Measuring Your A1C
An A1C test gives you and your provider insight into all of your blood glucose ups and downs over the past two or three months. It’s like the 24/7 video of your blood sugar levels. Observing your A1C results and your blood glucose (also known as blood sugar) results together over time are two of the key tools you and your health care provider can use to monitor your progress and revise your therapy as needed over the years.
Recent research is changing the way health professionals look at A1C levels. Instead of setting tight controls across the board, a healthy A1C level is now a moving target that depends on the patient. In the past, an A1C of 7 percent was considered a healthy goal for everyone. Yehuda Handelsman, M.D., medical director of the Metabolic Institute of America in Tarzana, California, says experts now recommend taking a patient-centered approach to managing A1C levels, which means evaluating goals based on individual diabetes management needs and personal and lifestyle preferences.
Current ADA Goals
The 2015 American Diabetes Association (ADA) Standards of Medical Care in Diabetes advise the following A1C levels:
• 6.5 percent or less: This is a more stringent goal. Health care providers might suggest this for people who can achieve this goal without experiencing a lot of hypoglycemia episodes or other negative effects of having lower blood glucose levels. This may be people who have not had diabetes for many years (short duration); people with type 2 diabetes using lifestyle changes and/or a glucose-lowering medication that doesn’t cause hypoglycemia; younger adults with many years to live healthfully; and people with no significant heart and blood vessel disease.
• 7 percent: This is a reasonable A1C goal for many adults with diabetes who are not pregnant. At this level, studies have shown that people experience fewer long-term complications such as retinopathy and nerve damage if that target can be achieved and sustained over the years.
• 7.5 percent: This is the goal recommended for all children with diabetes (0 to 18 years old). It’s important with children and their parents to balance the long-term health benefits of glucose control with the risks of hypoglycemia, especially in children younger than 6 years old who may be unable to recognize or articulate symptoms. (It is noted that a lower A1C goal of <7% is reasonable if it can be achieved without too many episodes of hypoglycemia.)
• 8 percent or less: This is considered a less stringent goal. It may be appropriate for people with a history of severe hypoglycemia; those who have had diabetes for many years and have difficulty achieving tighter control; and people who are not expected to live many more years due to one or more diabetes-related complications or other medical problems.
How Often to Get A1C Checked
The frequency of your A1C tests depends on your diabetes goals, how well you’re doing with your management, and your provider’s guidance. If you’ve been recently diagnosed; made some changes in your diabetes management, like started a new glucose-lowering medication; or had a medical problem or surgery, you may need to have a your A1C checked quarterly. However, if your glucose levels and A1C are pretty stable, you may do well having your A1C checked just twice a year. Talk to your health care provider about how frequently you should have the test and your individual goal.