From the Guidelines
An A1c of 8.5% corresponds to an estimated average blood glucose level of approximately 200 mg/dL (11.1 mmol/L). This estimate is based on the most recent and highest quality study available, which provides a framework for considering treatment goals for glycemia in older adults with diabetes 1. The study suggests that an A1C of 8.5% equates to an estimated average glucose of approximately 200 mg/dL (11.1 mmol/L).
Context and Implications
For context, a normal A1c for someone without diabetes is below 5.7% (average glucose around 117 mg/dL), while the target for most people with diabetes is below 7.0% (average glucose around 154 mg/dL) 1. An A1c of 8.5% indicates suboptimal diabetes control and increases the risk for long-term complications such as heart disease, kidney problems, nerve damage, and eye issues.
Management Considerations
This level suggests that adjustments to the diabetes management plan may be necessary, which could include changes to medication, diet, exercise, or monitoring frequency. It is essential to discuss these results with a healthcare provider to develop a plan to bring blood glucose levels into a safer range. The provider may consider factors such as the patient's overall health status, presence of coexisting chronic illnesses, and risk of hypoglycemia or undue treatment burden when determining the appropriate treatment goals 1.
Key Points to Consider
- An A1c of 8.5% is above the target range for most people with diabetes.
- This level of A1c corresponds to an estimated average blood glucose level of approximately 200 mg/dL (11.1 mmol/L).
- Adjustments to the diabetes management plan may be necessary to bring blood glucose levels into a safer range.
- Discussion with a healthcare provider is essential to develop an individualized plan.
From the Research
Average Blood Glucose Level Corresponding to HbA1c 8.5%
- The average blood glucose level corresponding to a Hemoglobin A1c (HbA1c) of 8.5% is not directly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 2 mentions that a 32-week study of the combination of rosiglitazone with metformin in patients with mean baseline HbA1c 8.9% showed a mean HbA1c reduction of 2.3%, and an open-label cohort with baseline HbA1c 11.8% had a reduction in HbA1c to 7.8%.
- Additionally, study 2 states that with metformin plus sitagliptin, a mean placebo-adjusted HbA1c reduction of 2.1% from a baseline of 8.8% was reported.
- Study 5 found that patients with an average A1C >8% experienced a 16% increase in the likelihood of a cardiovascular event.
- Study 6 assessed the diagnostic and predictive capacity for diabetes of high-normal levels of haemoglobin A1C or fasting plasma glucose, but does not provide a direct correlation between HbA1c 8.5% and average blood glucose level.
Correlation Between HbA1c and Average Blood Glucose
- Although the exact average blood glucose level corresponding to HbA1c 8.5% is not provided, study 2 suggests that HbA1c levels can be reduced with various treatments, such as metformin, sitagliptin, and rosiglitazone.
- The American Diabetes Association provides a general correlation between HbA1c and average blood glucose levels, but this information is not included in the provided studies 2, 3, 4, 5, 6.