What is Hemoglobin A1c?

Hemoglobin A1c is a blood test that measures glucose (sugar) in your blood over a 3-month period. It is used to check your blood sugar control. Having good blood sugar (and blood pressure) control helps slow the rate of kidney disease if you have a kidney problem. Not all people with diabetes have kidney problems!

If you have protein in your urine—even in microscopic amounts—you may have early kidney disease. Protein is a large molecule that does not fit through the filters of healthy kidneys. If you have protein (albumin) in your urine, it may mean that you have a kidney problem. The good news is, there are treatments to help protect your kidneys. To learn more about protein, go to the Measuring Albumin Topic.

blood sample in test tube

What Does Hemoglobin A1c Do for You?

Some of the excess sugar in your blood bonds with the hemoglobin in your red blood cells. When your hemoglobin A1c is tested every 3 months, you and your care team can see how good your blood sugar control has been. Along with your charts of your blood sugar levels from one day to the next, the patterns give clues about how to adjust your medications. Changes in your need for insulin can be a clue that you may have a kidney problem. If your kidneys don’t work as well as they used to, they may not remove insulin from your blood. Insulin can build up—so you need less to keep your blood sugar in control. If you find that you need less insulin than you used to or you have more low blood sugars, talk to your care team. They can adjust your medications.

animation of red blood cell

What Does Your Hemoglobin A1c Mean?

Do you know your hemoglobin A1c? If you do, visit the eKidney Clinic site and use our Hemoglobin A1c Calculator to convert your A1c into your "mean plasma glucose” to see how you’re doing with your diabetes control.

Make a note of your result so you can talk with your VA care team about the best target for you.

Studies show that keeping your A1c level below 7.0 can help you avoid long-term problems of diabetes as having too much sugar in your blood gums up your blood vessels, which can cut off the blood supply to your eyes, limbs, and kidneys. In the long run, this can cause blindness, loss of limbs, or kidney failure. High blood sugar can also damage your heart and lead to heart attacks and strokes. Getting control of your diabetes can help you avoid these problems...

Having an A1c of 9.0 or higher can lead to a higher risk of long-term problems of diabetes.

NOTE: In later CKD, your care team may give you a slightly higher A1c target to keep you from having too many lows. There are things you can do to improve your blood sugar control. Keep reading to see what.

calculator

Check Your Blood Sugar Often

If you have diabetes, good blood sugar control can help protect your kidneys—and the rest of you. Knowing what your blood sugar is and how it reacts to what you do and what you eat is the first step to keeping it in control. With test strips and a glucometer, you can check your blood sugar and graph the results. You don’t have to always test on your fingers these days. Some glucometers may let you test on your arm—with no pain at all. If you have diabetes and don’t have a glucometer, talk to your care team. The VA will provide a glucometer and test strips for you. Ask about VA diabetes education classes, too.

glucometer and test stip being used on finger

What You Can Do About Your Hemoglobin A1c

Sweets and starchy foods like these can raise your blood sugar. Eating less of these foods can help you stay in the target range. This can be a hard change to make! Take small steps. Try changing one thing at a time. Ask your dietitian or health care team to help you set goals you can reach.

warning to limit starchy and sugary foods

Get Exercise.

Eating right and staying active can help you lower your A1c.

There are three key steps to staying active.

  1. Be physically active in 10-minute sessions
  2. Increase muscular strength with 2–3 days of strength training
  3. Don’t forget to stretch!

All of these things are in your control. No one else can eat or exercise for you. Visit MOVE!®, a VA program to help you get started with exercise and weight management.

people lifting weights