Beyond Blood Sugar: Testing A1c
More people need to know about the test for A1c -- or glycated hemoglobin -- that has revolutionized diabetes care.
Doing it Yourself continued...
"If A1c levels were something that you had to monitor every few days, a home test would make more sense," says Goldstein. "But A1c is a long-term measure of blood sugars and you don't need to do it very often, maybe every few months. So why do people need to do it at home and why would doctors want them to?"
"I'm concerned about people doing these at home," Kaufman tells WebMD. "I don't want people to start doing A1c tests on their own and then thinking they can skip healthcare visits. It's not a substitute."
Instead, Kaufman and Goldstein recommend that A1c tests be administered in the doctor's office, where other indications -- such as blood pressure, cholesterol levels, and weight -- can also be checked. "People with diabetes need to be seeing their doctors regularly anyway," says Goldstein.
However, Goldstein does see at least one useful application of the home A1c test. "I think it might be good as a home-screening test, like a home pregnancy test," he says, "for people who haven't been diagnosed with diabetes but who are concerned about getting the disease."
Various health organizations have been stressing the importance of A1c in recent years. The U. S. Department of Health and Human Services partnered with the ADA to develop the "ABCs of Diabetes Program," encouraging regular monitoring of A1c, blood pressure, and cholesterol. More recently, the American Association of Diabetes Educators began the "Aim. Believe. Achieve. Diabetes A1c Initiative," a national educational campaign to raise awareness about the A1c test.
Given the importance of the A1c and the risks of diabetes, you must get your doctor to tell you what your A1c is and, if it's too high, what you can do to lower it. Experts stress the importance of aggressive management of diabetes, and you may have to push yourself and your doctor to achieve a better A1c level.
"There are still some doctors out there who don't understand what A1c targets should be or how to achieve them," says Kaufman. "If you've got a high A1c and your healthcare provider isn't helping you, it's time to get a consultation with somebody else."
Originally published March 17, 2003.
Medically updated June 18, 2004.