Preparing for HbA1c

Overview

The HbA1c test is a simple blood test that measures your average blood sugar level over the past 2–3 months. It is used to diagnose diabetes and to see how well your diabetes is being managed. The name 'HbA1c' stands for 'haemoglobin A1c' – haemoglobin is the part of your red blood cells that carries oxygen, and the test checks how much sugar is attached to it.

Yes, the HbA1c test is very common. Millions of people have it each year to screen for diabetes or to monitor their blood sugar control.

Anyone can receive an HbA1c test, especially people who have symptoms of diabetes, are at risk for diabetes, or already have diabetes and need to check their management.

Symptoms

Common symptoms

• Feeling very thirsty more often than usual
• Urinating (peeing) a lot, especially at night
• Feeling tired and low on energy

Symptoms in children

• Sudden weight loss
• Bedwetting or more frequent urination
• Extreme hunger or thirst

Symptoms in older adults

• Blurred vision
• Slow-healing cuts or sores
• Numbness or tingling in hands or feet

Causes

Main causes

• High HbA1c is usually caused by diabetes (type 1 or type 2) or prediabetes.
• It can also be raised by conditions that affect red blood cells (like anaemia or kidney disease).
• Certain medications (like steroids) can temporarily increase HbA1c.

Risk factors

• Being overweight or living with obesity
• Being physically inactive
• Having a family history of diabetes
• Being over 40 years of age (or over 25 for people of South Asian, African-Caribbean, or certain ethnic backgrounds)

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above – call your local emergency number immediately.
• If your blood sugar levels are consistently very high despite following your treatment plan.

Book a routine appointment if:

• If you have any of the common symptoms of diabetes for more than a week or two.
• If you are due for a diabetes check-up (often every 3–6 months).
• If your doctor or nurse has advised you to have an HbA1c test as part of a regular health check.

Diagnosis

The HbA1c test is used to diagnose diabetes. A single result of 48 mmol/mol (6.5%) or higher suggests diabetes, though your doctor may repeat the test to confirm. For monitoring, the target for most people with diabetes is usually below 53 mmol/mol (7.0%), but your personal target will be set by your healthcare team.

Tests that may be done

• HbA1c blood test (the main test discussed here)
• Fasting blood glucose test (rarely used if HbA1c is unreliable)
• Oral glucose tolerance test (OGTT) – only sometimes for specific cases

What to expect at your appointment

The test is a simple blood draw from your arm or finger prick. You do not need to fast, but tell your doctor about any medicines or conditions that might affect red blood cells (like anaemia). The nurse or phlebotomist will take a small sample of blood. The result usually comes back in a few days. The test is safe and quick.

Treatment

Treatment for high HbA1c focuses on managing your blood sugar levels. This is usually done through a combination of healthy eating, physical activity, and sometimes medication. Your healthcare team will create a plan that works for you.

Self-care at home

• Follow a balanced diet low in added sugars and refined carbohydrates
• Get regular physical activity (at least 150 minutes of moderate exercise per week)
• Take any prescribed diabetes medicines exactly as directed
• Monitor your own blood sugar levels if advised by your doctor

Medical treatments

Depending on your situation, your doctor may recommend oral medicines or injectable therapies to help lower blood sugar. These are tailored to your needs. No specific names or doses are listed here – always follow your doctor’s advice.

When is surgery considered?

Surgery is not a treatment for a high HbA1c test itself. However, for some people with type 2 diabetes and severe obesity, weight-loss surgery (bariatric surgery) can improve blood sugar control. This is only considered after trying other approaches.

Living with this condition

Living with diabetes means checking your blood sugar regularly, taking care of your feet, attending routine check-ups, and making healthy choices every day. Managing your HbA1c is part of that. It is a lifelong journey, but most people can lead a full, active life with good support.

Lifestyle tips

• Stay active – walk, swim, cycle, or do activities you enjoy
• Eat regular meals with plenty of vegetables, whole grains, and lean protein
• Drink water instead of sugary drinks
• Avoid smoking and limit alcohol

Diet and exercise

A balanced diet and regular exercise are the cornerstones of managing blood sugar. Eating at regular times and including fibre-rich foods can help keep your levels stable. Exercise helps your body use insulin better. Aim for a mix of aerobic (like brisk walking) and strength activities.

Mental health and emotional wellbeing

Living with diabetes can be stressful, and it is common to feel anxious, frustrated, or down at times. Your emotional health matters just as much as your physical health. Talking to your healthcare team or a counsellor can help. You are not alone.

Prevention

A high HbA1c (diabetes) cannot always be prevented, especially type 1 diabetes. However, for type 2 diabetes, you can lower your risk by maintaining a healthy weight, staying active, eating well, and not smoking. If you have prediabetes (HbA1c between 42–47 mmol/mol), lifestyle changes can often prevent it from becoming diabetes.

Vaccines

There are no vaccines that prevent diabetes or directly affect HbA1c. However, people with diabetes are advised to have routine vaccinations (like flu and pneumonia) because they have a higher risk of infections.

Screening programmes

If you are over 40, or have risk factors like being overweight or having a family history of diabetes, your doctor may offer a screening HbA1c test every 1–3 years. This can catch high blood sugar early, when changes can make the biggest difference.

Complications

If left untreated

• Heart disease and stroke
• Kidney damage (nephropathy) that may lead to dialysis
• Nerve damage (neuropathy) causing pain or numbness in feet
• Eye damage (retinopathy) that can lead to blindness
• Foot problems, including ulcers and infections that may require amputation

Long-term outlook

With good blood sugar control, regular check-ups, and a healthy lifestyle, most people with diabetes can prevent or delay complications. Many people live long, healthy lives. Your healthcare team will work with you to keep your HbA1c in a safe range and support you every step of the way.

Find support

International organisations

• International Diabetes Federation (IDF)
• World Health Organization (WHO) – Diabetes

Local organisations

• Diabetes UK · United Kingdom
• National Health Service (NHS) – Diabetes · United Kingdom

Helplines

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.