The increase in popularity and usage of GLP-1s, or glucagon-like peptide-1 receptors, exposes media consumers to information and talk of A1C and diabetes almost daily via commercials and conversations.
But exposure, especially in a 30-second ad, doesn’t translate into actionable knowledge about improving and maintaining health. It’s essential to know precisely what A1C is, why you should remain aware of your number and how to respond if your physician tells you it is increasing or has entered the prediabetic range.
GLP-1s – such as Ozempic, Zepbound and Mounjaro – were intended to help people with type 2 diabetes manage blood glucose levels, measured by A1C. A1C is a blood test that determines the amount of glucose, a form of sugar, attached to hemoglobin, a protein in red blood cells.
Human bodies cannot function without glucose. It travels through the bloodstream to supply organs, muscles, the brain and the nervous system with nutrients and energy.
Insulin, a hormone, serves as a doorkeeper. It facilitates glucose’s entry into cells to provide the energy they need to function. Insulin regulates glucose levels in the blood, and diabetes develops when insulin is absent or cells resist it.
Type 1 diabetes is the result of the pancreas not making any insulin. Type 2 diabetes develops because the pancreas is producing an insufficient amount of insulin, or cells are not responding to insulin.
A1C levels are the bellwether of diabetes because they reveal if the amount of glucose in the blood is increasing and possibly approaching a level that indicates diabetes.
A1C levels show your average blood glucose levels during the last two to four months, as red blood cells, where you find hemoglobin, live between 100 and 120 days.
A normal A1C level is between 5% and 5.7%, which indicates the percentage of hemoglobin that is retaining glucose. Prediabetes is indicated by an A1C level of 5.7% and 6.4%. An A1C reading above 6.5% indicates diabetes.
The Centers for Disease Control and Prevention warns that sustained elevated and uncontrolled blood glucose levels can affect organs and functions within the body.
In the circulatory system, elevated blood glucose can damage blood vessel walls and decrease blood flow in the back of the eye, impairing vision. In the feet, reduced blood flow can delay the healing of wounds and lead to infections or amputation.
In the heart, damaged blood vessels can lead to heart failure, high blood pressure and heart attack. Stroke and memory loss can occur because of damage to blood vessels in the brain.
Diabetes can lead to nerve damage that causes tingling in the extremities, resulting in pain and making daily activities challenging. Nerve damage in the stomach can impede digestion. Hearing loss can result when nerve signals from the inner ear to the brain become obstructed.
Erectile dysfunction and vaginal dryness can result from decreased blood supply and nerve damage.
Specific genetic, demographic, physical and lifestyle characteristics are risk factors for developing diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases lists those risks as:
- Being prediabetic
- Having family members with diabetes
- Being older than 35
- Being obese or overweight
- Leading a sedentary life or having a job that includes extended periods of sitting
- Being African American, Hispanic, Pacific Islander, Asian American, Latino or Indigenous American
Lifestyle changes can help control and lower A1C and possibly stave off diabetes, according to Johns Hopkins Medicine. Exercising, eating more fiber-rich foods and losing weight can play a role in reducing blood glucose levels.
Additionally, the CDC found that smoking can increase the risk of developing type 2 diabetes. Physicians recommend quitting smoking to reduce the risk of diabetes.
Making those changes can reduce A1C. But don’t expect an immediate decrease. Remember, A1C reflects an average reading for the prior three to four months, which is about the time it takes for the body to replace the red blood cells that were retaining excess glucose.
