Decoding the A1C Chart: A Simple Guide to Your A1C Level and eAG

Understanding your health metrics can feel like deciphering a foreign language, especially when dealing with conditions like diabetes or prediabetes. One of the most important numbers you'll encounter is your A1C level. This article breaks down the A1C chart, explains what your A1C level means, and connects it to your estimated average glucose (eAG), all in a clear and easy-to-understand way.

What is A1C and Why is it Important?

The A1C test, also known as the glycated hemoglobin test, provides a snapshot of your average blood sugar levels over the past 2-3 months. Unlike a single blood sugar reading, which fluctuates throughout the day, A1C offers a broader picture of your blood sugar control. This makes it a crucial tool for diagnosing prediabetes, diabetes, and monitoring how well diabetes is being managed. It is a key indicator of your long-term glycemic control.

Essentially, A1C measures the percentage of your red blood cells that have glucose attached to them. The higher your blood sugar levels, the more glucose will bind to your red blood cells, resulting in a higher A1C percentage.

Understanding the A1C Chart

The A1C chart helps interpret your A1C level and determine if it falls within the normal, prediabetes, or diabetes range. Here’s a breakdown:

• Normal: Below 5.7%
• Prediabetes: 5.7% to 6.4%
• Diabetes: 6.5% or higher

Keep in mind that these ranges are general guidelines, and your doctor may have slightly different targets based on your individual health needs and circumstances. A healthcare professional should always be consulted for accurate diagnosis and treatment plans. The A1C test is generally repeated regularly in order to track diabetes management efforts.

A1C Levels and What They Mean

Let's delve a little deeper into what each A1C range signifies:

• A1C Below 5.7% (Normal): This indicates that your blood sugar levels are within the healthy range, and you are not at risk of developing diabetes. Maintaining a healthy lifestyle through diet and exercise can help keep your A1C within this target range.
• A1C Between 5.7% and 6.4% (Prediabetes): This range indicates prediabetes, meaning you have higher-than-normal blood sugar levels, but not high enough to be classified as diabetes. Prediabetes significantly increases your risk of developing type 2 diabetes, but it's also a stage where lifestyle changes, such as weight loss and increased physical activity, can effectively prevent or delay the progression to diabetes.
• A1C of 6.5% or Higher (Diabetes): This indicates that you have diabetes. Effective diabetes management is crucial to prevent long-term complications, and this involves lifestyle modifications (diet, exercise), medication (if prescribed), and regular monitoring of blood sugar levels. Maintaining target blood glucose levels is critical to avoiding complications.

Connecting A1C to Estimated Average Glucose (eAG)

The estimated average glucose (eAG) is another important metric that is often provided alongside your A1C result. The eAG is essentially an estimation of what your average blood sugar level has been in milligrams per deciliter (mg/dL) over the past 2-3 months, based on your A1C value. This makes it easier for some people to understand their blood sugar control, as eAG is expressed in the same units as a typical blood glucose meter reading.

The relationship between A1C and eAG is roughly linear. Here's a simplified chart connecting A1C to eAG.

A1C (%)	eAG (mg/dL)	eAG (mmol/L)
6.0	126	7.0
7.0	154	8.6
8.0	183	10.1
9.0	212	11.8
10.0	240	13.3
11.0	269	14.9
12.0	298	16.5

Note: This table provides approximate values. Your lab report may show slightly different figures.

The equation used to estimate eAG is:

• eAG (mg/dL) = (28.7 x A1C) - 46.7
• eAG (mmol/L) = (1.59 x A1C) - 2.59

Understanding the correlation between your A1C and eAG helps you better visualize your blood sugar control and make informed decisions regarding your health.

Factors Affecting A1C Accuracy

While A1C is a reliable test, certain factors can affect its accuracy:

• Anemia: Conditions that affect red blood cell turnover, like anemia, can falsely lower A1C readings.
• Hemoglobin Variants: Certain hemoglobin variants can interfere with the A1C test and lead to inaccurate results.
• Kidney Disease: Kidney disease can sometimes affect A1C levels.
• Pregnancy: A1C levels can be slightly lower during pregnancy.

If you have any of these what increases blood sugar conditions, your doctor may use other tests, such as fructosamine, to assess your blood sugar control.

