The A1C or Hemoglobin A1C test is something everyone living with diabetes should be familiar with.
It doesn’t show the whole picture of your diabetes management, but it can be a great indicator of whether your average blood sugar levels are within a healthy range.
Today, I’ll show you how to easily and accurately measure your A1C at home.
We’ll also discuss what an A1C test actually tells you, why it’s a relevant test, and how to interpret the results.
What is an A1C test
The A1C test is a blood test that reflects your average blood glucose over the last 3 months. It is reported as a percentage and people who don’t live with diabetes generally have an A1C below 5.7%.
That means that an A1C test can be a good starting point for a diabetes diagnosis as well as an indicator of whether your diabetes management approach is successful.
The American Diabetes Association has established the following A1C guidelines for using the test as part of a diabetes diagnosis:
A1C targets for people living with diabetes should be tailored to the individual, but generally, an A1C of 7% or lower is recommended. An A1C of 7% translates to an average blood sugar of around 154 mg/dl (8.6 mmol/L).
Some people living with diabetes strive for A1C levels below 5.7%, but aiming for a very low A1C is not always advisable, especially if it’s achieved through an excessive amount of hypoglycemia (low blood sugar).
Discuss your target A1C with your doctor and remember that it can always be adjusted up or down depending on what’s appropriate for you.
Why is it important to measure your A1C
Since elevated blood sugars can lead to a number of short- and long-term complications, it’s advisable to keep an eye on your A1C and ensure that it’s held at a healthy level.
If you find that your blood sugars (and thereby your A1C) are increasing above your target, there are several things you can do to reduce them, such as discussing adjusting your medication with your doctor, changing your diet, and making lifestyle changes
You can read our complete guide to lowering your A1C for more information.
Since the A1C tests give you a picture of your blood sugar level for the last 3 months, it makes sense to have your A1C measured at least every 3 months to keep track of how your blood sugars are progressing.
It the test is used for a diabetes diagnosis, you might have to also have your fasting blood sugar and antibody levels measured to determine which type of diabetes you live with, such as type 1 or type 2 diabetes.
How to use the A1C home test kit
There can be many reasons to measure your A1C at home, such as limited access to see your doctor, the distance to a lab, the cost of the lab work, etc.
There are great options for measuring your A1C at home, but please consult with your medical team before making any changes to your care or self-diagnosing diabetes.
One very affordable A1C home test kit is the A1CNow SelfCheck which I demonstrate how to use in the video below.
The kit comes with 4 A1C tests and will give you your A1C result in only 5 minutes. Follow the instructions that come with the kit and make sure to add enough blood or it will return an error message.
Are home A1C test kits accurate?
Most home A1C kits are considered to be as accurate as lab A1C tests. The results are accurate within plus/minus 0.5 percentage points, which is about the same as most lab results.
To ensure accuracy, look for products that are NGSP-certified (National Glycohemoglobin Standardization Program) and/or have FDA clearance or CE mark. All the products mentioned in this article are NGSP-certified.
When I tried the A1CNow SelfCheck at home (see the video above), the A1C results came back with exactly the same result as the A1C lab test I had done a few days earlier (I used Quest Diagnostics for the lab test).
How much does an A1C test kit cost?
The A1CNow SelfCheck I used in the video is $53.83 on Amazon (as of September 2020) for 4 tests. I chose this kit as it was the cheapest solution, but similar home A1C kits can be found on Amazon ranging from $60-$100 for 4 tests.
You can also find home A1C kits in most pharmacies such as CVS and Walmart.
A1C kits that require you to collect a blood sample at home and send it to a lab are also available.
These tests require a significantly larger blood collection (4-5 large droplets) and you can end up waiting up to 4 weeks (like I did when I tried it out) for your test results, depending on how fast the mail gets to the lab and back to you.
Is it covered by insurance?
Whereas most health insurances (private and government plans) cover blood work prescribed by your doctor and performed in a lab, it’s doubtful that your insurance will cover an at-home A1C test unless it’s a prescribed kit.
However, you can always call your insurance company or look up your benefits and find out if your plans cover at-home kits. If it does, your insurance company may have a preferred brand or specific process for you to get your kit.
Debbie Rom
Hi Christel,
Thankyou so much for all of your info.
I am on Metformin, twice daily, and I’d like to
know how and when is the best time to take it.
I take mine as soon as I get out of bed, then go
about making breakfast, then I do the finger stick
and check my blood. I write all of this in a book and
what I eat and drink. Then, I have my breakfast. Is
this right or wrong? Then I take my Metformin at 5pm
go about making dinner, then check my blood, and do
as I do in the morning. My numbers jump up and down
and I don’t know if I’m doing something wrong. Any
suggestions?
Christel Oerum
I think you’ll find this guide to Metformin helpful (https://diabetesstrong.com/everything-you-need-to-know-about-metformin/).
Generally, it’s recommended you take your Metformin with food and water to prevent gastric upset but if that’s not an issue for you you can probably continue to take it as you do. I don’t think when you take it has anything to do with your fluctuating blood sugars as long as you take it about the same time daily. Blood sugars will always fluctuate but if yours are generally elevated you might need to have your dose adjusted or start a different type of medication. A good idea is to bring your notebook to your next doctor’s appointment (I love that you’re keeping track) and show your doctor the fluctuations that you’re noticing. That will make it easier for your doctor to assess if your meds needs to be adjusted
Arshad Ahmed
are these FDA approved tests? if not, then how are these companies allowed to market these tests?
