A1C Test for Diabetes

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KEY POINTS

• The A1C blood test checks your child’s average blood glucose (sugar) over the past 3 months. The test is done to diagnose prediabetes or diabetes, or to see how well your child’s blood glucose is controlled if your child has been diagnosed with diabetes.
• Your child doesn’t need to fast before having the test and it can be done any time of the day. A small amount of blood is taken with a prick of the finger or from a vein in your child’s arm with a needle.
• Talk to your healthcare provider about what the test results mean and ask any questions you have.

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What is the A1C test?

The A1C ("A-one-C") is a blood test that checks your child’s average blood glucose (sugar) over the past 3 months. Glucose absorbed from the food your child eats or drinks goes into the bloodstream. The glucose sticks to the hemoglobin protein, which is the part of red blood cells that carry oxygen to the cells in the body. When glucose sticks to the hemoglobin, it forms hemoglobin A1C. The A1C stays in the blood for the life of the red blood cell, which is 90 to 120 days. This means that the amount of A1C in your child’s blood reflects the average level of the blood glucose over the past 3 months.

Another name for this test is hemoglobin A1C test. It is different from a regular blood glucose lab test or a finger stick blood glucose test. Daily checks of blood glucose show how well treatment is working throughout the day.

Why is this test done?

There are 3 reasons to check your child’s A1C:

• To diagnose prediabetes (blood glucose that is higher than normal, but not quite high enough to be called diabetes)
• To diagnose diabetes
• To see how well your child’s blood glucose is being controlled

If your child has diabetes, your child should have an A1C test every 3 to 6 months. A1C tests are important because:

• They can check the accuracy of the blood glucose results you get at home.
• They help predict your child’s risk of serious problems from diabetes. The higher the A1C, the greater the risk of eye, kidney, blood vessel, or nerve damage.

How do I prepare my child for this test?

Usually no preparation is needed for this test. Your child doesn’t need to fast before having the test and it can be done any time of the day.

Talk to your healthcare provider if you have any questions about the test.

How is the test done?

Having this test will take just a few minutes. A small amount of blood is taken with a prick of the finger or from a vein in your child’s arm.

At some pharmacies you may be able to buy a device that allows you to test A1C at home. The results of the home test may not be the same as results of tests done at your healthcare provider's office. Ask your child’s healthcare provider if you should check your child’s A1C levels at home.

Ask your healthcare provider when and how you will get the result of your child’s test.

What does the test result mean?

The A1C level in children is usually somewhat higher than for adults. For children under age 19 with diabetes, the A1C goal is 7.5.

A1C results may also be given as the eAG, or estimated average glucose. You can use your child’s A1C results and the chart below to know what your child’s average blood glucose has been.

 A1C   Estimated Average Glucose (eAG)
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 6     125 mg/dL
 7     154 mg/dL
 8     183 mg/dL
 9     212 mg/dL
 10     240 mg/dL
 11     269 mg/dL
 12     298 mg/dL
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Even though your child has the A1C test every few months, your child’s blood needs to also be tested at home as often as your child’s provider recommends. The blood glucose test results help you and your child’s healthcare provider know if your child is meeting treatment goals and has a stable blood glucose level.

What if my child’s test result is not normal?

If your child has not been diagnosed with diabetes and the test result is above normal, talk with your child’s healthcare provider about whether your child might have diabetes.

If your child has been diagnosed with diabetes and the A1C is high, the plan for treating your child’s diabetes may need to be changed or your child may need help from your provider, a diabetes educator, or a dietitian to help your child follow the plan. Your child’s healthcare provider will talk to you about how to lower your child’s blood glucose.

If your child’s test results are not normal, ask your child’s healthcare provider:

• If your child needs more tests
• What kind of treatment your child might need
• When your child needs to be tested again
• What lifestyle, diet, or other changes your child might need to make