Be aware of your A1C
The people dancing and singing in pharmaceutical commercials brag that “Drug X lowered my A1C!” This seems to make them happy, so you may be wondering what A1C is and why it may be an important number for you to know — especially during November, which is National Diabetes Awareness Month.
It’s important because an elevated A1C is a possible signal that you are at a higher risk of developing Type 2 diabetes. The good news is that if you can catch this disorder while it’s still in its “pre-diabetes” phase, you have a good chance of avoiding Type 2 diabetes altogether.
And avoiding elevated blood glucose means you also lessen the risk of its associated outcomes, such as a higher chance for stroke, heart disease, kidney failure, limb amputation and blindness.
Even if you have regular bloodwork at your doctor’s office, it may not include A1C, which requires a separate testing procedure. There were sometimes hassles with insurance coverage if the test was being used for screening and not diagnosing, but in 2024 Medicare began covering two screening A1C tests a year. If you have commercial insurance, you will want to check with them to see if the test is covered for you.
What does A1C measure?
An A1C test (also known as an HbA1C test) looks at a sample of your hemoglobin to find your average estimated blood glucose level over the previous three months, which is a more useful measure than a single point in time. While the standard blood glucose test requires fasting, the A1C test does not, making it easier on patients and their providers.
The number that comes back is expressed as a percentage. For example an A1C of 5.7 means that 5.7% of the hemoglobin is “glycated,” or linked to sugar.
What’s a normal A1C?
Typically, an A1C lower than 5.7 is considered “normal”; between 5.7 and less than 6.5 is considered “pre-diabetic.” This is the blinking yellow light that tells you it’s time to make some lifestyle changes to prevent full-blown diabetes. You know what these changes are: a healthier diet and more exercise, probably coupled with medication.
An A1C of 6.5 or higher indicates diabetes. That said, A1C can be affected by other factors, such as blood transfusions, medications, stress and hormone levels, so there’s no “one size fits all” interpretation. That’s why Medicare decided to cover two screening tests a year, in case levels are being affected by something else.
Should you get screened?
The American Medical Association is hopeful that making it easier for patients to get two A1C screenings a year will lead to earlier diagnosis of pre-diabetes and prevention of full-blown diabetes. Some of the symptoms of diabetes can be so subtle you may not even notice them, so if you have a family history of Type 2 diabetes, ask your doctor about getting screened.
Also, let your primary care provider know if you’re experiencing any of these symptoms: extreme thirst and/or hunger; more frequent urination; more fatigue; slow-healing sores; blurry vision.
A special offer from the American Red Cross
This November, in honor of Diabetes Awareness Month and its theme — “Taking Action to Prevent Diabetes-Related Health Problems” — the American Red Cross is offering free A1C screenings to all blood donors who haven’t received the test in the past 12 months. It has found that about one in every five donors has an A1C in the pre-diabetic or diabetic range.
To receive your free A1C result, make a successful blood, platelet or plasma donation and ensure you haven’t received an A1C test through the Red Cross in the past 12 months. Results will appear within one to two weeks in the Red Cross Blood Donor App or at RedCrossBlood.org. If your A1C is elevated, follow up with your health care provider.
Diabetes is recognized as a global public health epidemic, with the number of cases more than quadrupling since 1990. Cases in the U.S. are expected to surge more than 50% by 2030. More worrisome is that, according to 2021 estimates from Centers for Disease Control and Prevention, 8.7 million adults met the criteria for diabetes but were unaware of it.
Awareness is the first step toward controlling blood sugar and perhaps preventing diabetes. Your A1C can point the way.
• Teri (Dreher) Frykenberg, a registered nurse, board-certified patient advocate, is the founder of www.NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” available on Amazon. Frykenberg offers a free phone consultation to readers. Contact her at Teri@NurseAdvocateEntrepreneur.com.