Understanding your diabetes risk and managing the condition is all about knowing the numbers – your blood sugar numbers.
The A1C blood test measures your average blood glucose, or sugar numbers, over the past couple of months. The number gives an average snapshot of your sugar levels over a period in time rather than the results of a single day, and is a good measure of whether you have diabetes or are predisposed to it, said Dr. Adam Spitz, lead physician at Novant Health Endocrinology in Charlotte.
The numbers you need to know:
- An A1C reading of less than 5.7% is considered normal.
- 5.7% to 6.4% indicates prediabetes.
- 6.5% or higher signals diabetes.
While many people know their cholesterol, they don’t know their diabetes risk numbers. One-fourth of people with diabetes – and a majority of people with prediabetes – are unaware of it.
The advantage of the A1C compared to other methods of testing is that it requires no fasting and only a small amount of blood for the test.
“The hemoglobin A1C test provides the longer view,” Spitz said. “It’s reliable and more convenient than other blood sugar tests.”
Testing is crucial, Spitz said, because diabetes has no symptoms in the early stages.
Get the diabetes care you need
More than 1 in 3 American adults has prediabetes, the Centers for Disease Control and Prevention (CDC) reports. Another 11.6%, more than 38 million, have diabetes.
“The percentage of people could even be greater because symptoms may not appear early on,” Spitz said. “People can have blood sugar levels out of range for a long time and not realize it, during which time bad things are happening to their bodies.”
Diabetes is the eighth leading cause of death in the United States, according to the American Diabetes Association, and the condition has serious health consequences, including heart disease, blindness, kidney failure and lower limb amputation.
Many people with prediabetes will likely develop Type 2 diabetes within five years, unless they make lifestyle changes to get their weight and blood sugar under control, according to the CDC.
“Some people with prediabetes who successfully make and maintain lifestyle changes can reverse the course of their condition. In other cases, it will delay the onset of diabetes,” Spitz said.
“Weight management, losing weight and physical activity are extremely important for people managing type 2 diabetes,” Spitz said. “The American Diabetes Association recommends 150 minutes of moderate exercise a week. But that’s a tall order for folks who aren’t active."
Spitz said the most important part of exercise is just getting started. Any activity is better than no activity. Something as small as walking for 10 minutes after every meal can have an impact.
He added that patients have to be careful not just about their weight, but what they eat and carefully monitor carbohydrate intake. Learn more about that here in a story that includes a tasty recipe.
For people already diagnosed with diabetes, the A1C is an effective test for monitoring blood sugar levels, Spitz said. The American Diabetes Association recommends that patients with diabetes who are meeting treatment goals have the test twice a year. Your doctor may repeat the test more frequently until blood glucose levels reach recommended levels.
“It’s useful for following people with diabetes because it gives a better picture of glucose control over time, even at times of day when you aren't checking your blood sugar,” Spitz said.
When meeting with your doctor, the following questions are a good place to start:
- What is my A1C and what should my goal be?
- What are the signs and symptoms of high and low blood glucose?
- Do I need to make any changes to my diabetes management plan?
- What are the benefits and possible side effects of the medicine I’m taking?
- What are the possible causes of high and low blood glucose?
Patients should be their own advocates and request to be screened. Diabetes and prediabetes screening should be part of every annual physical in adults over age 45 and in younger people with risk factors.
Before seeing your doctor, learn about the risk factors such as a body mass index, or BMI, over 31, being older than 35, gestational diabetes and family history, and inform your doctor about any predisposing condition that may affect you.
