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Quick Guide
The hemoglobin A1c (HbA1c) test measures how much glucose has attached to hemoglobin in your blood over the past eight to 12 weeks. It’s a blood sugar test that reflects long-term trends, not a single moment in time. A CLIA-certified lab runs the test from a standard blood draw.
| Detail | Value |
|---|---|
| Sample type | Blood |
| Collection method | In-person blood draw at a lab or patient service center |
| Turnaround time | Typically one to three business days |
| Fasting required | No |
| Age requirement | Typically 18+ |
If you’ve had symptoms like increased thirst, frequent urination, or unexplained fatigue, an A1c test can show whether high blood sugar is behind them. No fasting or special prep is needed. If you’ve already been diagnosed with diabetes or prediabetes, retesting every three to six months tracks how well your current approach is working.
About the Hemoglobin A1c Test
Purpose of the test
The A1c test tells you and your provider whether blood sugar has been running too high over the past several months. It’s used to catch prediabetes before it becomes diabetes, confirm a diabetes diagnosis, and track how well treatment is working. Uncontrolled high blood sugar can damage the eyes, kidneys, nerves, and heart, so catching it early matters.
The test serves three purposes:
- Screening: The American Diabetes Association recommends A1c screening for adults 35 and older, and for younger adults who are overweight or have obesity and one or more additional risk factors for type 2 diabetes.
- Diagnosis: A1c can identify diabetes when symptoms like increased thirst, frequent urination, or unexplained fatigue suggest high blood sugar.
- Monitoring: Adults with diagnosed diabetes retest A1c every three to six months to see how well treatment is working.
The A1c test doesn’t identify type 1 versus type 2 diabetes, detect low blood sugar (hypoglycemia), or replace daily glucose monitoring. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it also isn’t used to screen for gestational diabetes during pregnancy.
What does the Hemoglobin A1c test measure?
The test is run from a single blood sample at a CLIA-certified lab.
- Hemoglobin A1c: The percentage of hemoglobin in your blood that has glucose attached, reflecting your average blood sugar over the past eight to 12 weeks.
Here’s why that window works. As explained by MedlinePlus, red blood cells live about three months, and glucose sticks to hemoglobin for each cell’s entire lifespan. The more glucose in your blood, the more hemoglobin gets coated. The lab measures that percentage and reports it as your A1c.
A finger-stick glucose test or a comprehensive metabolic panel shows your blood sugar right now. The A1c shows the average across months. That makes it far more useful for spotting sustained high blood sugar that might not show up on any single daily reading.
When should I get a Hemoglobin A1c test?
Consider testing if any of these apply:
- Frequent urination, increased thirst, or unexplained fatigue
- Blurred vision, slow-healing cuts, or tingling in the hands or feet
- Unexplained weight loss
- A family history of type 2 diabetes
- Being overweight or physically inactive
- A prior diagnosis of prediabetes
- A history of gestational diabetes or polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS)
For routine screening, the U.S. Preventive Services Task Force and the ADA recommend:
- Adults 35 to 70 who are overweight or obese, screened at regular intervals
- Adults under 35 with overweight or obesity and one or more risk factors such as family history, high blood pressure, low HDL cholesterol, high triglycerides, PCOS, or a history of gestational diabetes
- Adults with prediabetes, retested annually
- Adults with diagnosed diabetes, retested every three months during treatment changes or every six months when blood sugar is stable
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How It Works
How to get tested
You can order the Hemoglobin A1c Test yourself online, with no doctor visit or referral needed. A licensed physician reviews and authorizes your order as part of the process. Most results are ready in one to three business days and appear in your secure online account.
Before the test
No fasting is required. Eat and drink normally.
The A1c doesn’t measure what’s in your blood right now. It measures glucose that has already bonded to hemoglobin over weeks. Meal timing won’t change the reading.
Tell your provider about any conditions that could affect your red blood cells. The NIDDK notes that sickle cell disease, hemolytic anemia, iron deficiency anemia, thalassemia, and recent blood transfusions can all shift A1c results in ways that don’t reflect your true blood sugar. Your provider may choose a different test if any of these apply.
During the test
- Check in at the lab and bring a photo ID and any order confirmation.
- A phlebotomist ties a band around your upper arm, cleans the skin, and inserts a small needle into a vein, usually in the crook of your elbow.
- A small tube collects the blood. The draw takes about five minutes.
- A bandage goes over the site. You can leave right away.
You might feel a brief pinch when the needle goes in. Some people notice light bruising over the next day or two. That’s normal and clears on its own.
Call your provider if you notice lasting pain, swelling, or signs of infection at the draw site.
After the test
Results are typically ready within one to three business days after the lab receives your sample, though timing can vary by lab and provider system. Your results appear in your secure online account.
What Do My Results Mean?
