Question

Secondary prevention of type II diabetes includes monitoring of your patient glucose control. Your patient comes in confused about their blood tests results. Although he understands his fasting plasma glucose result, he does not understand what the HbA1c percentage means. You explain that an HbA1c level of 8.5% is equivalent to a glucose level of how many mg/dl?

Answer 1

HbA1c level of 8.5% is equivalent to a glucose level of 225 mg/dl.

HbA1c. It’s the best measure that we have of your average blood sugars over the last three months.

The HbA1c test is done by drawing blood from a vein. You may feel a slight pinch when the needle in inserted. Blood can be sent away to a lab or measured on a machine in your doctor’s office or at a hospital.

In people without diabetes, the HbA1c is usually between 4% and 6%.

4.0% to 4.6% A+ (Excellent)
4.7% to 4.9% A   (Excellent)
5.0% to 5.2% B   (O.K.)
5.3% to 5.4% C   (Bad)
5.5% to 5.9% C- (Bad)
6.0% to 6.4% D   (Very Bad)
6.5% to 6.9% D- (Very Bad)
7.0% or more F   (Failure)

Hb-A1c	8.0	8.1	8.2	8.3	8.4	8.5	8.6	8.7	8.8	8.9
mg/dl	207	211	215	218	222	225	229	232	236	240

Hb-A1c = 7.0% is "fine" according to the American Diabetes Association, but it is "Horrible" on my table... greater than HbA1c = 7.5% is either "Deathly" or it is "Suicidal"

The only diabetics who can accept a higher HbA1c than normal 85 mg/dl are those who have a digestive problem called "gastroparesis," which makes controlling blood glucose levels very difficult. But higher than normal glucose levels will harm them just the same, whether it is difficult for them to control their blood glucose, or not, so they should do all that they can to keep their blood sugars as close to "normal" as possible.

As I said, there is no forgiveness... high blood sugars will hurt you whether it is your fault or not, whether you can avoid it, or not.