HbA1c Does Not Need to Be Drawn in the Morning
No, hemoglobin A1c does not need to be drawn in the morning and does not require fasting. One of the primary advantages of A1c testing is the convenience of being able to draw it at any time of day without dietary preparation 1.
Key Advantages of A1c Testing
A1c measurement does not require fasting, making it significantly more convenient than fasting glucose or oral glucose tolerance tests for both patients and healthcare providers 1.
The test reflects average glycemia over approximately 3 months, representing the glycation of hemoglobin over the lifespan of red blood cells, which is independent of acute fluctuations in blood glucose 1.
A1c can be drawn at any time during the day without regard to meal timing, exercise, or time of day, as these factors do not significantly affect the result 1.
Clinical Laboratory vs Point-of-Care Testing
A1c measurements for diagnosis of diabetes should be performed by a clinical laboratory rather than point-of-care testing due to lack of standardization of point-of-care methods 1.
Point-of-care A1c testing can be used for monitoring established diabetes and allows for more timely treatment changes during clinical encounters, but the convenience of timing remains the same 1.
When A1c Should Be Ordered
Perform A1c testing at least twice yearly in patients meeting treatment goals with stable glycemic control 1.
Perform A1c testing quarterly (every 3 months) in patients whose therapy has changed or who are not meeting glycemic goals, as this interval allows sufficient time to assess the effect of treatment adjustments 1, 2.
Common Pitfall to Avoid
- Do not confuse A1c testing with fasting glucose testing—while fasting glucose requires an 8-hour fast and morning draw for standardization, A1c has no such requirement and can be drawn at the patient's convenience 1.