A1c results are reported as a percentage. The higher the percentage, the more glucose has been attached to hemoglobin, and the higher your average blood sugar has been. The ADA uses the following thresholds to interpret results:
| Result | A1c Level |
|---|---|
| Normal | Below 5.7% |
| Prediabetes | 5.7% to 6.4% |
| Diabetes | 6.5% or higher |
Reference ranges can vary slightly between labs. Your provider reads your result alongside your symptoms, health history, and any other tests to decide what it means for you.
Certain conditions can make A1c results misleading. Sickle cell trait, hemolytic anemia, iron deficiency anemia, thalassemia, and recent blood transfusions can cause falsely high or falsely low readings. If any of these apply, your provider may use a fasting plasma glucose or oral glucose tolerance test instead.
If your results are normal
Below 5.7% means your average blood sugar has been in a healthy range. That’s good news, but it doesn’t mean you can skip future testing. If you have risk factors for diabetes, retest every one to three years. The USPSTF recommends screening every three years as a reasonable approach for adults with normal blood glucose levels.
If your results show prediabetes
Between 5.7% and 6.4% means blood sugar has been higher than it should be, but hasn’t crossed into diabetes territory yet. Prediabetes is reversible. Losing five to seven percent of body weight, eating less refined sugar and processed carbohydrates, and getting 150 minutes of moderate exercise per week can help bring A1c back to normal. Your provider can recommend a retest schedule and help you figure out whether those changes are working.
If your results show diabetes
6.5% or higher on two separate tests is consistent with a diabetes diagnosis. According to the American Diabetes Association, each test usually needs to be repeated on a second day to diagnose diabetes, though a second test may not be required when blood glucose is very high or classic symptoms are present.
A diagnosis doesn’t mean your A1c is locked in place. Many people bring their levels down with medication, diet changes, and exercise. Your provider will set a target A1c based on your age, health history, and how prone you are to low blood sugar. The NIDDK notes that most adults with diabetes aim for below 7%, though that target varies by individual circumstances.
No doctor required
Order the test you want yourself, without a referral or insurance.
Certified lab quality
Samples are processed at accredited labs that meet national clinical standards.
Thousands of U.S. lab locations
Find a lab near you to give your sample.
Fast online results
Most are ready to view securely within a few business days.
Your results stay private
They reach you alone, not your insurer or your medical record.
Upfront pricing
Know the full cost before you order, with no surprise bills.
- Private Results in a Secure Online Portal
- Thousands of CLIA-Certified U.S. Labs
- Results Typically Ready in 1 to 3 Business Days
- Upfront pricing, no surprise bills
Sources
- American Diabetes Association. Diabetes Diagnosis & Tests. 2024.
- CDC. Diabetes Testing. 2024.
- MedlinePlus. Hemoglobin A1C (HbA1c) Test. 2025.
- National Institute of Diabetes and Digestive and Kidney Diseases. The A1C Test & Diabetes. 2018.
- National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes Tests & Diagnosis. 2023.
- U.S. Preventive Services Task Force. Prediabetes and Type 2 Diabetes: Screening. 2021.
Frequently Asked Questions
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How is the A1c test different from a daily finger-stick glucose test?
A finger-stick shows your blood sugar at one moment. The A1c reflects the average over eight to 12 weeks. Both are useful, but they answer different questions. The A1c is better for spotting sustained high blood sugar; daily monitoring is better for managing it day to day.
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Do I need to fast before the Hemoglobin A1c test?
No. Eat and drink normally before your appointment. The A1c measures glucose that has already bonded to hemoglobin over weeks, so what you ate this morning won’t change the result.
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Can certain health conditions affect my A1c result?
Yes. Sickle cell trait, thalassemia, hemolytic anemia, iron deficiency anemia, and recent blood transfusions can cause falsely high or low readings. Tell your provider before testing if any of these apply. They may use a different method to check your blood sugar.
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Is the A1c test accurate during pregnancy?
It’s less reliable during pregnancy. Red blood cell turnover increases when you’re pregnant, which shortens the window the A1c reflects and can make results look lower than your true average. For gestational diabetes screening, a glucose challenge test or oral glucose tolerance test is preferred. Talk with your provider about which test is right for you.
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What lifestyle changes can lower my A1c?
Eating fewer refined carbohydrates and added sugars, exercising regularly, and taking prescribed medications consistently all help. Even modest changes add up. Your provider can help you set a realistic target and timeline.
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Are there other names for this test?
Yes. The Hemoglobin A1c test is also called the HbA1c test, glycated hemoglobin test, glycosylated hemoglobin test, or glycohemoglobin test. You may see any of these names on a lab order or results report.
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Will anyone see my results besides me?
No. Your results go to your secure online account and are not shared with anyone else. You can download or print them to share with your own doctor if you choose.
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Can I use insurance to pay for this test?
We do not bill insurance directly, which keeps your testing and results private. You can pay with HSA or FSA funds, and we can provide an itemized receipt if you want to request reimbursement.