What is considered a health blood sugar? What is hemoglobin A1C?
Blood glucose aka blood sugar is a measure of your blood glucose in that specific moment of time. So, what time of day in relation to when you last ate is important to note when you’re looking to see if the number on your lab test or glucometer is in the non diabetic range.
Fasted blood glucose is measuring your blood sugar when you have not had anything to eat in about 8-10 hours before testing.
Fasted blood glucose ranges
- Non Diabetic below 100 mg/dl
- Pre Diabetic 100-125 mg/dl
- Diabetic 126+ mg/dl
Postprandial glucose measurements are measurements of your blood glucose after you have eaten something. You start seeing an increase in blood glucose about 10 minutes after you start eating, but the highest point of your blood sugar post meal is usually about 60 minutes after starting to eat. Most clinical postprandial glucose tests are 2 hours after they have the patient eat a meal with about 75 grams of carbohydrate.
Postprandial glucose ranges
- Non Diabetic below 140 mg/dl
- Pre Diabetic 140-199 mg/dl
- Diabetic 200+ mg/dl
Testing after meals is problematic because what you ate in that meal has a great influence on the result. However, it’s good to know the ranges, say if you had abnormal blood glucose on a random lab test and are trying to determine if it’s something to be worried about. In a non diabetic person you should expect to see the blood sugar levels return to about pre-meal levels around 2-3 hours after eating.
Hemoglobin A1C, or A1C for short, has become a much more widely used test in the last two decades. It’s one of the main blood tests used to diagnose Diabetes. A1C is a blood test that measures your average blood sugar level over the past 3 months. When sugar enters your bloodstream, it attaches to the protein in your red blood cells aka hemoglobin. Everyone has some sugar attached to their hemoglobin, but people with consistently higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar attached to the hemoglobin.
Hemoglobin A1C percentage ranges
- Non Diabetic A1C below 5.7 %
- Pre Diabetic A1C 5.7-6.4 %
- Diabetic A1C 6.5+ %
When should you be testing your A1C? If you have risk factors then you start testing early. What’s early? As Diabetes has become prevalent in children, we are starting to screen more frequently around the time puberty hits if the child has any risk factors. So, as soon as you are concerned, test!
What are risk factors for adults according to the CDC?
- Being overweight (BMI ≥25)
- >45 years or older
- Having a parent, brother, or sister with type 2 diabetes
- Being physically active less than 3 times a week
- Having ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
- Being African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)
- Having non-alcoholic fatty liver disease
If the A1C is in the normal range, repeat the test every 3 years. If it shows you have Pre-Diabetes, you should retest A1C as often as your doctor recommends, which is usually every 1 to 2 years. In someone newly diagnosed with Pre-Diabetes or Diabetes, you can retest as early as every 3 months, especially if you have started new diet and exercise habits and want to see how significant the impact of your work has on your average blood sugar. Testing more frequently than that is usually not helpful because the A1C is an average blood sugar over three months.
How does the A1C percentage correlate to the amount of blood sugar?
| A1C % | Average Blood sugar |
| 7 | 154 |
| 8 | 183 |
| 9 | 212 |
| 10 | 240 |
How do you check your blood sugar at home? You can purchase glucometers and testing strips at the local pharmacy, without a prescription, if you would like to have more data points. (If you’re Diabetic, these are usually covered by insurance, so check with your doctor first.) There are many videos on Youtube on how to use the different glucometers. There are even more expensive continuous glucose monitors that you wear for multiple days that can read your blood sugar the entire time. Checking your sugar at home can be very useful if you’re having a hard time decreasing your A1C and want to see what particular foods you are having a more significant response to. Overall, get curious, get involved in your health and you’ll find that the more you understand about the tests your doctor has you take and how your individual metabolic response is to food, the more empowered you are to make changes that support your wellness.
Coach Sarah, FNP-BC, MSN