HbA1C is the Best Biomarker to Predict Diabetes for Working Adults

As a working adult, your time is valuable and preventative health measures may not always seem a top priority. However, there is one biomarker you should pay close attention to that can indicate your risk for diabetes and impact your long term health—your HbA1c level.

Knowing your HbA1c level and what it means for your health can help add years to your life and life to your years. In this comprehensive guide, you'll learn why HbA1c is so important, ideal levels to aim for, how often you should be screened, and the lifestyle changes and medications that can help get your levels into a healthy range.

TLDR: HbA1c is a blood test that measures your average blood sugar levels over the past 2-3 months.

• An ideal HbA1c level is below 5.7%.
• An HbA1c level of 5.7% to 6.4% indicates prediabetes. A level of 6.5% or higher indicates you have diabetes.
• You should get your HbA1c tested at least once a year if you're at risk for diabetes.
• Lifestyle changes like a healthy diet, exercise and weight loss can help lower your HbA1c levels. Medications may also be needed.

What Is HbA1c and Why It Matters for Working Adults

What Is HbA1c?

HbA1c measures the percentage of hemoglobin that is glycated, or attached to blood sugar, in your red blood cells. An HbA1c level provides an accurate indication of your average blood sugar over the previous 2 to 3 months, and is usually regarded as the best way to diagnose prediabetes or diabetes.

Why HbA1c is Superior to Fasting Blood Glucose

Unlike fasting blood glucose that provides a snapshot of current blood sugar, HbA1c offers a more comprehensive assessment of long term glycemic control. Since HbA1c is not subject to temporary fluctuations from stress, diet or activity levels, it eliminates the variability and inaccuracies of blood glucose testing.

For busy working individuals with erratic schedules, HbA1c offers a convenient way to screen for diabetes without requiring fasting or timed blood draws.

How HbA1c Relates to Health Risks

Chronically high HbA1c levels mean prolonged exposure to high blood sugar, signifying an increased risk of developing type 2 diabetes and its associated complications - heart disease, kidney disease, or even nerve damage.

People with prediabetes or uncontrolled diabetes often have elevated HbA1c levels. Keeping your HbA1c in the healthy range helps lower your chances of developing diabetes by reducing damage from long-term high blood sugar.

In detail:

• High blood sugar over time causes tiny blood vessels that supply the heart, kidneys, and nerves to become damaged or blocked. This can lead to coronary artery disease, chronic kidney disease, and diabetic neuropathy.
• When blood sugar levels remain elevated for an extended period, it increases the workload on the pancreas. Over time, the pancreas may lose its ability to keep up, resulting in full-blown type 2 diabetes.
• The risk of heart attack, stroke, and other cardiovascular problems also rises with chronically high HbA1c. One study found that for every 1% increase in HbA1c above 6%, the risk of cardiovascular disease increased by 18%.
• Other complications like vision loss, amputations, and depression are more common in individuals with poorly controlled diabetes and HbA1c levels consistently above target.

Recommended HbA1c Levels for Optimal Health and Longevity

HbA1c Levels Below 5.7% Are Optimal

According to the American Diabetes Association, an HbA1c level below 5.7% is normal for most adults. Maintaining an HbA1c in this range has been shown to reduce the risk of diabetes and related health complications.

HbA1c Levels of 5.7% to 6.4% Indicate Prediabetes

If your HbA1c is between 5.7% to 6.4%, this indicates you have prediabetes. Individuals with prediabetes are very likely to develop type 2 diabetes within 10 years unless lifestyle changes are made.

Prediabetes can often be reversed by losing excess weight, following a healthy diet, and engaging in regular exercise. You should have your HbA1c tested annually if it is in the prediabetes range.

HbA1c Over 6.5% Indicates Diabetes

An HbA1c of 6.5% or higher on two separate tests means you have diabetes. At this point, lifestyle changes and medications may be needed to manage blood sugar levels and reduce health risks.

HbA1c should be tested at least twice a year for those with diabetes to monitor blood sugar control and determine if treatment needs adjustment.

How Often Working Adults Should Get HbA1c Screened

Non-Diabetics: Every 1-2 Years

HbA1c testing for non-diabetics should generally be done once every 1 to 2 years to screen for prediabetes or risk of developing diabetes. More frequent testing is not necessary for those with normal HbA1c levels unless there are significant risk factors or lifestyle changes.

Diabetics: Every 6 Months

For individuals with diagnosed diabetes, HbA1c testing should be done at least twice per year. More frequent monitoring, even every 3 months, is often recommended during the initial stages of diabetes treatment to help establish a baseline and determine an effective treatment plan.

Once blood sugar levels have been stabilized, testing every 4 to 6 months may be sufficient for those with well-controlled diabetes and a stable medication regimen.

Mito Health's flagship package, priced at $499, offers testing for HbA1c as well as 66 other carefully curated biomarkers that provide insight into various aspects of your health - this comprehensive suite of tests allows for early detection of common illnesses.

