What is HbA1c (Hemoglobin A1c)?
HbA1c is what’s known as glycated haemoglobin. Hemoglobin A1c or just A1c.
The ‘Hb’ refers to hemoglobin, a part of red blood cells that carry oxygen throughout your body. ‘A1c’ refers to a minor part of hemoglobin that sugar molecules attach to.
The amount of sugar attached is directly proportional to the amount of sugar in your blood at a given time, so this reading is used to accurately reflect average blood sugar levels.
This is something that’s made when the glucose (sugar) in your body sticks to your red blood cells. Your body can’t use the sugar properly, so more of it sticks to your blood cells and builds up in your blood. Red blood cells are active for around 3 months, which is why the reading is taken quarterly.
Too much sugar in the blood damages your blood vessels. This damage can lead to serious problems in parts of your body like your eyes and feet.
HbA1 can determine your average blood sugar (glucose) levels over the previous 3-months. That means it can be used to assess the quality of your diabetes management, as well as to diagnose pre-diabetes and diabetes.
Why is HbA1c so important for your Health ?
A high HbA1c means you have too much sugar in your blood. This means you’re more likely to develop diabetes complications, like serious problems with your eyes and feet.
Knowing your HbA1c level and it will help you reduce your risk of devastating complications. This means getting your HbA1c checked regularly.
It’s a vital check and one of your 15 healthcare essentials. You’re entitled to get this test at least once a year. But if your HbA1c is high or needs a little more attention, it’ll be done every three to six months.
Once you know your HbA1c level, it’s important you understand what the results mean and how to stop them from going too high. Even a slightly raised HbA1c level makes you more at risk of serious complications, so get all the facts here and be in the know about HbA1c.
The result of the HbA1c test lets your healthcare team know if they need to change your treatment or medication to help you manage your levels better. But it also tells you a number and it’s important you understand what this means. Some people find it helps to write their results down in a diary, to keep track of them and see if they can spot any trends.
How to lower your HbA1c levels
If your levels have gone above your target since your last check, it’s understandable to be worried. Even a slightly high HbA1c level puts you more at risk of developing serious complications in your body. But knowing your numbers and what that means is an important and good first step – now you need to know how to lower them.
Lots of things can cause your HbA1c levels to change and there’s action you and your healthcare team can take to bring them down to your target level:
-Your diabetes team may need to review your medication and increase the dose or try a new one.
-Ask them about local diabetes education courses there’s always more to learn with diabetes and a course will help you take practical steps to lower your HbA1c.
-Get more active– moving more is good for everyone, but it can specifically help to bring down your HbA1c levels.
-Get advice on balanced, healthy eating.
-Stop smoking -smoking makes it harder for blood to flow around your body.
And if you want to hear from others who are experiencing this too, think about joining Diabetes online forums It’s a place where you can chat to others or just read other people’s stories.
“Optimal/Functional” HbA1c Ranges vs. “Normal”
My HbA1c History and Forecast 2002-2019
In functional medicine, they are always looking beyond “normal” when it comes to lab marker ranges. Why? Because “normal” doesn’t necessarily equate to optimal if you’re interested in preventing disease—especially when it comes to preventing future blood sugar issues.
Optimal/Functional HbA1c Ranges:
Excellent: less than 6
Less than Optimal/Pre-diabetic stage: 5.4-6.0 (your lab will call this “normal” but, in functional medicine we consider this the concerned-zone)
Good: Anything above 6.0 reveals a problem state with blood sugar control
Individuals who have particularly high or low hemoglobin levels will not be able to rely on HbA1c ranges. Keep in mind too that HbA1c is not the only marker we recommend for assessing blood sugar issues and the insulin resistance that often causes it. But it’s a powerful one to assess for most.
The Health Affects of Chronically High HbA1c
The consequences of sub-optimal or less-than-optimal HbA1C ranges over a period of time include an increased risk of Certain cancers:
-Increased annual brain shrinkage
As mentioned above, chronically high HbA1c levels also corrode tissues, blood vessels and your organs most susceptible to glucose.
Some common examples include your optic nerve, your brain, your heart, and your kidneys—which directly correlate to the greater health consequences listed above.
What Causes High HbA1c?
It’s easy (especially in the integrative health world) to place the blame of high HbA1c levels squarely on too much sugar in the diet but that is not always the case folks!
The truth is there are a variety of foods and lifestyle factors that can directly affect your HbA1c levels such as:
-Sleep issues—believe it or not, sleep deprivation is a leading causal factor behind blood sugar imbalances. A recent study showed…
-Stress—chronic stress can really do a number on your blood sugar levels because excessive stress hormones raise blood sugar and can create insulin resistance. For example, a study showed…
-Too many carbs, or too many of the “wrong” carbs—for sure, excessive consumption of sugar and refined carbohydrates can wreak havoc on your blood sugar issues. But that doesn’t mean all carbs will hurt you. “Good carbs” like those found in moderate amounts of whole fruits, vegetables and even sweet potatoes or white potatoes with the skins-on should typically be included in a healthy diet.
-Artificial sweeteners—artificial sweeteners like aspartame, sucralose and saccharin have recently been shown to affect your blood sugar levels.
-Not enough muscle mass/lack of exercise—muscle helps your body regulate blood sugar. Therefore, if you’re lacking in lean muscle mass due to lack of exercise, that could contribute to high HbA1c
How to Lower your HbA1c Levels
-Reducing your intake of refined carbs and sugar—to make this easy, substitute stevia for sugar wherever you can (stevia is a non-artificial plant extract sweetener), cut back on processed foods, and try cutting down to just 1-2 servings of grains a day.
-Increase your protein intake—protein helps stabilize blood sugar while increasing satiety. And while you don’t need to go crazy with this, aim to have a little lean animal or plant-based protein at every meal and snack.
-Get on a regular exercise program—your goal here is not to kill yourself or run a marathon, rather focus on exercises that build muscle mass by challenging you. Burst or interval training, weight training, yoga, and other weight-bearing exercises are excellent for this.
-Work on stress management— believe it or not, this is one of the most profound things you can do to impact your blood sugar levels. Stress-busters include:
-Listening to music
-Spending time with friends
-Spending time in nature
-Getting off your screen more often
-Optimize your sleep—if you’re not getting 7.5-9 hours of sleep a night, your blood sugar will suffer. Some helpful tips to get more zzzzs include:
-Expose yourself to bright morning light (this helps reset your internal clock)
Stopping caffeine by noon
– Get enough exercise at least 4 hours before bedtime (this will make you tired and help connect body to mind)
-Turning off screens and devices 1-2 hours before bed (otherwise, all that full spectrum light tells your brain to Wake up!)
-Eat dinner earlier (active digestion can often keep people up at night)
Stick to a bedtime routine (this means you wind down and go to sleep the same way, at around the same time every night)
-Journal out your thoughts, next day’s plans, and worries before bed to clear your mind
Sleep in a completely dark room to stimulate natural melatonin production
How Often to Recheck HbA1c?
Physicians typically recommend patients with type 2 diabetes check their HbA1c every six months to ensure adequate treatment. I believe in the same vigilance to make sure that your lifestyle changes are giving you the Results you want. If your level falls in the concerned-zone above, we will recommend you check progress at least every 6 months.
From a prevention perspective with optimal levels, I recommend checking HbA1c every year or two. As you’ve learned in this article, many areas of lifestyle choices over time can add up to create insulin resistance and blood sugar imbalances. So it’s best to be empowered and stay on top of your body’s feedback to manage imbalance proactively – before it ever has a chance to become disease.