What is A1 c?

I was diagnosed with type 2 about 6 months ago while in the hospital for congestive heart failure. I saw an endocrinologist while in the hospital and once since leaving the hospital. I can’t see him anymore because I do not have insurance an dhe does not take self pay patients etc… I have not heard of the A1c number but I do check my BG several times a week . I take novolog and Lantus. And I read …whatever I can find. any insight about the A1 C would be very much appreciated.

HbA1C is the average of what your blood sugar is over a 3-4 month period. The lower the better.

when I test my blood glucose the numbers are like 120, or 148 or 250 etc… the numbers I have seen for people discussing A1 level are like 7, 6 etc. how do you get to that ?

HBA1C doesn’t have to do with your glucometer. It is a test that is done in the doctor’s office. The levels are a percent.

Here’s a website where you can compare in the different units of measure. http://diabetescenter.blogspot.com/2006/07/conversion-tool-a1c-to-blood-glucose.html
You can convert roughly by dividing BG levels by 18. So a BG mg/dl of 100 is about the same as 5.5mmol/l.

There are two main methods of describing concentrations: by weight, and
by molecular count. Weights are in grams, molecular counts in moles. In both cases, the unit
is usually modified by milli- or micro- or other prefix, and is always "per"
some volume, often a liter.

mmol/l is millimoles/liter, and is the world standard unit for measuring
glucose in blood.

mg/dl (milligrams/deciliter) is the traditional (U.S.) unit for measuring bG (blood

of course that makes sense! duh!!! metric conversion …you know it’s that old egocentric empirialist american blood I have that doesn’t even consider such an extrapolation…so does the test for A!C measure a 4 month average of blood test done in the doctors office only … how many samples make up a 4 month average?
I would think more samples increase validity of the average…am I on the right track?

A1c isn’t the same as mmol/L (the metric number). The numbers tend to run in the same range, which makes it confusing. A1c is given as a percentage.

Here’s a link to a chart that has all three sets of numbers: http://www.dlife.com/dLife/do/ShowContent/blood_sugar_management/testing/a1c_conversion.html

A meter reading is a measure of your blood sugar level at one particular time. An A1C is a measure of the precentage of your red blood cells which exhibit glycosylation (glucose attached to the hemoglobin protein in the red blood cell). Red blood cells are created continuosly and live for 3 - 4 months (I’ve seen 110 days given as an average life). The higher your blood sugar is when they are created the more likely glucose is to be attached to the hemoglobin. If you assume that the reaction which attaches the glucose to the hemoglobin is irreversible then you can use the A1C to estimate the average blood sugar level over the previous 3 months or so. Recent research suggests that the reaction is not irreversible, and so the A1C is actually correlated to a weighted average of blood sugar levels over a shorter period (some researchers suggest to only the last month or so and weighted most heavily to the last 2 weeks or so).

So, don’t try to compare your A1C directly to your blood sugar readings. You would need hundreds of readings a day to come close to an accurate average. Your A!C should be no higher than 7% if you are under control. Non diabetics have A1C’s around 4-6%, so the Diabetes authorities generally recommend aiming for an A1C of around 6% if you can get there without going hypoglycemic. Some people go further and recommend even lower targets.

I don’t really think I need to explain it anymore because the good people here have done a great job. The only thing I will say is if going to your endo is not an option anymore and don’t have another one to go to, keep a close eye on your daily tests and do the best you can to control those. If you can keep those in control, your A1c should follow suit. Good luck and keep the questions coming.

Take care and stay in control

thanks for the encouragement … I do plan on seeing a General practioner regarding several of my health issues of which my diabetes is one…albeit a big one . Everyone has been so considerate and helpful contributing whatever they can to make up all the pieces of the puzzle. If we all knew everything then there wouldnt be much need for the great network of support. Thank you.

Hello There! You all sound very helpful…I have a question…my husband has just found out about the big T2D. He is in the process of trying to get a job with the State of California Corrections…do you guys think they won’t accept now because of this (he is in the last stage of his process and now has come up)? We have an appointment tomorrow to see if his doc will say “yay” or “nay” … but I would love to know what you guys think. Tell me the truth now! (he is currently taking meds and checking his blood every morning).

Thanks, Jessica

Indeed, both of the titles referred to by Judith here are VERY good, plus both authors are members of the community AND if you prefer, you can also obtain them here through the Books section. That way, if you purchase them, you will be contributing to TuDiabetes:

Cody put it stright to the point that’s what it is and find another Dr who will pull oneon you when you can. That really helps with control alot!

I have read a lot of articles in newsletters of changing the way that the A1c is listed. The change is intended to jive with readings that we get on our glucose meters to clear up some of the confusion. I don’t know when this is supposed to happen, but it ought to knock out the need for conversions and possibly some error in the conversions. I don’t believe that I have heard of this mentioned yet. Has anyone else heard of this ?


I am sorry that you have such serious health concerns and no insurance. If you are having financial troubles because of your medical costs please visit my organization’s website www.ipump.org to see if you may qualify for free diabetes supplies or some assistance with the cost of your insulin.

An A1c is an important tool to help you understand how you are managing your diabetes – it is an average and not always accurate. An A1c should not be interpreted alone – your doctor should also use your meter readings along with your A1c beofre making any necessary changes in treatment. Many things can affect an A1c including medications you may be on for your heart condition. Also, if you have a lot of low blood sugars this will pull down an average A1c reading even when you also have high blood sugars. While some studies show chronic lows cause their own problems (mostly cognitive) having chronically high blood sugaris is what damages the body most over the long haul. To find out in-depth information about what an A1c is what the readings may indicate and what affects the test visit www.isletsofhope.com and use the pull-down menu and select “HbA1c” or you can go to the page direclty at http://www.isletsofhope.com/diabetes/treatment/hba1c_1.html.

According to the FDA home A1c tests are not considered accurate on young children and are no longer generally recommended. However, if you cannot go to a doctor you may opt to at least do a home test (about $20 per kit) now. These tests are usually done every 3 months on persons with diabetes but again, intepretting the test results requires you also look at your meter readings and trends. The reason I encourage this is that chronically high blood sugars can cause you further heart damage and should be addressed as quickly as possible.

If you wish to write to me privately at lahle@ipump.org and tell me what city, state and county you live in I can help you find local support for your medical needs if you currently do not have anyone to provide medical care for you.

Phillip, I know you have been through an awful lot and it is easy for us, as humans, to withdraw after such an ordeal, so it is a pleasure to see you join Tu Diabetes to make new friends and find answers. Good for you for reaching out!