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Diabetes Mellitus has become a disease which is common in every household and everyone is much aware of this disease and its complications. Other than the routinely checked fasting and post prandial sugar levels, many physicians are turning to Glycated haemoglobin or HbA1c to determine glycemic control.

Glycated/glycosylated haemoglobin or HbA1c or simply A1c is a test to measure the amount of sugar (glucose) which is attached to haemoglobin. Hemoglobin is a protein found in blood responsible for transporting oxygen. Glucose or sugar binds to haemoglobin and is transported in the body. The HbA1c test measures this glucose-hemoglobin complex quantitatively and gives an average measure of our body’s blood glucose levels over the past three months and hence, is routinely used to check pre-diabetes and diabetes. This test gives you a better insight regarding your blood sugar levels and whether it is well or poorly controlled.

As per the latest guidelines issued by American Diabetes Association (ADA) 2022, HbA1c is categorised as follows:


Category HbA1c level
Normal less than 5.7%
Pre-diabetes 5.7% to 6.4%
Diabetes 6.5% or higher

To obtain a blood sample for HbA1c test, your healthcare provider will insert a needle into your vein and draw blood. You do not need to fast before the A1C test and it can be done anytime of the day and also after meals.

Once blood is drawn, it is processed and the results are released usually within three hours. If your HbA1c is less than 5.7%, it means you have excellent glycemic (sugar) control. If it is between 5.7 to 6.4%, it indicates that you are in the Pre-diabetes category, which is a warning for you to control your sugar levels and that you need to monitor yourself better. If HbA1c is equal or more than 6.5%, it indicates Diabetes and/or poorly controlled blood sugar levels.

HbA1c is frequently used as either a standalone test or in combination with FBS (fasting blood sugar) and PPBS (post prandial blood sugar) tests to assess likelihood of diabetes and to assess progress of treatment. If you fall in the Pre-diabetes category, your treating physician will be able to suggest lifestyle modifications and refer you to a nutritionist to help you further. This way, you may be able to postpone developing diabetes or even prevent it. In case you fall in the Diabetes category, your HbA1c levels can give your physician a better view point in medical management which can help in preventing complications of diabetes.

Ideally, a diagnosed diabetic should test their HbA1c levels once in every months. Others can check HbA1c as per their requirement or by a physician’s reference.

Dr. Anu Sumi Issac

Consultant Pathologist
Aster Labs Trivandrum