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HbA1c Test Explained: Your 3-Month Blood Sugar Average
What is HbA1c, what do the results mean, and how often should people with diabetes have it checked? A clear guide to the most important diabetes blood test.
Quick answer
HbA1c measures the percentage of haemoglobin with sugar attached, reflecting your average blood sugar over the past two to three months. Below 5.7% is normal, 5.7% to 6.4% indicates prediabetes, and 6.5% or above indicates diabetes. Many adults with diabetes aim for below 7%, but your doctor will set a personal target. No fasting is needed.
In this article
HbA1c (also called A1C or glycated haemoglobin) is the main test used to diagnose diabetes and to see how well it is controlled.
How it works
Sugar in the blood sticks to haemoglobin, the protein in red blood cells. Red blood cells live for about three months, so HbA1c shows your average blood sugar over roughly the last two to three months. One high or low reading on a glucose meter does not change it much.
What the results mean
| HbA1c | Meaning |
|---|---|
| Below 5.7% | Normal |
| 5.7% to 6.4% | Prediabetes |
| 6.5% or above | Diabetes (confirmed by repeat testing) |
Some laboratories report HbA1c in mmol/mol. 6.5% is equal to 48 mmol/mol.
Targets for people with diabetes
Many adults with diabetes aim for an HbA1c below 7% (53 mmol/mol). Targets may be higher for older adults or people prone to low blood sugar, and lower for some younger people. Agree a personal target with your doctor.
How often should it be checked?
- Diabetes on target and stable: at least twice a year
- Treatment recently changed or not on target: about every three months
- Prediabetes: at least once a year
Things that can affect the result
Anaemia, recent blood loss or transfusion, pregnancy, kidney disease and some inherited haemoglobin conditions can make HbA1c less reliable. Your doctor may use other tests in these situations.
Do I need to fast?
No. HbA1c can be checked at any time of day.
Frequently asked questions
My HbA1c went up. What should I do?
Book a review. Your doctor will look at your diet, activity, medicines and home glucose readings, and adjust treatment if needed. Read our guide to diabetes check-ups.
Is HbA1c the same as my glucose meter reading?
No. A meter shows your sugar at that moment. HbA1c shows the long-term average.