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What do my A1C test results mean?

By: Mandy Jones, Contributor, living with diabetes

Apr. 17, 2018

If you’ve had a healthcare appointment lately, you may have heard your healthcare provider mention your “A1C level”.  So, what’s that mean, exactly?

A1C gives an estimate of your average blood sugar for the past three months. While your meter gives you an in-the-moment picture, this test gives a long-term overview. Specifically, it works by measuring how much sugar is attached to your red blood cells.2

What do my lab results mean?

A1C can be measured using a drop of blood from your fingertip, or a blood draw. This test is one of the standard recommended ways to diagnose diabetes, and is usually tested every 3-6 months. Most insurance companies cover at least two tests per year if you get your test done through your healthcare provider; you can also buy an at-home test kit from your local drugstore.3

When looking at your lab results, look for “Hemoglobin A1C” or “HbA1c” (sometimes it is also called “glycated hemoglobin”).4

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According to the American Diabetes Association (ADA) Standards of Care, an A1C greater than 6.4% indicates diabetes.1 An A1C between 5.7% and 6.4% indicates an increased risk of developing diabetes, or “prediabetes” as your healthcare provider may say.1

How does that affect my health?

Having a high A1C could mean that you’ve had high blood sugars for the past three months. Having high blood sugars over an extended period of time deteriorates blood vessels and nerves. This damage to blood vessels and nerves can put you at risk for heart attacks and strokes, damage to organs like the kidneys, reduced energy, and slower healing from infections.2

The ADA says that for people with diabetes (who aren’t pregnant) who are managing blood sugars with oral medications or insulin, a reasonable goal is to have an A1C of less than 7%.1 Some healthcare providers may suggest a higher or lower goal based on your individual medical history.

Is it an accurate picture of my blood sugar?

The ADA has a conversion calculator where you can enter your most recent A1C and it will estimate what your average blood sugar level has been over the last three months. However, this is best used in combination with the blood sugar results on your meter because the A1C test is not perfect. Two individuals with similar blood sugar levels over the last three months could get two different A1C results, since age, rage/ethnicity, and having low iron levels (anemia) can all affect the results. For example, an A1C of 9 could indicate an average blood sugar level measured on a meter anywhere from 170 to 249.5

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Secondly, since A1C only gives a 3-month average, it doesn’t show how much of a roller coaster your blood sugar has been on in between meals, and the amount of time out of range of your minimum and maximum blood sugar levels your body has had to endure.

Ideally, an A1C measurement can be used in combination with the blood sugar results on your meter to give you and your healthcare provider a real-life picture of your diabetes. 

The information provided on this blog is for general educational, communication and information purposes only and is not intended to replace medical advice, treatments or diagnosis by your own healthcare provider.

References

[1] American Diabetes Association. Standards of Medical Care in Diabetes 2018. Diabetes Care 2018 Jan;  vol41 (Supplement 1): S1 -S2. doi: 10.2337/dc18-S004.

[2] National Institute of Diabetes and Digestive and Kidney Diseases. The A1C Test & Diabetes. Site: https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test accessed 4/11/18

[3] Bunker, Katie. American Diabetes Association. Diabetes Forecast website. http://www.diabetesforecast.or... Pub 4/2009, accessed 4/11/18

[4] WebMD. Hemoglobin A1c (HbA1c) Test for Diabetes. WebMD website.  https://www.webmd.com/diabetes... Pub 4/2009, accessed 3/31/18

[5] Diabetes Care. Translating the A1c Assay Into Estimated Average Glucose Values. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742903/ accessed 4/3/18

Important Safety Information for Afrezza (insulin human) Inhalation Powder

Afrezza can cause serious side effects, including: Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza, your healthcare provider will give you a breathing test to check how your lungs are working.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about Afrezza? Afrezza can cause serious side effects, including: Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD).

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about Afrezza?

Afrezza can cause serious side effects, including:

Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza, your healthcare provider will give you a breathing test to check how your lungs are working.

  • Afrezza is a man-made insulin that is breathed-in through your lungs (inhaled) and is used to control high blood sugar in adults with diabetes mellitus. 
  • Afrezza is not for use in place of long-acting insulin. Afrezza must be used with long-acting insulin in people who have type 1 diabetes mellitus. 
  • Afrezza is not for use to treat diabetic ketoacidosis. 
  • It is not known if Afrezza is safe and effective for use in people who smoke. Afrezza is not for use in people who smoke or have recently stopped smoking (less than 6 months). 
  • It is not known if Afrezza is safe and effective in children under 18 years of age.

