To check if your sugar levels are high (even if you don't have diabetes), your doctor may do an A1C test.
It's an easy finger prick test that doesn't require you to fast before the test so it's convenient.
If your results come back in the 5.7% and 6.4% range, you could be pre-diabetic, and anything over 6.5% could mean you're diabetic.
But it's important that you know which factors influence the results of this test - because a recent study showed it can be wrong 73% of the time.
This is especially important if you suspect your blood sugar levels are high, your doctor is about to prescribe diabetes medication based on this test, or he's suggesting a dosage change based on the results of this test.
What you need to know about the A1C blood sugar test...
The full name of this test is the heamoglobin A1c (HbA1c) test.
Haemoglobin is encapsulated inside red blood cells and is reponsible for transporting oxygen and glucose to the body's cells.
When haemoglobin binds to glucose (blood sugar
), it converts to haemoglobin A1C and stays that way for the rest of the lifetime of the red blood cell (about two to three months).
That's what the A1C test measures - the percentage of haemoglobin A1C in your blood over the past two to three months - which gives you an indication whether your blood sugar is too high.
But there are a few factors that can skew the results of this test - find out below what they are - and about another test you can ask your doctor for as a second opinion.
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When the A1C test says you're diabetic or pre-diabetic and you're not...
The following circumstances can raise your A1C test results:
A deficiency in iron, vitamin B12, or folate (vitamin B9):
If you're low on these nutrients, your body can't make enough new red blood cells to replace old, dying ones, so there's more old and saturated red blood cells which can skew the results in favour of high blood sugar.
Malfunctioning kidneys lead to a low absorption of vitamins and minerals, which also means your body isn't able to make new red blood cells as well as it used to.
Triglycerides are a type of fat
in your blood. Too much of it (over 1,750 mg/dL) makes your A1C levels seem higher than they really are. If you have heart problems, know your triglyceride levels.
If you've had your spleen removed:
The spleen's job is get rid of old, damaged red blood cells. Without the spleen to mop these up, you'll have more old red blood cells in your bloodstream which will give you a higher A1C test result.
And there are also factors that can skew the results the other way too - keep reading...
When the A1C test says you don't have high blood sugar but you really do...
High doses of iron and B vitamins:
If you're taking iron or B vitamins in higher doses, for the treatment of anaemia for example, your body is making more red blood cells than it normally does which can lower the results of the A1C test.
You've recently donated blood or lost blood:
If you've lost a significant amount of blood, your body goes to work straight away to make more red blood cells, at a more rapid rate than it normally would, which can skew the test result.
During the first two trimesters of pregnancy, your body is very busy making lots of new red blood cells to get oxygen to the baby. This too will skew results.
If you're taking high dose vitamin E, it can reduce the number of red blood cells that have glucose attached to them. This can make your A1C test result seem low when it's not.
Chemo treatment and a few other pharmaceutical drugs can alter the results of the A1C test so if you're on medication, make sure your doctor knows about it.
If you suspect the A1C test result could be inaccurate - there is another test you can take to get a second opinion before you and your doctor make any changes to your medication. Read on...
A more accurate blood sugar test...
There is another test that's far more accurate than the A1C test but it's not as convenient because you have to fast for 12 before you take it.
Never-the-less, you can book your doc's appointment for first thing in the morning so that you fast overnight.
It's called the oral tolerance glucose test.
Ask your doc about it if you have any reason to doubt your A1C test results.