A1C (HbA1c)

A1C is a blood test that reflects your average blood glucose levels over the past 2-3 months. It measures the percentage of hemoglobin proteins in your blood that have glucose attached to them.

For most adults with diabetes, the American Diabetes Association recommends an A1C target of less than 7%, which indicates good blood sugar control.

eAG (Estimated Average Glucose)

eAG converts the A1C percentage into the same units (mg/dL or mmol/L) that you see on your glucose meter, making it easier to understand your average blood sugar level. This concept was introduced by the American Diabetes Association.

For example, an A1C of 7% corresponds to an eAG of approximately 154 mg/dL or 8.6 mmol/L.

Healthy Diet

Focus on a balanced diet rich in vegetables, lean proteins, whole grains, and healthy fats. Limit refined carbohydrates and processed foods.

Regular Physical Activity

Aim for at least 150 minutes of moderate-intensity exercise per week. Physical activity helps your body use insulin more efficiently.

Medication Adherence

Take medications as prescribed by your healthcare provider. Consistent medication use helps maintain stable blood glucose levels.

Regular Monitoring

Check your blood glucose regularly as recommended by your healthcare provider. This helps you understand how different factors affect your levels.

Stress

Stress hormones can raise blood glucose levels. Practice stress-reduction techniques such as meditation, deep breathing, or yoga.

Poor Diet

High intake of sugary foods, refined carbohydrates, and processed foods can cause blood glucose spikes.

Illness and Infection

Being sick can raise blood glucose levels as your body releases stress hormones to fight infection.

Sedentary Lifestyle

Lack of physical activity reduces insulin sensitivity and can lead to higher blood glucose levels.

Dehydration

Not drinking enough water can concentrate glucose in the bloodstream, leading to higher readings.

Normal/Non-diabetic range (below 5.7%) ADA target for most adults with diabetes (below 7%) High range - consult healthcare provider

Source: Adapted from the American Diabetes Association.

Type 1 Diabetes

Type 1 diabetes is an autoimmune condition where the immune system attacks and destroys insulin-producing beta cells in the pancreas. It typically develops in childhood or young adulthood and requires lifelong insulin therapy.

• Accounts for about 5-10% of all diabetes cases
• Cannot be prevented with lifestyle changes
• Requires daily insulin injections or an insulin pump
• Onset is usually sudden with symptoms developing quickly

Type 2 Diabetes

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas doesn't produce enough insulin. It's more common in adults but is increasingly seen in younger people.

• Accounts for about 90-95% of all diabetes cases
• Can often be managed with lifestyle changes, oral medications, and/or insulin
• Risk factors include obesity, family history, and sedentary lifestyle
• Symptoms may develop gradually over years

A1C targets are similar for both types, though individual goals may vary based on age, health status, and risk of hypoglycemia. Consult your healthcare provider for personalized recommendations.

The American Diabetes Association provides the following recommendations for A1C testing frequency:

At Least Twice Per Year

For patients with stable glycemic control who are meeting treatment goals, A1C testing should be performed at least twice per year.

Every 3 Months (Quarterly)

More frequent testing (quarterly) is recommended for patients who:

• Are not meeting their glycemic targets
• Have recently changed therapy
• Have conditions that may affect red blood cell turnover
• Are pregnant or planning pregnancy

Point-of-Care Testing

Point-of-care A1C testing may allow for more timely treatment changes during office visits. However, lab-based testing is still important for accuracy and may be preferred for diagnosis.

Hypoglycemia (Low Blood Sugar)

Generally defined as blood glucose below 70 mg/dL (3.9 mmol/L). Symptoms may include:

• Shakiness or trembling
• Sweating and chills
• Rapid heartbeat
• Confusion or difficulty concentrating
• Dizziness or lightheadedness
• Hunger and nausea
• Blurred vision
• Weakness or fatigue
• Irritability or mood changes

⚠️ Severe hypoglycemia can cause seizures, loss of consciousness, and requires immediate medical attention. Follow the "15-15 Rule": consume 15g of fast-acting carbohydrates, wait 15 minutes, and recheck blood sugar.

Hyperglycemia (High Blood Sugar)

Generally defined as blood glucose above 180 mg/dL (10 mmol/L) after meals or above 130 mg/dL (7.2 mmol/L) fasting. Symptoms may include:

• Increased thirst and dry mouth
• Frequent urination
• Fatigue and weakness
• Blurred vision
• Headaches
• Slow-healing cuts or sores
• Weight loss (in severe cases)
• Fruity-smelling breath (sign of ketoacidosis)

🚨 Diabetic Ketoacidosis (DKA) is a serious complication of very high blood sugar. If you experience nausea, vomiting, abdominal pain, or fruity breath odor, seek emergency medical care immediately.

The following trusted organizations provide comprehensive information about diabetes management, research, and support: