What is the hemoglobin A1c test?

The hemoglobin A1c ("A-one-C") test is a blood test used in the care of people who have diabetes. The hemoglobin A1c percentage is a way of looking at your child's average blood sugar control over a period of 2 or 3 months.

Sugar absorbed from the digestive system circulates in the bloodstream. When the blood sugar is high, the sugar attaches to the hemoglobin protein in red blood cells, forming hemoglobin A1c.

Red blood cells live 90 to 120 days. This means that once sugar has combined with the hemoglobin in red blood cells, the hemoglobin A1c stays in the blood for 90 to 120 days. This means the amount of hemoglobin A1c in your child's blood reflects how often and how high the blood sugar has been over the past 3 months.

Why is this test done?

Hemoglobin A1c is an excellent way to check how well blood sugar is being controlled over a 3-month period.

Hemoglobin A1c measurements are important because:

• They confirm your child's daily home blood sugar results and testing schedule.
• They help predict your child's risk of diabetic complications. The higher the hemoglobin A1c percentage, the greater the risk of developing diabetic eye, kidney, cardiovascular, and nervous system disease.

How do I prepare my child for this test?

No preparation is necessary except to prepare for the pain of a blood draw. One of the advantages of this test is that your child does not need to fast before having the test.

How is the test done?

Your child's healthcare provider will poke a finger with a lancet and fill a small tube with the blood. Sometimes blood is taken from your child's arm through a needle instead of using a finger poke.

At some pharmacies you may be able to buy a device that allows you to test A1c at home. You may find that the results of the home test are not the same as results of tests done at your provider's office.

How will I get the test result?

Ask your child's healthcare provider when you can learn the results. Ask whether you should call for the results or whether the provider will call you.

What does the test result mean?

Hemoglobin A1c percentages in children should be and usually are somewhat higher than for adults. For childhood diabetics the results are usually judged as follows:

• For age less than 6 years, A1c of 7.5% to 8.5% means good control.
• For age of 6 to 12 years, A1c under 8 % means good control.
• For age of 13 to 19 years, A1c under 7.5% % means good control.

What if my child's test result is not normal?

If your child has been diagnosed as diabetic and his or her test is not normal, the healthcare provider will talk to you about how to lower your child's blood sugar through diet, exercise, or medicine. Maintaining blood sugar levels and hemoglobin A1c levels in or near normal ranges will help your child avoid the complications of diabetes.