# HbA1c: Your three-month blood sugar

> HbA1c is your average blood sugar over three months. Check your result, see what normal, prediabetes and diabetes mean, and what you can do about it.

- Also called Hemoglobin A1c, A1c and Glycated hemoglobin
- Often on a standard checkup
- No fasting needed
- Web page: https://picardo.health/guides/biomarkers/hba1c

## The short answer

HbA1c is your average blood sugar over the last three months, as a percentage. Under 5.7% is normal. If yours is 5.7% to 6.4%, that’s prediabetes, which is common and often reversible.[1][7][8]

- **A good result:** Under 5.7%.[1]
- **If yours is 5.7% to 6.4%:** That’s prediabetes. In a major trial, aiming to lose at least 7% of body weight and walking 150 minutes a week cut the risk of diabetes by more than half.[4]
- **If yours is 6.5% or more:** That’s in the diabetes range. It needs a second test to confirm, and a clinician.[1]

## What is a normal HbA1c level?

The same cutoffs apply at every adult age, and the ADA uses them to diagnose prediabetes and diabetes:[1]

Have you been diagnosed with diabetes?

### No, or not sure

| Result (%) | What it means |
| --- | --- |
| Under 5.7 | Normal blood sugar |
| 5.7 to 6.4 | Prediabetes: a warning, not a diagnosis |
| 6.5 or more | In the diabetes range |

### Yes, I have diabetes

| Result (%) | What it means |
| --- | --- |
| Under 7.0 | At the usual goal |
| 7.0 to 7.9 | Above the usual goal |
| 8.0 or more | Well above the usual goal |

The normal, prediabetes and diabetes lines are for diagnosing people who don’t have diabetes, and they don’t apply in pregnancy.[1] Once you have diabetes, treatment lowers HbA1c, so a result of 6.2% doesn’t mean it’s gone. It’s read against your treatment goal instead.[3]

### Normal blood sugar

**Range:** Under 5.7%.

Your blood sugar has been in the normal range over the last few months.[1]

**How worried to be:** Nothing to worry about.

**What to do next:**

1. Retest at least every three years from age 35, or sooner if you gain weight or have other risk factors.[1]
2. A result under 4.8%, the bottom of Labcorp’s range, is uncommon. It can point to something affecting red blood cells, such as recent blood loss, so mention it to a clinician.[1][9]

### Prediabetes: a warning, not a diagnosis

**Range:** 5.7% to 6.4%.

Your blood sugar has been running higher than normal, but not in the diabetes range. Your risk of type 2 diabetes is raised, and it rises the closer you are to 6.4%.[1] Acting now can lower that risk.[4]

**How worried to be:** Not urgent, but don’t wait for it to rise. Many people bring it back to normal.[7]

**What to do next:**

1. If you have weight to lose, aim to lose at least 7%, the Diabetes Prevention Program’s goal: 14 pounds if you weigh 200.[4]
2. Build up to 150 minutes a week of brisk activity, such as walking.[4]
3. Retest in a year, or about three months after a change if you want to see progress.[1][3]

[Test fasting glucose, insulin and cholesterol, $14.25](https://app.picardo.health/labs/order?tests=001032,004333,235010&ref=guide-hba1c) Fast for at least 8 hours first.

### In the diabetes range

**Range:** 6.5% or higher.

A result of 6.5% or more on two tests means diabetes.[1] One result isn’t a diagnosis: anemia and some other conditions can make HbA1c read higher or lower than your blood sugar.[1]

**How worried to be:** See a clinician in the next week or two. Go sooner if you’re very thirsty, passing a lot of urine or losing weight without trying.[1]

**What to do next:**

1. Confirm it with a second HbA1c or a fasting glucose test.[1]
2. Book a clinician visit to plan treatment. The lifestyle changes for prediabetes still help.[6]

[Test HbA1c and fasting glucose, $7.25](https://app.picardo.health/labs/order?tests=001453,001032&ref=guide-hba1c) Fast for at least 8 hours first.

