What the heck is hemoglobin A1C?
An A1C test measures the percentage of glucose-containing red blood cell molecules present in the bloodstream.
Hemoglobin is an important protein in red blood cells that’s used to transport oxygen from the lungs to the rest of the body. There are several types of hemoglobin, the most common of which is hemoglobin A. When glucose molecules combine with hemoglobin A in the bloodstream, the resulting molecule is called hemoglobin A1C.
The more glucose in the bloodstream over a given amount of time, the more hemoglobin A molecules become hemoglobin A1C molecules. And of course, with diabetes, you want to keep that level of glucose as normal as possible. The proportion of A1C molecules in the blood is measured by an A1C test—that’s why it’s reported as a percentage.
David B. Sacks of Harvard Medical School and Brigham and Women’s Hospital describes it: “The way hemoglobin A1C forms is that glucose in the blood goes into the red blood cell and attaches to the hemoglobin. The more glucose in the blood, the more will stick onto the hemoglobin.
“The red blood cell lives in the blood for approximately 120 days because of the long lifespan of the red blood cell. So hemoglobin is there longer, and more glucose is stuck to it—so A1C is reported as a percentage of total hemoglobin in the blood.
“An A1C of 7 means that 7 percent of the hemoglobin has glucose stuck to it.”
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