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If you or someone you care for has diabetes, you may have heard a doctor or dentist mention the term Hemoglobin A1c (HbA1c) when referring to tests that monitor blood sugar levels. It can be a real challenge to keep up with the true meaning of all of these values, so we’d like to answer some frequently asked questions regarding HbA1c. Monitoring HbA1c is an important part of diabetes care, which can impact your oral as well as overall health.

Here are five things you need to know about HbA1c:

1. WHAT IS HbA1c?

Your HbA1c value is a measure of your glycosylated hemoglobin, which is the percentage of your red blood cells that have glucose (sugars) attached to them. Furthermore, it is an average of blood sugar control over a 2 to 3 month period. The higher your HbA1c level, the more glucose is bound to your blood cells. A high level of HbA1c may be a warning sign of diabetes as well as how well or poorly the body is handling sugars.

2. WHY IS HbA1c IMPORTANT?

HbA1c value is helpful in telling you about blood sugar control over a period of time. This test is different from a blood glucose reading that diabetic patients may take multiple times per day. With an HbA1c value, your doctor is able to see a bigger picture of how well your blood sugar is controlled over a long period of time—not just a snapshot of the past few hours.

Higher HbA1c can mean that a person is at greater risk for some of the complications of uncontrolled diabetes, which can include poor wound healing, blindness, and kidney failure.

3. DOES DIABETES AFFECT MY ORAL HEALTH? HOW?

It is important that you know and discuss your diabetic status and control of diabetes with your dentist and dental hygienist. Depending on the type and severity of your diabetes, you could be at risk of dry mouth, gum disease, fungal infections, tooth decay, mouth ulcers, and you may heal slower after a dental surgery such as tooth extractions. Maintaining a target HbA1c, as advised by your doctor, can lower your risk for these oral complications. This is not only beneficial for your oral health, but it is an important part of maintaining overall health.

4. WHEN SHOULD MY HbA1c LEVEL BE MEASURED?


The American Diabetes Association recommends that those with diabetes should have their HbA1c levels measured by their physician at least twice per year. Each time you go for an HbA1c test, a medical professional will draw a sample of blood to send to the lab for testing. There is no need to fast before you get your blood tested for HbA1c levels.

5. WHAT SHOULD BE MY TARGET HbA1c LEVEL?

Every person with diabetes is different, but typically your physician will want a target HbA1c lower than 6.5%. Individuals without diabetes usually have HbA1c levels between about 4% and 5.6%. However, individuals with an HbA1c between 5.7% and 6.4% might be at risk for the development of diabetes.

Christine Downey, DDS, MS, and Ben Anders, DDS Candidate
The University of North Carolina at Chapel Hill School of Dentistry