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What is an A1C Test?

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ID: ANH24277
MEDICAL ANIMATION TRANSCRIPT: An A1C test is a blood test that can be used to estimate the average amount of glucose, or sugar, in your blood over the past three months. Other names for this test are HbA1c, glycated hemoglobin, and glycosylated hemoglobin. This test is often used to screen for or manage diabetes and pre-diabetes, conditions that can happen when your blood sugar is too high. In order to understand how the test works, it's important to know about red blood cells and how your blood sugar affects them. Most of the cells in your blood are called red blood cells. They are made in your bone marrow, which is the tissue in the center of your bones. From there, they travel to your lungs where they pick up oxygen from the air you breathe in. This happens in tiny air sacks in your lungs called alveoli. Here, oxygen attaches to proteins inside your red blood cells called hemoglobin. Your red blood cells then deliver the oxygen to tissues throughout your body. After about three months, red blood cells wear out. As the worn-out cells pass through your liver and spleen, other types of blood cells called macrophages, destroy them and remove them from your blood. Glucose in your blood can affect your red blood cells. After you eat, your body breaks down food into glucose and releases it into your blood. Your tissue cells take the glucose out of your blood and use it as their main source of energy. It's normal for some of the glucose in your blood to stick to the hemoglobin in your red blood cells. This process is called glycosylation. If your tissue cells aren't able to use the glucose, it can build up in the blood. This is called hyperglycemia. If you have high blood glucose, more of the hemoglobin in your red blood cells will have glucose stuck to it. An A1C test shows the percentage of red blood cells that have glucose attached to them. If your A1C numbers are higher, it means that your red blood cells were exposed to higher levels of blood glucose in the previous three months. The test shows results from this time period because glucose can only stick to hemoglobin while your red blood cells are alive and they live for about three months. Higher-than-normal average blood glucose can mean you have diabetes. Your healthcare practitioner may recommend you get an A1C test if you are over 45 years old, are under 45 and have one or more risk factors for diabetes, or you had diabetes during pregnancy, called gestational diabetes. During an A1C test, a health care professional, called a phlebotomist, will take a sample of blood from a vein in your arm or from one of your fingers using a small needle. At the lab, your blood sample will be tested to measure the amount of red blood cells that have glucose sticking to the hemoglobin in them. Your A1C numbers, which show the percentage of glucose-attached red blood cells, can be used to estimate your average blood glucose during the past three months. Your A1C test result may include a chart that shows estimated average blood glucose range based on A1C numbers. A normal A1C result means your blood sugar level is in the non-diabetic range, or an A1C result may be considered normal for you even if your blood sugar is slightly outside the non-diabetic range. This may happen because of your age or medical conditions you have such as diabetes. An abnormally-high A1C test result means your blood sugar has been too high over the past three months. You may be diagnosed with prediabetes or diabetes if you haven't already been told you have it. Or, if you're living with diabetes, an abnormal result means your blood sugar is not well controlled. If your A1C result stays high, your healthcare practitioner will talk to you about how to manage your blood sugar. People with diabetes will need to have an A1C test at least twice a year. People with prediabetes will need to be tested every year or two, or as often as your healthcare practitioner recommends. If your A1C is normal, but you've had gestational diabetes, or you have risk factors for diabetes, then you will need the test every three years. To find out more about the A1C test, talk to your healthcare practitioner.
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