Christel Oerum
It is FDA cleared, you can read the specifications here: https://ptsdiagnostics.com/a1cnow-plus-system/
SantinA Caruso
Good morning Christel,
I happened upon you and your website this morning looking for suggested, at home, A1C test kits. Your information and insight is fantastic and I wonder if this information translates over to T2D’s. I am a recently diagnosed and refuse to take medicine and am trying to keep my BG levels within normal to pre-diabetic having done so for almost a year. As of late, my fasting BG is rising >125-140. I do not fit the T2D phenotype. I am thin, very active, and eat mostly a 1:1 protein to carb diet and am a pescetarian.
I want to learn how to eat, when to eat and what to eat and need to know if your information translates over to T2D or should I seek information and learning else where before reaching out my my local medical professionals.
Christel Oerum
Thank you, I’m glad you enjoy the content and find it helpful. Yes, everything in this article is relevant for people living with any type of diabetes.
As for specific, type 2 or pre-diabetes content, just use the navigation bar on the top of the page and you’ll find all of the categories. I do think this specific article would be good for you to read: https://diabetesstrong.com/is-type-2-diabetes-reversible/
Finally, please make sure that you have been tested for antibodies to ensure that you have the right diagnosis (https://diabetesstrong.com/lada-diabetes/). You can easily be lean and active and live with type 2, but as you mention we don’t see that that often
Keith
I don’t understand how A1C can be an average of anything if you are just imputing today’s blood. I know I sound retarded.
Christel Oerum
A blood draw today can reveal a lot about what has been going on in your body. An A1C test measures the percentage of red blood cells that have “sugar-coated” hemoglobin (a protein in your red blood cells). In the body, red blood cells are constantly forming and dying, but typically they live for about three months. Thus, the A1c test reflects the average of a person’s blood glucose levels over the past three months.
Cathy
I found out in April of this yr. I’m a diabetic, so my Dr. put me on the Metformin, horrible medicine, I had really bad side effects so I just started the insulin because he said it has less side effects. I have got my family telling me to see a specialist for my sugar, my Dr. is just a MD. What do you think?
Christel Oerum
Some MDs are excellent so there’s not a one size fits all answer. If you choose to see an endocrinologist make sure that the one you choose regularly sees people with type 2 diabetes. It’s can’t hurt to see a specialist, except they’re usually more expensive, for a second opinion
Susan
Insulin makes you gain weight even if you are super careful with what you eat all day every day. I would try to put up with the Metformin side effects for about a month if I could avoid the insulin by taking Met. I am a Type 2 diabetic. I am struggling hard to lose the weight insulin caused me to gain even though I fought the weight gain every step of the way. And I am still fighting.
Christel Oerum
It’s not quite true that everyone who takes insulin gains weight. There are plenty of people living with insulin-dependent diabetes that do not have weight issues and even some who struggle to keep on weight.
That doesn’t take away from your experience but I think we have to be very careful with blanket statements like that as they can scare some people away from a medication that can save their life.
You can read more about insulin and weight gain here https://diabetesstrong.com/insulin-weight-gain-does-tighter-control-make-you-loosen-your-belt/
Shaunti
The HgA1c now self check, after 4 test, can you get more test or is the kit disposed?
Christel Oerum
I haven’t seen any brands that sell the cartridges by themselves, so you’d have to order a new kit if you want more than 4 tests
Jacqui
So does the .5 difference mean a 7.0 lab test could read 6.5-7.5?
Christel Oerum
Yes, that is what it means
Erica
Where are the resources showing that the at-home ones are within plus/minus 0.5 percentage points? Thanks!
Christel Oerum
Here is the clinical data on the A1CNow SelfCheck specifically: https://ptsdiagnostics.com/a1cnow-accuracy/
Pam Koretsky
Is there going to be anything on GMI vs A1C for control and risk indicators? Lots of us are on CGMs now and have access to GMI numbers between blood work.
Christel Oerum
That’s not included in this article, but could be talked about in future pieces
Kevin
I find the reports from my Dexcom to be much more helpful than an A1c. More detail let’s me make more accurate adjustments and Time in Range seems a much better overall number to look at
Rebecca
With Pandemic I really don’t want to go in to a lab or dr office every 3 mos so was thinking of doing the A1c test at home and waiting another few mos (after vaccine since Ivan high risk). I went 3 mos ago and did not like the experience. Lab did not have precautions!! Why do we need to be checked every 3 mos instead of say 6? Time flies by! Type2 7 years
Christel Oerum
Then maybe this home test is for you. I agree, going to a lab right now is not the best experience.
The 3-months is to keep an eye on our numbers, so your doctor can react and suggest treatment changes if needed.
Aline
Hello,
Great info thank you.
I could not find the video on how to use the a1c kit.
Thank you.
Christel Oerum
Oh no, a few things could be going on. Some browsers won’t show it ? Another reason could be an ad blocker, if that’s the case you’d have to disable that. If none of that works, hang tight, I’m in the process of creating a more comprehensive A1C comparison for YouTube and this product is included
Christel Oerum
Hi Aline – the video is now part of this YouTube guide: https://youtu.be/5UYYB1L90pY