Use of A1C Recommended to Diagnosis Not Simply Manage Diabetes


The American Diabetes Association’s is publishing its new Clinical Practice Recommendations as a supplement to the January issue of Diabetes Care. Many doctors already use the A1C test as a means of diagnosing diabetes, but ADA wants it to become the standard.

The A1C test can be used to diagnosing diabetes, identify pre-diabetes, and to measure how well people are doing to keep their blood glucose levels under control.

The A1C is also called the Glycohemoglobin or Hemoglobin A1c test. It is measured in terms of percentages and reflects the average blood glucose control for the two- to three-month period before the test.


Unlike the Fasting Plasma Glucose (FPG) and the Oral Glucose Tolerance Test (OGTT) which require overnight fasting, the A1C can be done with a simple blood draw and no fasting.

Hemoglobin is a protein on red blood cells that carries oxygen in the blood. When blood sugar is too high it combines with hemoglobin. The more excess glucose in the blood, the higher the percentage of A1C. Healthy adults without diabetes or pre-diabetes have an A1C of about 5%. Diabetes patients with very poorly controlled disease can have levels as high as 25%.

Under the new ADA recommendations, people with A1C levels between 5.7% and 6.4% will be considered to have prediabetes and those with levels of 6.5% or higher will be considered to have diabetes.

If patients can be caught in the pre-diabetes range, then with lifestyle changes type 2 diabetes may well be prevented. The Centers for Disease Control and Prevention has estimated that 57 million Americans have pre-diabetes. Diabetes is newly diagnosed in 1.6 million people every year.

The ADA recommends that most people with diabetes maintain a goal of keeping A1C levels at or below 7 percent in order to properly manage their disease. Research shows that controlling blood glucose levels helps to prevent serious diabetes-related complications, such as kidney disease, nerve damage and problems with the eyes and gums.