A1C Recommended as Diagnostic Tool


New recommendations issued by the American Diabetes Association (ADA) call for the addition of the hemoglobin A1C[1], or A1C, test to the tools currently used to diagnose prediabetes[2] and Type 2 diabetes[3]. According to statistics from the Centers for Disease Control and Prevention, 57 million people in the United States have prediabetes, with 1.6 million newly diagnosed each year, while nearly 24 million people in the country have Type 2 diabetes, 5.7 million of them undiagnosed.

The A1C test, which involves having a small amount of blood drawn, looks at the concentration of red blood cells that have glucose molecules attached, reflecting the concentration of glucose in the blood. Because the red blood cells in a blood sample used for an A1c test are a mixture of cells of different ages, the test gives a “weighted” average of blood glucose control over the previous 2–3 months. An A1C level of less than 7% is the target for most people who have diabetes.

Based on the new recommendations, a result on the A1C of 5.7% to 6.4% would place a person’s blood glucose levels in the prediabetes range, while an A1C of 6.5% or higher would indicate diabetes. The A1C test would join the fasting plasma glucose, or FPG, test[4] (which involves measuring the amount of glucose in a person’s blood after at least eight hours without food or drink) and the oral glucose tolerance test, or OGTT[5] (which measures a person’s blood glucose response to the consumption of a glucose-rich drink after at least eight hours without food or drink) as diagnostic tools for diabetes and prediabetes.

According Richard M. Bergenstal, MD, President-Elect of the ADA for medicine and science, “We believe that use of the A1C, because it doesn’t require fasting, will encourage more people to get tested for Type 2 diabetes and help further reduce the number of people who are undiagnosed but living with this chronic and potentially life-threatening disease… Unlike many chronic diseases, Type 2 diabetes actually can be prevented, as long as lifestyle changes are made while blood glucose levels are still in the prediabetes range.”

For more information on the recommendations, read “American Diabetes Association’s New Clinical Practice Recommendations Promote A1c as Diagnostic Test for Diabetes and Pre-Diabetes”[6] or see the ADA’s Clinical Practice Recommendations[7] in Diabetes Care. And to learn more about A1C, check out the article“H-B-A-1-C: What It Is and Why It Matters.”[8]

  1. hemoglobin A1C: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/hba1c/
  2. prediabetes: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/prediabetes/
  3. Type 2 diabetes: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/type-2-diabetes/
  4. fasting plasma glucose, or FPG, test: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/fasting_plasma_glucose_test/
  5. oral glucose tolerance test, or OGTT: http://www.diabetesselfmanagement.com/Articles/Diabetes-Definitions/oral_glucose_tolerance_test_ogtt/
  6. “American Diabetes Association’s New Clinical Practice Recommendations Promote A1c as Diagnostic Test for Diabetes and Pre-Diabetes”: http://www.diabetesincontrol.com/articles/diabetes-news/8789-american-diabetes-associations-new-clinical-practice-recommendations-promote-a1c-as-diagnostic-test-for-diabetes-and-pre-diabetes
  7. Clinical Practice Recommendations: http://care.diabetesjournals.org/content/33/Supplement_1
  8. “H-B-A-1-C: What It Is and Why It Matters.”: http://www.diabetesselfmanagement.com/Articles/Blood-Glucose-Monitoring/h_b_a_1_c/

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Diane Fennell: Diane Fennell has been an editor at Diabetes Self-Management magazine since 2003. She is currently the Editorial Director. (Diane Fennell is not a medical professional.)

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