By Alana Mauger

You’ve probably seen those pharmaceutical commercials – people dancing in the streets, singing catchy tunes about lowering their A1C. The jingles stick in your head for hours. But since its National Diabetes Awareness Month, it’s worth asking: what exactly is A1C, and why does it matter for your health?

Diabetes Basics

Diabetes is a condition that occurs when your blood glucose – also known as blood sugar – is too high. There are two main types:

• Type 1 diabetes is an autoimmune condition where the body cannot produce insulin. It’s usually diagnosed in childhood and treated with insulin. Only about 5-10% of Americans with diabetes have type 1.

• Type 2 diabetes accounts for 90–95% of cases. In type 2, the body doesn’t make enough insulin or doesn’t use it effectively. Risk factors include age, family history, race and ethnicity, as well as lifestyle factors like weight, waist circumference and physical activity. Treatment options include medications, insulin and/or lifestyle changes.

Type 2 diabetes is a chronic condition that requires ongoing management. Without proper control, it can lead to serious complications such as cardiovascular disease, kidney damage, vision and nerve problems and a weakened immune system.

What Does the A1C Test Measure?

A1C is a simple blood test that can be used to diagnose type 2 diabetes and prediabetes. It’s also the primary tool used for monitoring diabetes over time. Unlike a fingerstick test that shows blood sugar at a single moment, the A1C test measures your average blood sugar over the past three months.

The U.S. Centers for Disease Control and Prevention (CDC) breaks it down like this. When sugar enters your bloodstream, it attaches to hemoglobin, a protein in red blood cells. Everyone has some sugar, but people with higher levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin. Here’s the breakdown:

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

For those living with diabetes, the goal is typically an A1C below 7%.

Why Your A1C Matters

While there’s no cure for type 1 diabetes, evidence shows that type 2 can be prevented, delayed and even put into remission with medications and/or lifestyle changes, especially during the prediabetes stage, which has little or no symptoms. Even without developing diabetes, an elevated A1C can indicate a higher risk for other health complications like heart disease, stroke and kidney disease.

Getting Tested

The CDC recommends A1C testing every three years for adults age 45 and older. Testing should be more frequent for those who:

• Have a family history of diabetes
• Are overweight or obese
• Have been diagnosed with prediabetes
• Had gestational diabetes during pregnancy
• Show symptoms of diabetes

Your primary care provider can order the test and explain results. If your A1C level is high, your provider will likely order a fasting blood glucose test before making a diabetes diagnosis.

Understanding Diabetes as a Blood Donor

To help empower and educate blood donors in November, the American Red Cross will perform free A1C testing on successful donations (one result per donor in a 12-month period).

Since March, the Red Cross has performed about 550,000 A1C tests, empowering donors with vital health insights. Of those, about 145,000 individuals were notified of concerning A1C levels – potential indicators of chronic conditions like prediabetes and diabetes.

Fasting is not required for the A1C test, which measures an individual’s average blood sugar levels over the past three months. It’s always important to eat a nutritious meal before giving blood or platelets.

People with prediabetes and diabetes are generally eligible to donate blood, platelets and plasma if they are feeling well and their diabetes is well managed. To learn more about understanding diabetes as a blood donor, visit RedCrossBlood.org/Diabetes.