Medically Reviewed By: Tom Iarocci, MD
The A1C test is an indicator of a person’s blood sugar levels, on average, over the previous 2 to 3 months. Someone without diabetes typically has an A1C of less than 5.7%, but if you have diabetes, it is very difficult to have such a low A1C. A typical recommendation for those with diabetes is that A1C be 7% or lower. The caveat is that having an A1C <7% is not the right goal for everyone. Use the information below and talk to your doctor about what your A1C goal should be.
A1C: Different Goals For Different People:
The 2017 American Diabetes Association (ADA) recommendations indicate that different A1C goals (ranging from <6.5% to <8%) may be appropriate, depending on a person’s individual circumstances. These guidelines refer to non-pregnant adults.
1.) A1C below 6.5% is the most stringent goal. This can be suggested to people if they are able to achieve this without suffering the negative effects of low blood sugar levels, or hypoglycemic episodes. The ADA points out that this goal might be appropriate in people who have had only a short duration of diabetes, or if people are taking metformin and making lifestyle changes as their only diabetes treatments. Such a goal might also be appropriate for younger people with diabetes who still have many years of life expectancy ahead of them, or for people who have no significant heart and blood vessel disease.
2.) A1C below 7% is probably the most commonly pursued A1C goal for non-pregnant adults with diabetes. Various studies have demonstrated that keeping your A1C below 7% can reduce your risk for some of the complications that involve the nerves, eyesight and kidneys. This is particularly true if they you are able to sustain these levels in the good range for a long time.
3.) A1C below 7.5% is the recommendation for children between 0 and 18 who have type 1 diabetes. The goal A1C used to be higher, due in part to concerns about the risks of hypoglycemia when shooting for a lower A1C, but the recommended target was revised downward in 2014. It is very important that parents understand the importance of finding a balance between the risks of hypoglycemia and the long-term benefits of properly controlling glucose in the body. This is particularly true in children under the age of 6, as they will find it difficult to articulate or recognize symptoms of low blood sugar. The ADA indicated that if children do not have many low blood sugar episodes, a goal of 7% and lower should be achievable, although this must be done with proper support and monitoring of a physician.
4.) A1C below 8% is a less stringent goal. This might be an appropriate goal for someone who suffers from severe hypoglycemia, or has already had diabetes for many years and struggles but fails to reach lower A1C levels. It may also be an appropriate goal for some elderly people, or those who have serious complications or medical problems and related concerns that supersede the benefits of tighter glycemic control.
How Often Do You Need an A1C?
Once you and your doctor settle on an A1C goal, you will also want to be mindful of how often you should have this test done. If you have only recently been diagnosed, or if there have been recent changes to your treatment plan, more frequent A1C testing may be necessary, such as four times a year. Once things are stable, getting an A1C twice a year will often be enough.