According to the CDC, an A1C level of 20 would be considered diabetes.
A1C is also known as glycated hemoglobin, hemoglobin A1C, or HbA1c and is a form of hemoglobin linked to sugar. Using a blood test, an A1C test measures your average blood sugar levels over the past 3 months.
According to the CDC, a normal A1C level is below 5.7, a level of 5.7 to 6.4 indicates prediabetes, and a level of 6.5 or higher would indicate diabetes.
Within the 5.7 to 6.4 prediabetes range, the risk for developing type 2 diabetes goes up each time the number increases.
While levels below 4.0 are theoretically possible, they aren't common. Similarly, it would be extremely rare to have an A1C over 15.0.
An A1C level of 20 may be written on a lab report simply as 20 or 20%.
For those familiar with estimated average glucose, or eAG, A1C levels convert quite easily to mg/dl using the formula 28.7 x A1C – 46.7 = eAG mg/dl. This means an A1C of 20 would be equal to 527 mg/dl. Mg/dl is typically used in the United States and stands for miligrams per deciliter.
Similarly, you can convert A1C levels to mmol/l by using the formula (28.7 x A1C – 46.7) / 18 = eAG mmol/l. This means an A1C of 20 would be equal to 29.3 mmol/l. Mmol/l stands for millimoles per litre and is typically used in the United Kingdom.
You can view an exhaustive A1C conversion chart right on this website.
A1C is typically measured by a blood test, also called a blood glucose test, ordered by your doctor. Compared to traditional blood glucose tests, fasting is not required for A1C tests.
You can also measure A1C levels at home with digital A1C meters. To use one, you typically prick a finger with a lancet or fingerstick, add a drop of blood to a test strip, and insert the strip into the meter. While convenient, the reliability of readings from at-home A1C tests is debated.
If you have an HSA as part of your health insurance plan, you'll be pleased to find that blood glucose monitors and blood glucose test strips are considered eligible expenses.
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The information on this page is intended to be an educational reference and is not to be taken as medical advice. If you think you're having a medical emergency, please call 911 immediately.