Staying Healthy with Diabetes Includes A1C (HbA1c) Testing

Sure, you test your glucose level several times a day. You’re aware of diet and exercise issues and do your best to stay on track — staying healthy with diabetes. But what about your hemoglobin A1c level? What does it mean and why is it so important?

The hemoglobin A1c test is a simple lab test that shows the average amount of sugar in your blood over the last two to three months. It’s the best way to find out if your blood sugar is under control. All people with type 2 diabetes should have a hemoglobin A1c test at least twice a year. If your treatment changes or if your blood sugar level stays too high, you should get a hemoglobin A1c test at least every three months until your blood sugar level improves. Regular testing will help you and your doctor to track your blood sugar levels over time and plan long-term treatment options to reach your target level of control.

Red blood cells are continually dying and being replaced, so at any given time they have a range of ages in your body. In a sense, your blood tells the history of your glucose level over the last few months. For example, if your levels were not in control three weeks ago, glycated hemoglobin will persist in the blood cells that were active at that time. If your blood sugar tends to go up at night, when you are less likely to self-monitor, your HbA1c test will indicate a higher average level of blood sugar than you found through self-monitoring.

A good hemoglobin A1c reading for people with type 2 diabetes is less than 7%. You can do a lot to bring down a high blood sugar level and get it under control. Start by asking your healthcare provider for a hemoglobin A1c t est. If your hemoglobin A1c test result is too high, talk to your healthcare provider about how to lower it. Keep your goal in sight, but remember that lowering your hemoglobin A1c levels by any amount improves your chances of staying healthy.

Know Your A1c

Find out how much you know about the hemoglobin A1c test (also called A-1-c). Mark each statement true or false. Then see how you did by checking the correct answers and explanations on this page.

  1. An A1c test measures the average amount of glucose in your blood over the last 3 months. T F
  2. It’s important to know your A1c number. T F
  3. All people with diabetes need to have an A1c test. T F
  4. The A1c goal for people with diabetes is less than 7 percent. T F
  5. Most people can tell what their blood sugar levels are simply by how they feel. T F
  6. You can do something about high blood glucose. T F
  7. An A1c number over 8 percent is a sign that one or more parts of your treatment plan needs to be changed. T F
  8. There’s no proof that lowering your A1c number can reduce your chances of getting serious eye, kidney and nerve damage. T F
  1. True. The A1c test shows the average amount of glucose (sugar) in your blood over the last 3 months. The A1c is the best test to find out if your blood glucose is under control over a period of time.
  2. True. If you know your A1c number, you will have a sense of your diabetes control. A result above 8 percent is a sign that you should work with your health care provider to change your treatment plan. A 7 percent or lower result is a sign that your treatment plan is working, and your blood glucose is under control.
  3. True. All people with diabetes should have an A1c test at least twice a year and up to four times a year. If your blood glucose levels are too high or too low, work with your health care provider to reach your target level of control.
  4. True. The A1c goal for people with diabetes is under 7 percent. But, if you can lower your A1c number by any amount, you will improve your chances of staying healthy.
  5. False. Research shows that few people can tell their blood glucose levels simply by how they feel. Checking your blood glucose is the only way to know for sure whether you reach your blood glucose goals.
  6. True. You can do a lot to bring down high blood glucose levels and get them under control. Start by asking your health care provider for an A1c test. If your A1c test result is too high, talk to your health care provider about how to lower it. To get your blood glucose under control, follow the meal plan recommended by your health care provider, increase your physical activity, take your prescribed diabetes medicines and consult your health care provider often.
  7. True. A change in treatment is almost always needed if your A1c is higher than 8 percent. Common causes of high blood glucose include eating too much food or eating the wrong foods, lack of physical activity, stress, a need to incre ase and/or change medicines and infection or illness. If your A1c number is too high, work with your health care provider to change your treatment plan.
  8. False. Recent studies show that the lower the hemoglobin A1c number, the greater the chances that you will slow or prevent the development of serious heart, eye, kidney and nerve damage.

Q Is the A1C test important for everyone with diabetes?

A Whether you have type 1 or type 2 diabetes, the A1C test is a very important and meaningful test that determines your overall glucose control. A1C shows your average blood glucose for the two to three months prior to the test.

It also tells you your risk for long term problems from diabetes. Research has shown that the closer your hemoglobin A1C is to 7 percent or less, the less likely you are to develop problems, such as retinopathy (damage to the retinas in your eyes), nephropathy (kidney disease) and neuropathy (nerve damage).

Remember, A1C testing is not a replacement for regulary monitoring your blood glucose levels. It’s helpful to compare the A1C test result with your blood glucose monitoring results. Ask yourself if they make sense. If they don’t, you may need to check your blood glucose more often or at different times. Checking your blood glucose at different times can help you answer questions about why your A1C doesn’t match your blood glucose readings. If your A1C test result and your blood glucose values are higher or lower than your targets, discuss ways to make changes in your diabetes care with your health care providers.

The Importance of A1C Testing

Checking blood glucose daily is important. But don’t forget to check your A1Cs regularly, as well. The A1C (or hemoglobin A1C) test is a blood test that shows your average blood glucose results over the previous two to three months. It gives you the big picture of your blood glucose levels, including all of the ups and downs.

According to the American Diabetes Association (ADA), your A1C should be 7 percent or lower. If your A1C is higher, you and your health care provider may need to make changes in your diabetes care plan. Your provider may suggest changes to your medication regimen. You may also benefit from more education or a visit with a dietitian.


Since the invention of the A1C test about 20 years ago, it has been done only in a health care provider’s office or a lab, using a blood sample from the finger or arm. But now you can check your A1C yourself with an over-the-counter A1C test. These devices have been approved by the Food and Drug Administration (FDA).


According to the ADA, you need to have your A1C checked when you first find out you have diabetes. After that, the ADA recommends getting an A1C test at least twice a year. Your A1C testing schedule may be different. For example, if you start a new diabetes medication or your blood glucose readings aren’t in your target range, your A1C needs to be checked every three months.


The A1C test does not replace daily glucose monitoring or visits with your health care provider. If you choose to use the at-home A1C tests, share your results with your health care provider, just as you would your daily blood glucose readings.

  • Register For This Twitter Chat Series

    When you register, we will send you timely reminders about upcoming Twitter chats via email.

    Simply enter your email address below and click on the "Register Me" button.

  • This field is for validation purposes and should be left unchanged.

Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded, a popular Health and Wellness website in 2009. was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of, does not provide medical advice, diagnosis or treatment. See additional information.