What does the A1C test mean?

Question:  I was recently told by my doctor I have pre-diabetes and that I need to lose weight, eat right, and get my sugar levels down.  On a 12 hour fast, my glucose level was 73 yet my A1C was 6.1%.  If my glucose is low, why is my A1c still high?  What can I do?

Answer:  The A1C test is an average of blood sugar control over the past 90 days.  It is measured in a percentage which correlates with an estimated average glucose level.  For example,  a person with an A1C of 6.0% has had an estimated average glucose of 126 mg/dL over the past 90 days.  Some people may have a lower blood sugar when they wake up, but may experience spikes in their blood sugars throughout the day due to food intake, stress, meds, etc, resulting in an elevated average.  The fact that your fasting blood glucose is low is a good sign.   Usually post-prandial, or after-meal, numbers are the first numbers to rise when diabetes is starting to develop.  This is likely where you are at and this is a perfect time to make lifestyle changes to prevent the further progression of diabetes.  Research has shown that weight loss, exercise, and healthy eating habits can decrease the risk of diabetes progression up to 58%.