Diabetes Awareness: Understanding and Managing Your A1C

In honor of American Diabetes Month, MUSC Health's Brittany Jones, PharmD, highlights the importance of understanding how the A1c can help you know your risk for diabetes and how to manage it.

What is diabetes?

Diabetes is a chronic health condition in people with high levels of glucose, also known as sugar, in the blood. Some amounts of sugar in the blood is important so your body can get energy for things like breathing, heart beating, and daily activities such as walking and talking. The amount of sugar goes up or down with the help of insulin; a hormone produced naturally by the pancreas. If your body can't make enough insulin or doesn’t use the insulin like it should, this can cause diabetes. Luckily, diabetes is a condition that can be managed.

Risk factors for diabetes

There are different types of diabetes. Type 1 diabetes is when the body does not produce any insulin at all. Typically, children, teens, and young adults are more likely to develop it with the biggest known risk factor being family history. Type 2 diabetes usually occurs in those who are older and who still may make some insulin. At the time of diagnosis for type 2 diabetes, the pancreas has about 50% left to be able to make insulin.

Risk factors for type 2 diabetes include obesity, age of 45 years or older, family history, and not being active. Prediabetes and gestational diabetes are also risk factors for type 2 that may occur years before. Lastly, African Americans, Latino Americans, American Indians, and Alaskan Natives are at a higher risk of type 2 and prediabetes.

If you're at risk, or even currently managing diabetes, it's crucial to stay updated on your average blood sugar levels, which can be easily managed with an A1C test. The higher your A1C, the greater your risk is for developing type 2 diabetes — that's why knowing your A1C matters and knowing it early!

What is an A1C?

The A1c is a simple blood test that tells you the average blood sugar levels for the past two to three months. The value is reported as a percentage and lines up with an average blood sugar level depending on where it is.

A normal A1C level is below 5.7%. Those that have prediabetes have an A1c level between 5.7% to 6.4%. A level of 6.5% or more indicates diabetes.

For most people living with diabetes, their A1C goal is less than 7%, but this can be different based on what else is going on. Make sure to talk with your doctor or pharmacist about more specific goals for you.

How does an A1c test differ from a simple glucose tolerance test?

An oral glucose tolerance test (OGTT) measures your body's response to sugar while an A1C test reflects your blood sugar level more long term. An OGTT is used to screen for type 2 diabetes and also help diagnose gestational diabetes, which can develop during pregnancy.

On the other hand, an A1C test is used to diagnose pre-diabetes and diabetes. Also, if you already have diabetes, the test is a great way to monitor blood sugar levels to see how you are doing to manage it.

How to manage the A1C

The first step to managing the A1C is by getting one checked regularly. If you're 45 or older, or have risk factors, then your doctor or pharmacist will recommend how often you have to get it done based off of those risk factors. This can be anywhere from every one to three years. If you already have diabetes, the A1c test is done at least twice a year or more often if your blood sugar levels are not at goal.

Making lifestyle changes is a big part of getting and keeping your A1C levels down. No matter if you have diabetes or not, I recommend some of the following to help you get that better A1c:

• Make small goals- Set and work on your goals like a target weight. Make sure though that they are something that you can reach in a reasonable time. You will feel better about yourself when you meet each goal and will want to make more for the future.
• Plan ahead- Meal planning cuts down on making unhealthy, last-minute decisions. This doesn’t always have to be long term planning either. Setting out what you are going to eat the next day is just as helpful as setting it out for the whole week.
• Watch how much and how often you eat- Monitor your portion sizes and try to eat smaller more frequent meals throughout the day instead of 1 to 2 bigger meals. Try to fill up more on veggies and cut out as many sugary drinks as you can.
• Keep moving- The key is getting your heart rate up for at least 150 minutes per week. The time should be broken up throughout the week and can include stuff you already probably do like housework and gardening. Remember that every step counts!
• Track progress- Keeping a journal of what you are doing in regards to food, exercise, and medications helps you keep track of how well you are doing. By seeing all the different changes that happen along the way, you will feel better about yourself and the choices you have made to a better, healthier you!

Talk to your doctor or pharmacist for a complete, personal therapy plan, including nutrition and exercise, that's right for you and your needs.

Make an appointment with an MUSC provider to discuss managing your A1C via MyChart or by calling 843-792-7000.

For information on MUSC Health's Diabetes Prevention Program, please see below.

Get Your SHINE On

MUSC Health's SHINE program is based on the Centers for Disease Control and Prevention (CDC) Prevent T2 Curriculum. The primary goal of the program is to prevent or delay the onset of type 2 diabetes. Adults 18 years of age and older with a diagnosis of pre-diabetes are eligible to participate in the program.

Learn more about the SHINE program.