doctor may also recommend a baseline A1C test once you turn 45, sooner if you’re overweight or have one or more risk factors for diabetes.


The A1C test is particularly helpful when diagnosing prediabetes or diabetes. It can be used either on its own or in conjunction with other types of diabetes tests. This should be done regularly if your doctor has diagnosed you with prediabetes, or if you show symptoms of prediabetes, have risk factors of diabetes, or have cardiovascular disease. It can also be done to confirm a diabetes diagnosis. While more commonly used for type 2 diabetes diagnoses (as it tends to occur later in life), the A1C test is also used in diagnosing type 1 diabetes. To confirm this diagnosis, your doctor will administer two separate blood tests on two different days. These may both be an A1C test or one A1C and one other diagnostic blood test such as fasting or a random blood sugar test.


For individuals living with diabetes, A1C tests are used to help monitor your treatment plan and adjust diabetes management techniques. This gives you better insight regarding what’s working and what should be further amended.

You don’t need to do anything to prepare for an A1C test. It’s done by obtaining blood work from a lab. If you are getting other tests done at the same time, your doctor may provide you with more information on what’s needed for accurate readings.


When to Get an A1C Test

The timing of your A1C test will depend on your symptoms or doctor’s treatment plans. If you have prediabetes, your doctor will likely recommend undergoing an A1C test at least once every year to keep an eye on any changes. If your blood sugar level is consistently within your target range and you don’t use insulin, an A1C test should be done twice a year. If you do take insulin and tend to struggle with keeping blood sugar stable, your doctor may recommend coming in for an A1C test up to four times a year, or every three months. Higher frequencies may also be utilized as part of a treatment-monitoring plan put forth by your doctor.


A1C Results and What They Mean

When you receive your A1C results, they’ll most often be in the form of a percentage. There are three different tiers that will tell you what your numbers mean:

  • Normal A1C levels will be below 5.7%
  • A1C levels that indicate prediabetes fall between 5.7% and 6.4%

A1C levels diagnosing diabetes are above 6.5%


If your results are in the prediabetes range, it’s important to pay special attention to the number. The closer the A1C level is to 6.4%, the greater your risk of developing diabetes over the coming years.

In some situations, you may find that your A1C results are expressed as something called “estimated average glucose” or eAG for short. This is more commonly used for individuals who have already been diagnosed with diabetes and the eAG readings will resemble what you see on your blood glucose monitors at home. However, the eAG readings from an A1C test will represent your average blood glucose levels over the past three months, so it’s likely to be different from your most recent reading. The higher the number, the greater the A1C percent. You can see how the numbers coincide in the chart below:

A1C (%)

eAG (mg/dl)




















For healthy diabetes management, it’s important to try to keep your A1C levels under 7%. This is the best way to help reduce your risk for developing diabetes-related complications throughout the course of your life. If you receive results that are greater than 7%, your doctor will talk to you about making adjustments in your current diabetes management plan. Creating consistent, healthy lifestyles while continuing to check your blood sugar levels is one of the most important ways to support your longevity.

When provided with your eAG in addition to A1C percentage, you’ll gain a better understanding of self-monitoring at home. This allows you to keep track of your daily average blood sugar levels and make short-term adjustments as necessary, which will eventually translate into long-term results. If you have any questions or concerns regarding your A1C results or eAG number, talk to your doctor.


Limitations of the A1C Test

As with many tests, there are a few things that can interfere with the overall accuracy of the A1C reading. Some factors may increase levels, while others create a substantial decrease in your normal A1C output. Some of the most impactful instances include:

  • Recent blood loss
  • Heavy blood loss
  • Anemias
  • Recent blood transfusion
  • Hemoglobin variants
  • Pregnancy
  • Certain medications


Additional tests will be recommended by your doctor if you experience one or more of the factors above. Women who are pregnant may undergo an A1C test in addition to further testing to check for gestational diabetes.

The A1C test is only one part of the toolkit available for effectively managing your diabetes. However, A1C levels can provide you with some valuable insight on how you’re managing your diabetes and what changes need to be made. Remember, before you start a new eating plan or exercise regimen, always talk to your doctor. It’s important that you continue to get the nutrients you need to support healthy functioning, so fad diets or extremes should be avoided. Remember, managing your diabetes is always the most important task at hand and your A1C test should never replace regular monitoring of your blood glucose levels. To help simplify diabetes management and reduce your risks of serious complications, Byram Healthcare has a range of continuous blood glucose monitors. We also offer diabetes support and educational materials to give you everything you need for comprehensive care.