What Is A1C and Should I Get Tested?

Most people have heard of diabetes. Far fewer understand the test that catches it early — before symptoms appear, before damage is done, and when lifestyle changes can still make a real difference.

That test is the A1C.

The A1C test (also called hemoglobin A1C or HbA1c) measures your average blood sugar level over the past 2 to 3 months. Unlike a fasting glucose test, which gives you a snapshot of your blood sugar at one moment in time, the A1C reflects a longer picture.

Here is how it works: sugar in your bloodstream naturally attaches to hemoglobin, the protein inside red blood cells that carries oxygen. Red blood cells live for about 3 months, so the percentage of hemoglobin coated with sugar gives doctors — and you — a reliable average of how high your blood sugar has been running.

The result is expressed as a percentage. The higher the percentage, the higher your average blood sugar.

If you have already been diagnosed with diabetes, your doctor will typically aim to keep your A1C below 7% to reduce the risk of complications.

Prediabetes means your blood sugar is higher than normal but not yet high enough to be classified as type 2 diabetes. It is not a minor issue — it is a serious warning sign.

According to the CDC, over 96 million American adults have prediabetes. About 80% of them do not know it.

The good news: prediabetes is reversible. Studies show that losing 5–7% of body weight and getting 150 minutes of moderate exercise per week can reduce the risk of progressing to type 2 diabetes by up to 58%.

But you cannot act on information you do not have. That is why testing matters.

The American Diabetes Association recommends A1C testing for adults who have any of the following risk factors:

• Age 45 or older — risk increases with age
• Overweight or obese — especially with a BMI over 25
• Family history of diabetes — a parent or sibling with type 2 diabetes
• Physically inactive — less than 3 sessions of moderate exercise per week
• History of gestational diabetes — diabetes during pregnancy
• Polycystic ovary syndrome (PCOS)
• High blood pressure — 130/80 mmHg or higher
• Abnormal cholesterol or triglycerides
• History of heart disease or stroke

If you have no risk factors, testing is still recommended starting at age 35 and every 3 years after that.

If you have prediabetes, the ADA recommends testing every year.

No — and this is one of its biggest advantages over a fasting glucose test.

You do not need to fast before an A1C test. You can eat and drink normally before your lab visit. This makes it easier to fit into your schedule and removes one of the most common barriers to getting tested.

Both tests measure blood sugar, but they measure different things:

Fasting glucose measures your blood sugar at a single point in time after you have not eaten for at least 8 hours. It can fluctuate based on what you ate the day before, stress, illness, or how well you slept.

A1C reflects your average blood sugar over 2–3 months. It is less affected by day-to-day variation and does not require fasting, making it a more stable and convenient measure of long-term blood sugar control.

For most people, the A1C is the preferred screening test. Your doctor may order both if they want a complete picture.

If your A1C comes back in the prediabetes or diabetes range, the most important thing is not to panic — it is to act.

For prediabetes:

• Talk to your doctor about a structured prevention program
• Focus on diet changes: reduce refined carbohydrates and added sugars
• Increase physical activity — even walking 30 minutes a day makes a measurable difference
• Retest in 3–6 months to track your progress

For diabetes:

• Work with your healthcare provider to develop a management plan
• Medication may be recommended alongside lifestyle changes
• Regular monitoring — both at-home glucose checks and periodic A1C tests — becomes part of your routine

Yes. You do not need a doctor's order or insurance to get an A1C test.

At Reliable Exams, you can order an A1C test online, visit a nearby LabCorp or Quest Diagnostics location, and receive your results in 1–2 business days — all without a doctor's visit or insurance claim.

Our Diabetes Panel goes further, combining A1C with a comprehensive metabolic panel and microalbumin test to give you a complete picture of your blood sugar, kidney function, and metabolic health in a single visit.

• No risk factors, normal results: every 3 years starting at age 35
• Risk factors present: annually
• Prediabetes: every 6–12 months
• Diagnosed diabetes: every 3 months until stable, then every 6 months

The A1C test is one of the most important preventive health tests available. It catches a condition that affects tens of millions of Americans — most of whom have no idea. It requires no fasting, takes minutes at the lab, and gives you actionable information about your long-term health.

If you have any of the risk factors listed above — or if you simply have not been tested recently — there is no reason to wait for a doctor's appointment.

Order your A1C test today and get results in 1–2 business days.