Taking Action Based on Your A1C Results

Once you know your A1C level, the most important step is to discuss the results with your doctor. Your doctor will help you understand what your A1C level means how does blood sugar affect blood pressure for your individual health and develop a personalized plan to manage your blood sugar. This plan may include:

• Lifestyle Modifications: Dietary changes, regular exercise, and weight loss are essential for managing blood sugar levels in both prediabetes and diabetes. Focusing on whole, unprocessed foods, limiting sugary drinks and refined carbohydrates, and engaging in at least 150 minutes of moderate-intensity exercise per week can significantly improve your A1C. Understanding diabetes nutrition is key.
• Medication: If lifestyle changes are not enough to achieve your target A1C, your doctor may prescribe medication to help lower your blood sugar.
• Regular Monitoring: Regularly checking your blood sugar levels with a home glucose meter can help you track your progress and make adjustments to your lifestyle or medication as needed. Monitoring for hyperglycemia and hypoglycemia is crucial.

Conclusion

The A1C chart and your eAG provide invaluable information about your blood sugar control over time. Understanding these metrics empowers you to take proactive steps to manage your health and prevent or delay the complications of diabetes. Remember to always discuss your A1C results with your healthcare provider to create a personalized management plan that works best for you. Armed with knowledge about your A1C level and with support from your doctor, you can successfully manage your blood glucose and improve your overall well-being.

Gary Edelson, DVM, highlights the importance of at-home monitoring, the ease of setting up the AlphaTRAK 2 monitor, and observing glucose ranges. Dr. Edelson also demonstrates on a stuffed animal where to take the blood samples as well as how to read the AlphaTRAK 2 monitor. Interview Transcript (modified for readability) Gary Edelson, DVM: In-home monitoring and checking your pet's glucose is really, really important because they don't have that stress that they do in a veterinary setting. And we know that stress actually increases their glucose, so it can make readings a little bit artificially elevated. So, when we're testing our pet's glucose at home, it's in a low-stress environment, we're going to get an actual reading, and then we can communicate those readings to our veterinarian and keep a nice log. At-home testing requires a meter and strips, and I recommend the AlphaTRAK 2 starter kit by Zoetis. Inside this box, you're going to find strips. The strips are labeled with a reference code, one for dogs as well as one for cats. And it's really important that we set our meter accurately. When we do set the meter, we're going to take a strip out of the vial, and it's an instant-on technology, so when you put the strip into the meter it's going to come on and program to the correct number. And you can go up or down by the tests of the button. Within a couple of seconds, it's going to display to insert your blood sample, at which point you would insert your little sample into either side of the test strips, another key feature of the AlphaTRAK 2 meter. Obtaining a blood sample may be a little intimidating for some, but it's actually a very easy, safe, and gentle process to obtain with your pet at home. First, you're going to grab a lancet. The lancet has a little cover on it that gets twisted off to expose the tiny, little needle. And on dogs and cats, there are 3 main sites that I like to use. One would be the ear, the other would be the lip, and the third would be the paw. And we'll go over on a stuffed animal where to do that so we're better apt to practice on our pet when we need to get the blood sample. So, the first site would be the ear. I use the inner margin of the ear and I always pinch the skin where I'm going to do it, and this helps sensitize the nerves so it's not as painful when you get your sample. We take the lancet, hold it by the base, and we carefully go between our pinched fingers to get the sample. And then shortly after you squeeze, you'll get a drop of blood, in which case you would then take your strip and apply it to the blood sample, wait for the beep and then get a result. The next site would be the lip. You would take the lip and fold it up. And again, same thing: You take your fingers, you would squeeze between the lip, you would take your lancing device and go right between your fingers, squeeze for a second to get your blood sample, and same process with your meter. The last site would be the paw. We gently bend the paws back, take the paw pad, again squeeze, take your lancing device and go between, push down, up, and squeeze until you get your blood sample. Good boy. Glucose ranges are from about 120 to 250 mmol/L in a stabilized diabetic animal. The most dangerous situation is where that blood sugar falls too low, so below 100 mmol/L. And this is where your pet can be very tired-called lethargy-weak and doesn't want to stand up. This is an emergency situation. You want to make sure you have Karo syrup or a high-sugar-concentration syrup to put on your pet's lips and call your veterinarian immediately. High ranges would be over 250 mmol/L, where we're really not fully regulated. And, again, you want to talk to your veterinarian about possibly getting into a normal reference range, between 120 and 250 mmol/L, and this is to ensure that your pet is not drinking a lot of water, not peeing a lot, and being very comfortable at home. At-home monitoring, when we first start out, I do like to get daily samples. I try to pick out different times throughout the day, whether it's before our first insulin injection, several hours after, a different time in the afternoon, or before our last insulin injection. And make sure you're creating a chart where you are writing these numbers down so you can always discuss this with your veterinarian before making any changes. A blood glucose curve is a series of measurements starting right before we take our insulin injection and every hour to 2 hours after, for about a full 12 hours. And the key of this glucose curve is to find the highest level and the lowest level, called the nadir, to better regulate your pet at home. View other Pet Connections videos on our website: