For many with diabetes the focus is usually on what the sugar value is, but for the physician the focus is on control. Controlling your diabetes and optimizing sugar levels is the best way to prevent developing complications from diabetes which can affect every organ system in the body. And although it may be important to check your sugars daily to know what your sugar levels are, this one-time snapshot value may not prevent an adequate representation of your overall diabetes control.
The A1c (or hemoglobin A1c) is a blood test you may be familiar with if you have diabetes. This simple test gives a broad picture of your average blood sugar levels over the past three months. Commonly used to diagnose prediabetes and diabetes, it is the main test your physician will use to manage your diabetes. In simplest terms the A1c is a measure of how much sugar is attached to hemoglobin, a protein in your red blood cells. The more sugar present in your blood stream on average, the higher the percentage of your red blood cells that have sugar-coated hemoglobin. Once sugar is attached to hemoglobin, it is permanent for the lifespan of the red blood cell which is about three months, thus giving a true representation of how high sugars have been on average during that time compared to a one-time sugar value which may be high or low depending on timing around meals when it was checked.
So, what do the numbers mean? Generally speaking, the higher the A1c value the more uncontrolled the diabetes, and thus the greater the risk of developing diabetes related complications. Everybody has some sugar attached to hemoglobin, but people with diabetes just have more. A normal A1c value is less than 5.7%, but if your level is greater this is a red flag that measures should be taken to improve your sugars and health. Prediabetes has an A1c range of 5.7% to 6.4%, and diabetes is diagnosed once your A1c is 6.5% or greater. Once diabetes is diagnosed the goal is to get the A1c value back down to an acceptable level. Although there is no one-size-fits all target since the goal A1c level can vary depending on age and other factors, but for most adults the goal is to maintain an A1c less than 7%.
Diabetes is a chronic condition that takes life-long efforts to manage. Checking an A1c is a way to monitor the progress, and hopefully improvement, of your diabetes. If your A1c is elevated, the best way to lower it is by effectively managing your sugars with a healthy diet, exercise, and maintain a healthy weight if overweight or obese. Also, regularly taking medications as prescribed by your doctor is very important to the management of your sugars. Diabetes that is not well managed results in complications that can be debilitating. So don’t let diabetes have control over you and speak to your doctor about your A1c to take control back.
Dr. Santos is a board certified Family Physician faculty member who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.