A high hemoglobin A1C may tell your doctor more than you want to share. Why? Because it tells the truth about your blood glucose average and where it has been trending for the past three months.
If you have not been as consistent as you hoped, a comparison of your A1C “score” to your daily reported blood glucose levels (BGs) may reveal some discrepancies. And discrepancies like that may lead to a slightly interrogative session with your doc.
Those of you who have been there, can relate. You may even be able to picture your doctor giving you that severe look over the top of his thick glasses.
Understanding the A1C
Why is an A1C every three months? Because your body cycles your red blood cells every 120 days, or roughly three months. Hemoglobin is one of the main proteins on the surface of your red blood cells. So, as your blood circulates around your body, the sugar in your blood starts to “stick” to the hemoglobin, hence hemoglobin A1C. The higher your blood sugar, the more it sticks to your hemoglobin. Since the red blood cells and sugar are constantly circulating through your body, it is a pretty good measure of your average level.
Not only does a high A1C tell your doctor that your BGs are running high, it can also give him a pretty good guess of what your average is. You can do some simple math to predict your average blood glucose from your A1C reading, too. You can do the math yourself or you can just search for an “A1C calculator” online. For example, an A1C of 7.0 is roughly equal to an average blood glucose in the 150s. For each 1.0 more than 7.0, simply add another 30 to 150.
What does it mean? A high A1C could mean two things: Either your BGs are running high and your medication regimen needs to be adjusted or you are not sticking with your meds, your glucose checks, or your diet as much as you want to. If it’s the second, you will want to be straight forward with your doctor, because you don’t want your meds increased unless you really need it.
So why is hemoglobin A1C used? Believe it or not, it’s not because your doctor wants to catch you red handed. It is used because research shows it is a good predictor of your risk for developing complications from diabetes. The goal is to keep you healthy for as long as possible and one of the best ways to do it is by getting your A1C down to less than 7.0.
How can you lower your A1C score? Consistent management of diabetes through medication, glucose checks, diet, exercise, and stress reduction. And don’t forget patience; remember that it will take three months of consistent management before you get a completely new and improved A1C reading.
You can find out more about Hemoglobin A1C at Mayo Clinic’s website.
Bob Chestnut is a senior medical student at the University of Utah.