When blood glucose is high, glucose can attach to red blood cells. Hemoglobin A1c is a measure of the percentage of red blood cells that have glucose attached. This measure provides a general view of glucose levels over the previous three months, which is the lifecycle of red blood cells. For instance, a hemoglobin A1c of 6% may reflect an average blood sugar of 135 mg/dl while a result of 7% may represent an average of 170 mg/dl.

According to the American Diabetes Association, the goal for well-controlled diabetes is under 7%. The American Association of Clinical Endocrinologists recommend maintaining hemoglobin A1c at or below 6.5%.(7,8)

Of special interest is research that suggested that each 1% reduction in A1c may yield a 10% decrease in relative risk of microvascular complications and that the impact of intensive therapy to control A1c may persist beyond the period of tight control.(9,10,11)

Type 1 diabetes is generally treated with exercise, insulin, and a balanced diet. Type 2 diabetes is treated with weight loss efforts, diet, and exercise. If these treatments do not adequately lower blood sugars, then oral medications may be used. Finally, insulin treatment may be required if blood sugar levels remain elevated.