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Hemoglobin A1c, commonly known as HbA1c or glycated hemoglobin, is a blood test that provides important information about long-term blood sugar control. This test measures the percentage of hemoglobin proteins in red blood cells that have glucose attached to them. Since red blood cells live for approximately three months, the HbA1c test reflects average blood glucose levels over the past two to three months. This makes it a valuable tool for monitoring diabetes management and assessing the risk of developing diabetes-related complications.

The test works by measuring how much glucose has bonded to hemoglobin in the blood. When blood sugar levels are elevated over time, more glucose attaches to hemoglobin molecules through a process called glycation. Unlike daily blood glucose tests that show sugar levels at a single moment, HbA1c provides a broader picture of glucose control over an extended period. For people with diabetes, the test is typically performed every three to six months to evaluate how well treatment plans are working. For those without diabetes, it may be used as a screening tool to identify prediabetes or diabetes risk.

Test results are reported as a percentage. For most adults without diabetes, a normal HbA1c level is below 5.7 percent. Levels between 5.7 and 6.4 percent indicate prediabetes, meaning blood sugar levels are higher than normal but not yet high enough to be classified as diabetes. An HbA1c level of 6.5 percent or higher on two separate tests indicates diabetes. For people already diagnosed with diabetes, treatment goals are typically set to keep HbA1c below 7 percent, though individual targets may vary based on age, health status, and other factors.

One of the main advantages of the HbA1c test is that it does not require fasting, and it can be performed at any time of day. This makes it more convenient than traditional glucose tests that require patients to fast overnight. The test is also less affected by short-term factors like stress, illness, or recent meals. However, certain conditions can affect the accuracy of HbA1c results, including anemia, blood loss, recent blood transfusions, certain types of hemoglobin variants, and kidney or liver disease. Healthcare providers take these factors into account when interpreting results and may recommend additional testing if needed.