### At the usual goal

**Range:** Under 7% with diabetes.

For most adults with diabetes, the American Diabetes Association’s goal is under 7%, as long as it can be reached without frequent low blood sugar.[3] This is a treatment result, not a sign the diabetes has gone. Your clinician may set a lower or higher goal for you.[3]

**How worried to be:** Nothing to worry about from this number.

**What to do next:**

1. Keep testing as your clinician advises, usually every three to six months.[3]
2. If you take insulin or a sulfonylurea such as glipizide and get shaky, sweaty spells, tell your clinician. A low HbA1c can come with low blood sugar, and your goal or doses may need changing.[3]

### Above the usual goal

**Range:** 7% to 7.9% with diabetes.

This is above the usual goal of under 7%.[3] For some people, such as older adults or those with frequent low blood sugar, the American Diabetes Association says a goal under 8% can be right.[3]

**How worried to be:** Not urgent. Worth reviewing with your clinician at your next visit.

**What to do next:**

1. Ask your clinician what your goal is, and whether your treatment needs changing.[3]
2. Activity and food changes still lower HbA1c on top of medicine.[6]

### Well above the usual goal

**Range:** 8% or higher with diabetes.

Your blood sugar has been running well above the usual goal over the last three months.[3] The higher it is, the higher the risk of damage to eyes, kidneys and nerves over time.[3]

**How worried to be:** See your clinician in the next few weeks to review your treatment. Go sooner if you’re very thirsty, passing a lot of urine or losing weight without trying.[1]

**What to do next:**

1. Book a visit to review your treatment. Don’t change your medicines on your own.[3]
2. If you check your blood sugar at home and it stays at 300 mg/dL or more, call 911 or go to an emergency department.[10]

[Test fasting glucose, $3.25](https://app.picardo.health/labs/order?tests=001032&ref=guide-hba1c) Fast for at least 8 hours first.

## What is HbA1c?

> Think of HbA1c as a three-month average. One slice of cake won’t move it; months of high blood sugar will.

Sugar in your blood sticks to hemoglobin, the protein in red blood cells that carries oxygen. Red blood cells live about three months, so the share with sugar attached reflects your average blood sugar over that time.[1]

| HbA1c | Outside the US | Average blood sugar |
| --- | --- | --- |
| Under 5.7% | Under 39 mmol/mol | Under about 117 mg/dL |
| 5.7% to 6.4% | 39 to 47 mmol/mol | About 117 to 137 mg/dL |
| 6.5% or higher | 48 mmol/mol or higher | About 140 mg/dL or higher |

Average blood sugar uses the ADAG formula: 28.7 × HbA1c − 46.7.[2]

## Can prediabetes be reversed?

Often, yes. In the Diabetes Prevention Program, people with prediabetes who lost weight and got active cut their risk of diabetes by 58% over about three years.[4] People who get their blood sugar back to normal, even for a while, have a much lower risk of diabetes years later.[7]

Prediabetes is also common: more than 2 in 5 US adults have it, and 8 in 10 of them don’t know.[8]

## How to lower HbA1c

- **A structured lifestyle program:** Aiming to lose at least 7% of body weight, with 150 minutes a week of activity, cut diabetes risk by 58%.[4] How much it helps: a lot. How sure we are: very sure.
- **Metformin:** Cut diabetes risk by 31% in the same trial, so less than lifestyle change did.[4] How much it helps: some. How sure we are: very sure.
- **Regular activity:** In people with type 2 diabetes, 8 weeks or more of structured exercise lowered HbA1c even without weight loss.[6] How much it helps: some. How sure we are: fairly sure.
- **Fewer refined carbs and less added sugar:** The ADA advises cutting back on refined grains, sweets and sugary drinks to help manage blood sugar.[6] How much it helps: some. How sure we are: fairly sure.

HbA1c moves slowly, because it’s a three-month average. Give a change about three months before you retest.[3]

## What can throw off your result?

- Anemia, recent blood loss or a transfusion
- Hemoglobin variants, such as sickle cell trait, with some lab methods
- Advanced kidney or liver disease
- Pregnancy, which lowers HbA1c

In these situations, clinicians diagnose diabetes with glucose tests, such as fasting glucose or a glucose tolerance test,[1] and may track it with a glucose monitor instead.[3]

## Who should get an HbA1c test?

- Every adult from age 35, at least every three years.[1]
- Anyone younger with extra weight and another risk factor, such as diabetes in a parent, brother or sister, or high blood pressure.[1]
- Everyone with prediabetes, every year.[1]

The US Preventive Services Task Force recommends screening adults aged 35 to 70 who have overweight or obesity.[5]

## How to get an HbA1c test, and what it costs

An HbA1c test costs $4.00 through Picardo.

