Important Facts for Diabetes Hemoglobin A1C Tests
DefinitionPercentage of adults aged 18 or older with diagnosed diabetes who self-report they had at least two A1C tests during the prior 12 months.
NumeratorNumber of adults 18 or older with diagnosed diabetes who had at least two A1C tests in the past 12 months.
DenominatorTotal number of surveyed adults 18 or older who were ever told by a health care professional that they had diabetes (excludes women with a history of gestational diabetes). Responses of "Don't know" and "Refused" were excluded from the analysis.
Data Interpretation IssuesBeginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. This methodology utilizes additional demographic information (such as education, race, and marital status) in the weighting procedure. Both of these methodology changes were implemented to account for an increased number of U.S. households without landline phones and an under-representation of certain demographic groups that were not well-represented in the sample. More details about these changes can be found at: [http://health.utah.gov/opha/publications/brfss/Raking/Raking%20impact%202011.pdf].
Why Is This Important?Proper diabetes management requires regular monitoring of blood sugar levels. Glucometers provide immediate feedback on blood sugar levels. An A1C test, however, tells a person what his or her average blood sugar level has been over the past two or three months and is a more reliable indicator of blood sugar control. An A1C level indicates the amount of sugar that is attached to red blood cells (hemoglobin cells). Red blood cells are replaced every two or three months and sugar stays attached to the cells until they die. When levels of blood sugar are high, more sugar is available to attach to red blood cells. For most people with diabetes, the target A1C level is less than 7 percent. Higher levels suggest that a change in therapy may be needed. Therefore, obtaining regular A1C tests plays an important role in diabetes management. The American Diabetes Association recommends that people with diabetes have an A1C test at least two times a year. However, the test should be conducted more often for individuals who are not meeting target blood sugar goals, or who have had a recent change in therapy. (See [http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s15#T7])
Healthy People Objective D-11:Increase the proportion of adults with diabetes who have a glycosylated hemoglobin measurement at least twice a year
U.S. Target: 71.1 percent