Managing your blood sugar is important if you have diabetes. According to the Centers for Disease Control and Prevention (CDC), a simple blood test can measure your average blood sugar levels over the past three months, helping you keep track of this important number.

The A1C test, also known as the hemoglobin A1C or HbA1c test, measures your average blood sugar levels over the past three months. It’s one of the commonly used tests to diagnose diabetes, and it’s also the main test to help you and your healthcare team manage your condition. Higher A1C levels are linked to diabetes complications, such as heart disease, stroke, and kidney damage.

The goal for most people with diabetes is 7% or less, according to the CDC. However, your personal goal will depend on many things, such as your age and any other medical conditions. Your provider will help you set your own individual A1C goal. Be sure to get your A1C tested in addition to—not instead of—regular blood sugar self-testing.

These questions and answers help explain more about the A1C test and why it’s important to have this test at least twice a year.

What does the A1C test measure?
When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.

How often should I get an A1C test?
The CDC recommends getting an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your provider about how often is right for you.

How is the test done?
The test is done in a provider’s office or a lab using a sample of blood from a finger stick or from your arm. You don’t need to do anything special to prepare for your A1C test. However, ask your provider if other tests will be done at the same time and if you need to prepare for them.

What does my A1C result mean?
A normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your blood sugar meter:

• 7% AIC=154  eAG mg/dL
• 8% AIC=183  eAG mg/dL
• 9% AIC=212  eAG mg/dL
• 10% AIC=240 eAG mg/dL

What can affect your A1C result?
Several factors can falsely increase or decrease your A1C result, including:

• Kidney failure, liver disease, or severe anemia
• If you are of African, Mediterranean, or Southeast Asian descent 
• You have family members with sickle cell anemia or a thalassemia link 
• Certain medicines, including opioids and some HIV medications
• Blood loss or blood transfusions
• Early or late pregnancy

Let your provider know if any of these factors apply to you, and ask if you need additional tests to find out.

Get help to manage your diabetes

If you need help controlling your blood sugar or other issues related to your diabetes, ask your provider about talking with a certified diabetes educator or registered dietitian. 

You can also work with a BCBSRI Care Manager, who can help you create a care plan to better manage your diabetes. You can take advantage of our Care Management Program at no additional cost through your BCBSRI health plan.¹ You can get in touch with a Care Manager by calling 1-844-563-0892 or emailing care@bcbsri.org.

For more information on diabetes, please visit the Centers for Disease Control and Prevention.