From the Guidelines
The A1C test should be performed at least twice a year in patients with stable glycemic control and quarterly in patients whose therapy has changed or who are not meeting glycemic goals. This recommendation is based on the most recent and highest quality study, which suggests that the frequency of A1C testing should depend on the clinical situation, the treatment regimen, and the clinician’s judgment 1.
Key Points to Consider
- The A1C test reflects average glycemia over approximately 3 months and has strong predictive value for diabetes complications.
- The test is the major tool for assessing glycemic control and should be performed routinely in all patients with diabetes at initial assessment and as part of continuing care.
- Point-of-care testing for A1C provides the opportunity for more timely treatment changes 1.
- The frequency of A1C testing may be adjusted based on individual circumstances, such as pregnancy or certain medical conditions.
Clinical Implications
- Regular monitoring of A1C levels allows for timely adjustments to medication, diet, or lifestyle interventions before complications develop.
- The A1C test provides valuable information about average blood glucose levels over the previous 2-3 months, helping healthcare providers assess how well diabetes management strategies are working over time.
- By following the recommended testing frequency, healthcare providers can optimize glycemic control and reduce the risk of diabetes-related complications 1.
From the Research
Frequency of Hemoglobin A1C (HbA1C) Checks
- The American Diabetes Association recommends checking HbA1C levels at least semiannually in diabetic patients who have stable glycemic control and quarterly in patients whose therapy has changed or who are not meeting glycemic goals 2.
- For patients not meeting HbA1C goals, testing is indicated every 3-months to assess glycemic control, adjust medications, suggest lifestyle changes, and offer counseling 3.
- The recommendation is to measure HbA1C every 3-6 months, and treat to a target level of < 7% 4.
- More frequent patient-provider encounters may lead to faster control of HbA1C level, with encounters every 2 weeks associated with the fastest achievement of HbA1C targets for patients with diabetes mellitus 5.
Special Considerations
- Patients with a baseline HbA1C >9% may benefit the most from more frequent monitoring and interventions, such as the initiation of intermittently scanned continuous glucose monitoring (isCGM) 6.
- The frequency of HbA1C checks may need to be adjusted based on individual patient factors, such as changes in therapy or the presence of comorbidities 3, 2.
- Regular monitoring of HbA1C levels can help improve diabetes control and reduce the risk of long-term complications, especially microvascular complications 4, 2.