Treatment of Type2 Diabetes

Translating Your A1c to a Blood Sugar Level

We have HbA1c tests during check-ups but we don’t often talk about what our A1c implies about how to manage our daily blood sugar

There are 3 acronyms you need to know when it comes to understanding your overall blood sugar levels:

  1. HbA1c: Hemoglobin A1c — This blood test measures the amount of glucose that accumulates around your nerve-endings and blood vessels over the course of the prior 3 months. It is the most heavily affected by your blood sugars during the most recent 2 weeks. 
  2. AGEs: Advanced Glycogenated End-Products — This measures the glucose that accumulates and damages the nerve endings and blood vessels throughout your entire body. The more AGEs you have in your bloodstream, the more likely you will develop common diabetes complications including retinopathy, neuropathy, gastroparesis, kidney disease, and skin issues. The more AGEs you have, the higher your A1c will be.
  3. eAG: Estimated Average Glucose Level — This is the average blood sugar level your A1c translates to, so you can get a better idea of how well your current diabetes management is working to keep you healthy.

Let’s take a closer look at what your A1c really means in terms of your daily diabetes management.

Translate your A1c to a blood sugar level

It’s important to understand how your A1c translates to a blood sugar level because it helps you get a better idea of where your blood sugars really are throughout any given day.

An eAG offers the average blood sugar level based on your A1c, but it can also give you a general range of your blood sugar levels.

This can be eye-opening because you might think, “Oh, I don’t check my blood sugar often because it’s usually fine,” and you might assume you’re rarely above 160 mg/dL, for example.

But if your A1c comes back 8 percent, that translates to an average blood sugar level of 183 mg/dL, and a general range of 147 mg/dL to 216 mg/dL, which means your blood sugar is actually often above 160 mg/dL.

The American Diabetes Association offers this A1c/ eAG calculator to easily translate your A1c results to an eAG or Average Blood Glucose mg/dL.

A1c Average Blood Glucose mg/dL Range of BG mg/dL
12% 298 240 – 347
11% 269 217 – 314
10% 240 193 – 282
9% 212 170 –249
8% 183 147 – 217
7% 154 123 – 185
6% 126 100 – 152

The ADA Recommends an A1c Below 7 Percent to Prevent Complications

While nobody’s blood sugars are managed perfect, it is helpful to know what levels to aim for and the likely range this implies for your BG. 

So, if your A1c is 8 percent, and your goal is to get under 7 percent, that means your new blood range goal is somewhere below that 123 mg/dL to 185 mg/dL range.

This might mean correcting your blood sugar sooner than you have in the past (taking insulin for a 165 mg/dL when you may not have in the past) and checking your blood sugar more often in general!

And of course, do keep in mind that for some people, an A1c above 7 percent might actually be best for their health and safety. This includes:

  • Smaller children who cannot pinpoint and express symptoms of low blood sugar
  • People with hypoglycemia unawareness
  • People who recently experienced severe hypoglycemia (stroke, seizure, loss of consciousness) and are still recovering both mentally and physically
  • Senior citizens with diabetes

Your A1c is a very personal number. At the end of the day, we all have other aspects of life that make diabetes management more difficult. 

Talk to your healthcare team about the most reasonable goal for you, and give yourself plenty of time to gradually improve your blood sugar levels while you work towards that goal.

Ginger Vieira has lived with Type 1 diabetes and Celiac disease since 1999, and fibromyalgia since 2014. She is the author of 4 books: Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, Your Diabetes Science Experiment. Ginger creates content regularly for Diabetes Strong, Healthline, HealthCentral, DiabetesDaily, EverydayHealth and her YouTube Channel. Her background includes a B.S. in Professional Writing, certifications in cognitive coaching, Ashtanga yoga, and personal training with several records in drug-free powerlifting. She lives in Vermont with two kiddos and two dogs.

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