Do not use Afrezza if you:

  • Have chronic lung problems such as asthma or COPD.
  • Are allergic to regular human insulin or any of the ingredients in Afrezza. See the end of this Medication Guide for a complete list of ingredients in Afrezza. 

Before using Afrezza, tell your healthcare provider about all your medical conditions, including if you:

  • Have lung problems such as asthma or COPD
  • Have or have had lung cancer
  • Are using any inhaled medications
  • Smoke or have recently stopped smoking
  • Have kidney or liver problems
  • Are pregnant, planning to become pregnant, or are breastfeeding. Afrezza may harm your unborn or breastfeeding baby.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins or herbal supplements.

Before you start using Afrezza, talk to your healthcare provider about low blood sugar and how to manage it.

  • Read the detailed Instructions for Use that comes with your Afrezza.
  • Take Afrezza exactly as your healthcare provider tells you to. Your healthcare provider should tell you how much Afrezza to use and when to use it.
  • Know the strength of Afrezza you use. Do not change the amount of Afrezza you use unless your healthcare provider tells you to.
  • Take Afrezza at the beginning of your meal.
  • Check your blood sugar levels. Ask your healthcare provider what your blood sugar should be and when you should check your blood sugar levels.
  • Keep Afrezza and all medicines out of the reach of children.
  • Change in level of physical activity or exercise, weight gain or loss, increased stress, illness, change in diet, or because of other medicines you take. 

While using Afrezza do not:

  • Drive or operate heavy machinery, until you know how Afrezza affects you.
  • Drink alcohol or use over-the-counter medicines that contain alcohol.
  • Smoke.

Afrezza may cause serious side effects that can lead to death, including:

See “What is the most important information I should know about Afrezza?” at the top of this page.

  • Low blood sugar (hypoglycemia). Signs and symptoms that may indicate low blood sugar include:
    • Dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability or mood change, hunger.
  • Decreased lung function. Your healthcare provider should check how your lungs are working before you start using Afrezza, 6 months after you start using it and yearly after that.
  • Lung cancer. In studies of Afrezza in people with diabetes, lung cancer occurred in a few more people who were taking Afrezza than in people who were taking other diabetes medications. There were too few cases to know if lung cancer was related to Afrezza. If you have lung cancer, you and your healthcare provider should decide if you should use Afrezza.
  • Diabetic ketoacidosis. Talk to your healthcare provider if you have an illness. Your Afrezza dose or how often you check your blood sugar may need to be changed.
  • Severe allergic reaction (whole body reaction). Get medical help right away if you have any of these signs or symptoms of a severe allergic reaction:
    • A rash over your whole body, trouble breathing, a fast heartbeat, or sweating.
  • Low potassium in your blood (hypokalemia).
  • Heart failure. Taking certain diabetes pills called thiazolidinediones or “TZDs” with Afrezza may cause heart failure in some people. This can happen even if you have never had heart failure or heart problems before. If you already have heart failure it may get worse while you take TZDs with Afrezza. Your healthcare provider should monitor you closely while you are taking TZDs with Afrezza. Tell your healthcare provider if you have any new or worse symptoms of heart failure including:
    • Shortness of breath, swelling of your ankles or feet, sudden weight gain.

Treatment with TZDs and Afrezza may need to be changed or stopped by your healthcare provider if you have new or worse heart failure.

Get emergency medical help if you have:

• Trouble breathing, shortness of breath, fast heartbeat, swelling of your face, tongue, or throat, sweating, extreme drowsiness, dizziness, confusion.

The most common side effects of Afrezza include:

  • Low blood sugar (hypoglycemia), cough, sore throat

These are not all the possible side effects of Afrezza. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088).

Active ingredient: human insulin

Inactive ingredients: fumaryl diketopiperazine, polysorbate 80

General information about the safe and effective use of Afrezza.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Afrezza for a condition for which it was not prescribed. Do not give Afrezza to other people, even if they have the same symptoms that you have. It may harm them.

This Medication Guide summarizes the most important information about Afrezza. If you would like more information, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about Afrezza that is written for health professionals. For more information, go to www.afrezza.com or call MannKind Corp. 1-877-323-8505.