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In your the body sugar sticks, particularly to proteins. The red blood cells that circulate in the body live for about 3 months before they die off. When sugar sticks to these cells, it gives us an idea of how much sugar is around for the preceding 3 months. In most labs, the normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it’s less than 7.0%. The benefits of measuring A1c is that is gives a more reasonable view of what’s happening over the course of time, and the value does not bounce as much as finger stick blood sugar measurements.

Although there are no guidelines to use A1c as a screening tool, it gives the physician a good idea that someone is diabetic if the value is elevated. Right now, it is used as a standard tool to determine blood sugar control in patients known to have diabetes. The American Diabetes Association currently recommends an A1c goal of less than 7.0%.

Studies have shown that there is a 10% decrease in relative risk for every 1 % eduction in A1c. So, if a patients starts off with an A1c of 10.7 and drops to 8.2, though there are not yet at goal, they have managed to decrease their risk of microvascular complications by about 20%. The closer to normal the A1c, the lower the absolute risk for microvascular complications.