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Hemoglobin A1c, also known as glycated hemoglobin or HbA1c, is a laboratory test that measures the average blood glucose levels over the past two to three months. This test is essential for diagnosing and monitoring diabetes. When glucose circulates in the blood, it binds to hemoglobin, the protein in red blood cells that carries oxygen throughout the body. The higher the blood glucose levels, the more glucose attaches to hemoglobin. Since red blood cells live for approximately three months, the HbA1c test provides a long-term picture of glucose control, unlike daily blood sugar tests that only show glucose levels at a specific moment.

The HbA1c test is measured as a percentage. For people without diabetes, normal HbA1c levels are typically below 5.7 percent. A result between 5.7 and 6.4 percent indicates prediabetes, which means blood glucose levels are higher than normal but not high enough to be classified as diabetes. An HbA1c level of 6.5 percent or higher on two separate tests indicates diabetes. For individuals already diagnosed with diabetes, the American Diabetes Association generally recommends maintaining an HbA1c level below 7 percent to reduce the risk of complications, though individual targets may vary based on age, health status, and other factors.

Healthcare providers use the HbA1c test both for diagnosis and ongoing management of diabetes. For monitoring purposes, people with well-controlled diabetes may need testing twice a year, while those with poorly controlled diabetes or those who have recently changed treatment may require more frequent testing, often every three months. The test requires a simple blood sample and does not require fasting, making it convenient for patients. Results help healthcare providers assess whether current diabetes management strategies are effective or if adjustments to medication, diet, or lifestyle are needed.

Several factors can affect HbA1c test results. Conditions that affect red blood cell lifespan, such as anemia, recent blood loss, or blood transfusions, may lead to inaccurate readings. Certain hemoglobin variants, more common in people of African, Mediterranean, or Southeast Asian descent, can also interfere with some testing methods. In these cases, healthcare providers may use alternative tests or different laboratory methods to ensure accurate results. Understanding HbA1c levels and their significance helps patients and healthcare providers work together to manage diabetes effectively and prevent long-term complications such as heart disease, kidney damage, nerve damage, and vision problems.