HbA1c, or often just called A1c (Glycated Haemoglobin A1c), is a protein that binds to RBC (red blood cell) wall, that averages a 3-month lifespan. It gets covered in glucose and the percentage coverage is measured, which gives an indication of average blood glucose, and thus blood glucose control.
Your doctor, or health care specialist will initially order this blood test to screen for blood sugar issues and diabetes. A healthy non-diabetic reading is considered to be under 5.7% Although most healthy non-diabetes have readings around 5% or a little under. Readings which are higher and between 5.7% to 6.4% are considered prediabetic or at high risk of diabetes, and readings higher than 6.5% are considered diabetic and indicate that further investigation is required to determine the cause of the elevated HbA1c result.
Ideally, they should then order a C-peptide test, to see how much insulin you are making, and an antibody test to see if you are producing any Type 1 associated antibodies, such as GAD (glutamic acid decarboxylase), or ICA (Islet Cell Antibodies), there are five Type 1 associated antibodies, but GAD and ICA are the most commonly tested. Typically, if you have Type 1 diabetes, you will have elevated antibodies and low C-peptide, and if you are Type 2 diabetes you will have no antibodies and elevated C-peptide.
Once diagnosed your doctor, or health care specialist will want to test your A1c every 3 months to monitor your diabetes. Ideally, you want to bring your A1c down to around 5% if you want to avoid health risks and diabetic complications.
Although this test is a great tool for identifying blood sugar issues and monitoring blood sugar control, there are factors that can influence the results and so they should always be viewed in conjunction with your daily blood sugar readings.
You may be told that as a diabetic you cannot expect to have an A1c of below 6.5%, this is simply not true. Having an A1c above 5% carries significant risk of complications such as heart disease, so why should you settle for an A1c above 5% just because you have diabetes?
The first thing you can do to lower your A1c is to address your diet. Cutting out sugar, and refined and processed foods it the first positive step, but will likely not get you an A1c below 5%. Going further and adopting a low carbohydrate diet is the most powerful dietary intervention for lowering A1c. As a diabetic, you cannot metabolise carbohydrates because you either don’t make enough or any insulin as in Type1 diabetes, or you are resistant to insulin as in Type 2 diabetes. Either way, going low carb is extremely powerful. You can read my post here on why. http://upgradeddiabetic.com/blog/2019/11/27/why-low-carb-is-so-powerful-for-diabetics/
Second on the list is exercise, our muscles utilise glucose, and the more muscle we have the better we can control blood glucose. Lifting weights, and I don’t mean becoming a bodybuilder unless you want to that is, is an ideal way to increase muscle mass. The more muscle mass and the more active you are, the better your blood sugar control will be. Additionally going for a brisk walk before and after meals have a positive impact of postprandial blood sugar levels.
In addition to going low carb and exercise, studies show that those who monitor blood glucose more frequently and/or wear a CGM have better A1c’s. This is because from doing so you learn how your body responds not only to food but other factors that influence blood sugar such as stress, exercise, sleep, medication, illness, and more. Knowing more about your diabetes allows you to take action, and make changes to your diet, lifestyle and medication regime to optimise your blood sugar management.
When you’re doing all of the above and still not getting the A1c you desire, there are some other factors you can investigate. Stress, gut health, nutritional deficiencies, poor sleep, weight around the middle, your medication/insulin regimen, inflammation, dental health & environmental toxins could all be hampering your effort to obtain your desired A1c. You may want to seek the help of someone qualified to help you navigate your health to help you uncover whats underlying you being able to reach your goals.
Like what you read and want to learn more? I post lots of info on health and diabetes on my FB page https://www.facebook.com/upgradeddiabetic/, and I also run a dedicated community for people who have diabetes, a place to share and learn, and feel supported, https://www.facebook.com/groups/upgradeddiabetic/