In addition to testing, you will receive a personalized health optimization plan from our doctors incorporating supplements, nutrition, exercise and sleep strategies, discounted pricing for specialized additional tests, and access to exclusive health and longevity events.

Lifestyle Changes to Optimize HbA1c Levels

To optimize your HbA1c levels, several lifestyle changes can help. Making healthy choices regarding diet, exercise, sleep, and stress management are key to improving glycemic control.

Diet

• Eat plenty of non-starchy vegetables: Vegetables like spinach, kale, broccoli, carrots, zucchini, and eggplant are high in fiber, nutrients, and water content to aid with blood sugar control. Aim for at least 2-3 cups of vegetables with both lunch and dinner.
• Choose whole fruit over juice: Fruit contains natural sugars but also fiber that slows absorption. Limit juice and dried fruit. Opt for 1-2 pieces of whole fruit per day.
• Go for whole grains: Whole grain foods like brown rice, oats, quinoa, and 100% whole wheat bread and pasta contain more fiber and nutrients to help stabilize blood sugar. Limit refined grains.
• Include lean proteins at every meal: Protein-rich foods like chicken, fish, eggs, legumes, and nuts help keep you full and support stable blood sugar. Aim for a palm-sized portion of protein with each meal.
• Choose healthy fats: Unsaturated fats from olive oil, avocado, nuts, and seeds can improve insulin sensitivity. Limit saturated fat from red meat and full-fat dairy.

Exercise

• Aim for at least 150 minutes of moderate-intensity aerobic activity weekly. This could mean 30 minutes, 5 times per week.
• Include both cardiovascular exercise and resistance training. Aim for 2-3 strength training sessions weekly, focusing on all major muscle groups.
• Increase activity gradually over weeks and months to avoid injury. Start by walking more and increase speed or distance over time.
• Join an exercise class or find an activity you enjoy like swimming, cycling or team sports. This can improve motivation and adherence over the long term.

Sleep

• Aiming for 7 to 8 hours of sleep per night can help regulate glucose and hormone levels.
• Lack of sleep can elevate cortisol, raise blood sugar, and increase risk of weight gain.
• Establish a relaxing bedtime routine, limit screen time and blue light exposure before bed.

Stress Management

• Chronic stress leads to elevated cortisol which can negatively impact blood sugar control.
• Practicing self-care through meditation, yoga, spending time in nature or with loved ones helps lower stress and improve wellbeing.
• Seeking counseling or professional help if needed is also advised.

Making incremental changes to your daily habits and lifestyle can significantly lower your HbA1c over time. Be patient through the process and stick with sustainable adjustments for the best chance of success in optimizing your glucose control and health.

Medications That Can Help Lower Elevated HbA1c

To properly manage an elevated HbA1c level, certain medications may be recommended by your physician. The following medications can help lower HbA1c and reduce the risk of diabetes complications:

Metformin

Metformin is considered a first-line treatment for type 2 diabetes and prediabetes. It lowers blood sugar levels by reducing glucose production in the liver and increasing insulin sensitivity.

Metformin is usually very well tolerated, with the most common side effects being gastrointestinal issues like nausea or diarrhea.

Sulfonylureas

Sulfonylureas stimulate the pancreas to produce more insulin. Examples include glipizide, glyburide, and glimepiride.

They can cause hypoglycemia so close monitoring of blood sugar levels is needed. Weight gain is also possible.

GLP-1 Receptor Agonists

GLP-1 receptor agonists stimulate the release of insulin from the pancreas and suppress appetite. They include exenatide, liraglutide, dulaglutide, and semaglutide.

Common side effects are nausea and diarrhea. They tend to cause some weight loss which can be a benefit for some patients.

DPP-4 Inhibitors

DPP-4 inhibitors prevent the breakdown of GLP-1, which stimulates insulin release. Examples are sitagliptin and saxagliptin.

They tend to be very well tolerated with few side effects. They do not usually cause weight gain or hypoglycemia.

Insulin

For some individuals, insulin injections may be required to control blood sugar and lower HbA1c. There are many types of insulin available with different times of onset and durations of action.

Insulin can cause weight gain and hypoglycemia so close monitoring is needed, especially when first started or the dosage is changed.

Following your physician’s recommended treatment plan, making the necessary lifestyle changes, and properly managing any prescribed medications can successfully help lower your HbA1c to a healthier range and reduce health risks. Be sure to regularly test your HbA1c, usually every 3 to 6 months, to monitor your levels and make any needed medication adjustments.

Conclusion

In summary, HbA1c is a critical biomarker for your long term health and longevity as a working adult. While it may not seem urgent if you feel well today, checking for and maintaining healthy HbA1c levels reduces your risk of diabetes and related complications that can significantly impact your productivity, independence, and lifespan.

At Mito Health, we specialize in advanced health diagnostics to test your HbA1c levels (along with 66 other biomarkers) - to form a science-based, personalized health plan to help you optimize your health. Sign up for our flagship package today to take control of your health and your future.