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Hemoglobin A1c (HbA1c) is a biomarker that measures the amount of glucose in your blood that is attached to hemoglobin, the molecule in your red blood cells important for carrying oxygen throughout the body. HbA1c gives an average of your blood sugar over the past 2–3 months, providing a snapshot of your ability to maintain healthy blood sugar over time. This test can detect prediabetes, help diagnose diabetes, and be used to monitor the effectiveness of diabetes treatments. Diabetes causes blood glucose levels to stay elevated for long periods of time after a meal, eventually resulting in damage to the eyes, kidneys, nerves, circulatory system, and other organs. Hyperglycemia—the chronic state of having high blood sugar—is also known to adversely affect the immune system¹.

The higher your percentage of HbA1c, the greater your blood sugar levels over the past 2–3 months and the greater your risk of having prediabetes or diabetes.

With this information, your healthcare professional can make informed decisions about your diet, lifestyle, and medications to help you control your blood sugar level better. For diabetics, the American Diabetes Association recommends testing your HbA1c at least twice a year².

Additionally, those with elevated HbA1c and a genetic variant of the haptoglobin protein called Hp2-2 have a significantly increased risk of heart disease³. Learn more about haptoglobin.


  1. Watts M. HbA1c and the immune system. 18 March 2020. Diabetes.co.uk. https://www.diabetes.co.uk/blog/2020/03/hba1c-and-the-immune-system.html  
  2. American Diabetes Association. Understanding A1C. 6 July 2021. https://www.diabetes.org/a1c 
  3. Cahill LE, Levy AP, Chiuve SE, et al. Haptoglobin genotype is a consistent marker of coronary heart disease risk among individuals with elevated glycosylated hemoglobin. J Am Coll Cardiol 2013;61(7):728–737.
Last updated:
August 6, 2021

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