How Diabetes is Managed II
Diabetes management with hemoglobin A1C

Once diabetes has been diagnosed, the hemoglobin A1c test will be used by your health care providers, in addition to your home sugar tests, to control your diabetes. Remember, the goal is to prevent diabetes complications. (People say "hemoglobin A-one-c.")

What is hemoglobin A1C (HbA1C)?

  • Hemoglobin is in the red blood cells. It carries oxygen to every cell in the body.
  • Sugar in the blood attaches to hemoglobin and creates hemoglobin A1c.
  • The more sugar in the blood, the higher percentage of cells with hemoglobin A1c.
  • Red blood cells live for about 3 months. So the sugar you have eaten over the past three months is attached to those cells. This is how the test shows your average blood sugar for the last three month period.
Use of HbA1C
  • It is a blood test that is used up to four times a year to help persons manage their diabetes.
  • HbA1c gives an indication of the average blood sugar over the last 90 days.
  • The ideal goal is to have a Hba1c of less than 7%.
Hemoglobin A1C
  • The test for hemoglobin A1c is usually only done every 90 days.
  • The next chart compares A1c readings with average blood sugar reading.
  • For example, if your A1c is 5%, it means on the average your daily blood sugar reading for that 3-month period was around 90.

  • HbA1C and average blood sugars
    HbA1c resultAverage Blood Sugar
    5% 90
    6% 120
    7% 150
    8% 180
    9% 210
    10% 240
    11% 270
    12% 300
Which test is more important?
  • How often you check your blood glucose varies for each individual.
  • If your A1c is low, you must be in good control.
  • If your A1c is high, the results from your fasting blood sugars may be more important.
  • If your A1c is high, you and your health care provider know that your diabetes is not in good control and something needs to change: your diet, your physical activity or your medications. Looking at how your blood sugars fluctuate at different times of the day helps your doctor know what type of medication, what dosage and what time the medicine should be given. .
Tests can help manage diabetes
  • If you have diabetes, your goals should be to keep the blood sugar at:
    • Fasting: at or below 80-120 mg/dl.
    • After meals: at or below 180 mg/dl.
    • Bedtime: between 100-140 mg/dl.
    • Look at the chart on the first page to see what Hba1c's these blood sugars would be.

Blood glucose and medication
  • The amounts and types of diabetes medication that are prescribed for individuals are based on these tests: Hba1c and blood sugars.
  • Your medications may change if:
    • your blood sugar gets out of control (is high).
    • your blood sugar gets too low.
    • if you are able to achieve good control and are able to keep your blood sugar in the recommended ranges.

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