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Hemoglobin A1c, commonly known as HbA1c or glycated hemoglobin, is a laboratory test that measures the average blood sugar levels over the past two to three months. This test is essential for diagnosing and monitoring diabetes mellitus. When glucose circulates in the bloodstream, it attaches to hemoglobin, the protein in red blood cells that carries oxygen throughout the body. The amount of glucose that binds to hemoglobin is directly proportional to the average glucose concentration in the blood. Since red blood cells live for approximately three months, the HbA1c test provides a long-term picture of blood sugar control rather than just a snapshot of glucose levels at a single moment.

The HbA1c test is measured as a percentage, indicating what proportion of hemoglobin is coated with sugar. For people without diabetes, a normal HbA1c level is typically below 5.7 percent. Levels between 5.7 and 6.4 percent indicate prediabetes, a condition where 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 individuals already diagnosed with diabetes, the target HbA1c level is usually below 7 percent, though this goal may vary depending on individual circumstances, age, and other health conditions.

Healthcare providers use the HbA1c test for multiple purposes. It helps diagnose type 2 diabetes and prediabetes, though it may be used alongside other tests like fasting blood glucose or oral glucose tolerance tests. For people already living with diabetes, regular HbA1c testing, typically every three to six months, helps assess how well their treatment plan is working. The test results guide decisions about medication adjustments, lifestyle modifications, and overall diabetes management strategies. Unlike daily blood glucose monitoring, which shows immediate fluctuations, HbA1c provides a broader view of blood sugar control over time.

Several factors can affect HbA1c test results. Conditions that influence red blood cell lifespan, such as anemia, recent blood loss, blood transfusions, or certain hemoglobin variants, may lead to inaccurate results. Kidney disease, liver disease, and certain medications can also impact readings. People with these conditions may need alternative testing methods or more frequent monitoring. The test requires a simple blood draw and no special preparation, such as fasting, is needed. Results are usually available within a few days and are reported as a percentage, making them easy to track over time and compare with previous results to evaluate trends in blood sugar management.