- [HbA1c on its own, $4.00](https://app.picardo.health/labs/order?tests=001453&ref=guide-hba1c). Labcorp 001453, no fasting needed.

Every order comes with:

- Results in 2 to 3 days, in the app
- Physician follow-up if you want one
- Free Labcorp draw, or $75 at home
- No other fees. HSA and FSA eligible.

It’s also part of the [Base Core Annual – Men](https://picardo.health/labs/panels/base-core-men), [Base Core Annual – Women](https://picardo.health/labs/panels/base-core-women), [Heart Health](https://picardo.health/labs/panels/heart-health), [Brain Health Screening](https://picardo.health/labs/panels/brain-health), [Fertility](https://picardo.health/labs/panels/fertility) and [Celiac / GI](https://picardo.health/labs/panels/celiac-gi) panels, if you’d rather test more at once.

Already have a result? [Ask Picardo about it](https://app.picardo.health/auth).

## Questions people ask

### Is an HbA1c of 5.7% bad?

It’s the bottom of the prediabetes range.[1] It’s an early warning, not diabetes. Lifestyle change prevents type 2 diabetes in people with prediabetes, though most trials enrolled people by glucose tests rather than HbA1c.[1][4]

### How quickly can HbA1c change?

Slowly. It reflects about three months of blood sugar, so clinicians usually wait about three months after a change before retesting.[3]

### Do I need to fast for an HbA1c test?

No. HbA1c reflects the past few months, so a recent meal doesn’t change it.[1]

### What’s the difference between HbA1c and fasting glucose?

Fasting glucose is a snapshot of one morning; HbA1c is a three-month average. One can be normal while the other isn’t, so clinicians sometimes use both.[1]

### What is a normal HbA1c for my age?

Under 5.7% at every adult age. The ADA doesn’t use age-specific cutoffs.[1]

## Often checked alongside

- [Fasting glucose](https://picardo.health/guides/biomarkers/fasting-glucose.md): Blood sugar after an overnight fast
- [Fasting insulin](https://picardo.health/guides/biomarkers/fasting-insulin.md): An early sign of insulin resistance
- [HOMA-IR](https://picardo.health/guides/biomarkers/homa-ir.md): An insulin resistance score from glucose and insulin
- [ApoB](https://picardo.health/guides/biomarkers/apob.md): How many plaque-building particles you have

## Test details

- **Labcorp test:** Hemoglobin (Hb) A1c, 001453
- **LOINC:** 4548-4
- **Sample:** Blood
- **Fasting:** Not needed[1]
- **Typical lab range:** 4.8% to 5.6%[9]
- **Units:** % (NGSP) in the US; mmol/mol (IFCC) elsewhere

## Sources

1. American Diabetes Association Professional Practice Committee for Diabetes. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S27–S49. https://doi.org/10.2337/dc26-S002
2. Nathan DM, Kuenen J, Borg R, et al. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31(8):1473–1478. https://doi.org/10.2337/dc08-0545
3. American Diabetes Association Professional Practice Committee for Diabetes. 6. Glycemic goals, hypoglycemia and hyperglycemic crises: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S132–S149. https://doi.org/10.2337/dc26-S006
4. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. https://doi.org/10.1056/NEJMoa012512
5. US Preventive Services Task Force. Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(8):736–743. https://doi.org/10.1001/jama.2021.12531
6. American Diabetes Association Professional Practice Committee for Diabetes. 5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S89–S131. https://doi.org/10.2337/dc26-S005
7. Perreault L, Pan Q, Mather KJ, et al. Effect of regression from prediabetes to normal glucose regulation on long-term reduction in diabetes risk: results from the Diabetes Prevention Program Outcomes Study. Lancet. 2012;379(9833):2243–2251. https://doi.org/10.1016/S0140-6736(12)60525-X
8. Centers for Disease Control and Prevention. A U.S. report card. Updated February 11, 2026. Accessed October 28, 2026. https://www.cdc.gov/diabetes/communication-resources/diabetes-statistics.html
9. Labcorp. Hemoglobin (Hb) A1c, test 001453. Labcorp test menu. Accessed October 28, 2026. https://www.labcorp.com/tests/001453/hemoglobin-hb-a1c
10. Centers for Disease Control and Prevention. Diabetic ketoacidosis. Updated May 15, 2024. Accessed November 3, 2026. https://www.cdc.gov/diabetes/about/diabetic-ketoacidosis.html

Updated 2026-11-03. This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.