Understanding HbA1C: Your essential guide to managing blood glucose levels
For people living with diabetes, whether Type 1 (T1D) or Type 2 (T2D), managing blood glucose is a daily task. But how do you know if your blood sugar is in control over the long term? That’s where HbA1C comes in. You might have heard your doctor mention it or seen it on your medical reports, but what exactly does it mean, and why is it so important?
In this article, we’ll break down what HbA1C is, why it matters for diabetes management, and how you can work towards maintaining a healthy level. Whether you’re living with Type 1 diabetes, Type 2 diabetes, or are just health-conscious, understanding your HbA1C is key to long-term well-being.
What is HbA1C?
HbA1C, or glycated haemoglobin, is a measure of your average blood glucose (sugar) levels over the past two to three months. Haemoglobin is the protein in red blood cells responsible for carrying oxygen throughout your body. When glucose enters your bloodstream, it sticks to haemoglobin, creating glycated haemoglobin (HbA1C). The higher your blood sugar levels, the more glucose attaches to your haemoglobin, and this is reflected in your HbA1C result.
Unlike the finger-prick tests or continuous glucose monitors (CGMs), which give you a snapshot of your blood sugar levels at a specific moment, the HbA1C test provides a long-term view. This makes it a crucial marker for overall diabetes control.
Why is HbA1C important?
For people with diabetes, maintaining an appropriate HbA1C level is essential because it gives insight into how well blood glucose has been managed over time. A high level indicates prolonged periods of elevated blood sugar, which increases the risk of diabetes-related complications such as:
- Cardiovascular disease (heart attacks and strokes)
- Kidney disease
- Nerve damage (neuropathy)
- Eye damage (retinopathy)
The lower your HbA1C level, the lower your risk of developing these complications. That’s why healthcare professionals place so much emphasis on this number during your diabetes review appointments.
What is a healthy HbA1C level?
In the UK, HbA1C levels are typically measured in mmol/mol (millimoles per mole), though you may also see them reported as a percentage. For most adults with diabetes, the NHS recommends aiming for a level of:
- 48 mmol/mol (6.5%) or below.
This target applies to both Type 1 and Type 2 diabetes. However, your individual goal may vary depending on factors like age, overall health, and how long you’ve had diabetes. Your healthcare team will work with you to set a personalised target that balances the benefits of lowering your HbA1C with the risk of hypoglycaemia (low blood sugar).
For people without diabetes, a normal HbA1C level is typically below 42 mmol/mol (6%).
How is it tested?
The HbA1C test is typically performed by drawing a small blood sample, either from a vein or via a finger-prick test, depending on your healthcare provider. This blood sample is then analysed to determine the percentage of haemoglobin that is glycated. Most people with diabetes will have their HbA1C checked at least once every 3 to 6 months, depending on how well their blood glucose is being managed.
Regular tests allow you and your healthcare team to track your progress and adjust your treatment plan if needed. For example, if your HbA1C is higher than your target, it may signal the need for adjustments in insulin dosing, medication, or lifestyle changes such as diet and exercise.
Factors that can affect your HbA1C level
Although HbA1C is a reliable measure of long-term blood glucose control, several factors can influence the result, including:
- Illness or stress: Both can cause temporary spikes in blood glucose levels, which may raise your average blood glucose.
- Medications: Some medicines, like steroids, can elevate blood glucose levels, leading to a higher HbA1C.
- Anaemia or haemoglobin variants: Certain conditions that affect red blood cells, like anaemia, can lead to inaccurate readings.
If any of these factors apply to you, it’s important to discuss them with your healthcare provider to ensure your HbA1C result is interpreted correctly.
How to lower your level
Lowering your HbA1C is an important goal for managing diabetes and preventing complications. Here are some proven strategies:
- Carbohydrate counting and insulin adjustment
For people with T1D, counting carbs and adjusting insulin doses accordingly can help maintain stable blood sugar levels. Using tools like continuous glucose monitors (CGMs) can also provide valuable insights into how your body responds to different foods and activities. - Diet and nutrition
Eating a balanced diet rich in whole grains, vegetables, lean proteins, and healthy fats can help regulate blood sugar. Avoiding processed foods and sugary snacks is also crucial for maintaining a healthy HbA1C. - Exercise
Regular physical activity helps improve insulin sensitivity and lowers blood glucose levels. Aim for at least 150 minutes of moderate exercise per week, such as walking, swimming, or cycling. - Medication and insulin management
If you’re on medication or insulin therapy, following your treatment plan is vital for keeping your HbA1C in check. Make sure to take your prescribed doses at the right times and discuss any concerns with your healthcare team. - Stress management
Stress can wreak havoc on blood sugar levels. Incorporating stress-reducing practices such as meditation, yoga, or even deep breathing exercises into your routine can help you stay calm and better manage your diabetes.
HbA1C is a key indicator of long-term blood glucose control and plays a central role in diabetes management. Regular testing, combined with lifestyle adjustments and appropriate treatment, can help you maintain a healthy level and reduce the risk of complications.
By working closely with your healthcare team, following a well-balanced diet, staying active, and managing stress, you can keep your HbA1C within your target range and live a healthier life with diabetes.