In our community, many people are affected by diabetes and prediabetes, often without knowing it. One key tool we use in medicine to understand long-term blood sugar is the A1C test.
The A1C test, also called the hemoglobin A1C or HbA1c test, is a simple blood test that measures your average blood sugar (glucose) over the past 2–3 months. Unlike checking your blood sugar at home, which tells you how levels are at that moment, the A1C gives a fuller picture of your blood sugar trends over time. This is because glucose sticks to hemoglobin, a protein in red blood cells, and those cells live about three months. The test reports the percentage of hemoglobin coated with sugar; the higher the percentage, the higher the average blood sugar.
The A1C test is used in several important ways. First, it helps detect risk early. An A1C level between 5.7 percent and 6.4 percent suggests prediabetes, meaning blood sugar levels are higher than normal and there is an increased risk of developing type 2 diabetes. It is also used to diagnose diabetes. An A1C of 6.5 percent or higher on more than one occasion typically indicates diabetes is present. For people who already have diabetes, the A1C helps guide ongoing care by showing how well lifestyle choices and treatments, including medications, are controlling blood sugar over time. Many clinicians aim for an A1C goal around 7 percent or less for many nonpregnant adults, although this target is individualized based on a person’s overall health, age, and preferences.
High blood sugar over time can lead to serious complications such as heart disease, kidney problems, nerve damage, and vision loss. Regular A1C testing, about twice a year for most adults with stable diabetes, or more frequently if treatment changes, helps catch issues early and adjust care before complications develop.
The A1C test doesn’t require fasting and can be done during a routine clinic visit, making it a practical and powerful way to support your long-term health. Talk to your primary care provider about how you would benefit from testing your A1C.
Dr. Juliana Tovar is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501(c)(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.