An HbA1c reading on its own isn’t very helpful unless you know what it really means about your daily blood sugar levels.
Understanding how your A1c accumulates over the course of 3 months and how it translates to an actual average blood sugar level is a critical part of diabetes management that is often never explained in the doctor’s office.
In this article, we’ll talk about how AGEs lead to your A1c, how your A1c result translates to an eAG, and what you can do next with that information!
Table of Contents
What your A1c is really measuring: Advanced Glycogenated End-Products
Your A1c is actually a measurement of the amount of “advanced glycogenated end-products” that have accumulated in your bloodstream over the course of the prior 3 months.
Also known as “AGEs,” these are essentially a form of excess sugar from your bloodstream that is responsible for damaging crucial nerve-endings and blood vessels throughout your entire body.
The more AGEs are present in your bloodstream, the more damage your body is experiencing that results in the classic list of diabetes complications like retinopathy, neuropathy, hair-loss, gastroparesis, dermopathy, and nephropathy.
The higher your blood sugars are on a daily basis, the more AGEs build-up in your bloodstream. The more AGEs there are in your bloodstream means the higher your next A1c result will be!
While we don’t talk about AGEs regularly in the doctor’s office or online, they are exactly what your A1c is measuring.
What is an estimated average glucose level?
Before we start talking about A1c results, we need to clear up one thing: your eAG.
Your eAG is simply your “estimated average glucose level” or blood sugar level.
Your eAG is another term rarely used in doctor’s offices, but it’s pretty darn important if you’re trying to improve your A1c and your overall risk of diabetes complications.
We all know our blood sugar never stays put in one place for very long, so your eAG doesn’t imply that your blood sugar is always that number, but instead it’s the middle of the overall range of your blood sugar’s fluctuations each day.
Okay, let’s get more specific…
Translating your A1c to a blood sugar level
It’s easy to see an A1c result of 8.0 percent and think, “Oh, my blood sugars are usually in-range. Everything is fine.” But if you look more closely at what an 8.0 percent A1c really translates to as a blood sugar level, you may be surprised.
You can use this easy A1c/ eAG conversion chart from the American Diabetes Association to instantly translate your latest A1c result to an eAG.
You can read more about blood sugar levels in the post “What are Normal Blood Sugar Levels?”
Determining your own A1c and eAG goals
In an ideal world, sure, we would all eat zero carbohydrates and our A1cs would be a magical 5.0. But managing diabetes is not that simple.
This means that determining that right A1c goal for you, your body, and your life as a person with diabetes is a very personal decision that you and your healthcare team decide on.
For instance, someone with a background of hypoglycemia unawareness may find a target A1c of 6.0 percent to simply be too dangerous, putting them at too much risk for severe hypoglycemia.
Someone who lives by themselves may find that sleeping with blood sugars lower than 120 mg/dL, for example, is simply too scary.
Someone who has in recovery from diabulimia and has spent the past several years with blood sugars above 300 mg/dL will need to lower blood sugar levels very gradually with the help of their healthcare team and support team. This means their A1c is going to be set at a higher target than “normal,” too.
To learn more about setting A1c targets and lowering your A1c (and why it’s not always the best diabetes management goal), please read our comprehensive guide to lowering your A1c.
Everyone is in a different place with their diabetes management, and we all have different personal needs, challenges, and goals. And that needs to be okay. Focus on what’s right for you and your current life as a person with diabetes.
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Sounds like you’d benefit from working with a registered dietitian who understands diabetes. I suggest you reach out to Ben Tzeel (ben@yourdiabetesinsider.com) or have your doctor refer you to one
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