Amy Tenderich was diagnosed with type 1 diabetes in May of 2003. She is the founder and editor-in-chief of Diabetes Mine and co-authored the book Know Your Numbers, Outlive Your Diabetes. You will frequently find her speaking at diabetes, health, and social media events across the country.
Some people believe that if they get their A1c blood test done regularly, there’s no need for daily glucose testing.
It is true that the hemoglobin A1c (or simply A1c for short) is considered the “gold standard” of blood glucose measurement. It’s conducted in a laboratory and measures your average blood glucose levels for the past three months. This test is used as the main measure of your glucose management. (The recommended goal is a level of less than seven percent.)
The big picture
The A1c looks at the big picture, i.e. “What effect are my blood glucose levels having on my chance of future diabetes complications?” BUT, if your A1c turns out to be high, this test doesn’t provide a clue as to what you can do about it. A high A1c result tells you that you need to change something, but only your individual daily glucose results can provide the real clues about specific actions or strategies you might need to take. That’s why frequent home glucose testing matters!
Meeting your target A1c
What if you meet the A1c target (7.0 or below), while your before- and after-meal blood glucose numbers have been “off”? What does this mean?
Remember that the A1c is an average number. In other words, it's a point that reflects the “middle” of all your glucose values over the past three months. So you could have a “perfect” A1c result of 6.5 that might actually reflect the mid-point between several weeks of severe highs and lows. Not good.
If, however, your A1c met your target and you did not have frequent low blood glucose values, then all of your levels during the previous three months were okay. They were okay even if they were occasionally off-target. There will always be fluctuations, which is why the A1c is the perfect complement to daily testing.
In a nutshell: All of the existing clinical research tells us that your A1c is the vital indicator of your future health. Your glucose meter is a vital indicator of how you’re doing on a daily basis, leading up to your A1c.