Practitioner Corner: Interpretation of Hemoglobin A1C

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 A Marker for Blood Glucose Control 

Blood cellsHemoglobin A1c (HbA1c) measures the percentage of red blood cells (RBCs) that are saturated with glucose. Saturation of RBCs occurs when blood glucose is elevated. The higher the HbA1c, the higher the estimated average blood glucose. HbA1c is generally considered to be correlated with the average blood glucose over 2-3 months.

The higher the average blood glucose, the more damage that's done to delicate blood vessel linings, retinal tissue and microvasculature of the extremities and retina. Damage to these are contributors to all the complications that diabetics face.

Out of control diabetes usually correlates with HbA1c of above 7, which correlates with an average blood glucose of 154 or more. I've had patients with levels of 10 or more, suggesting that their average blood glucose is 240 or higher. Doctors consider their diabetic patients to be well controlled when their HbA1c is is between 6 and 7. (126-154) Yet study after study demonstrates serious damage to vasculature, retina, pancreas and nerves when blood sugar exceeds 120. Some studies report damage when glucose rises above 100!

So what's an ideal HbA1C? Most functional medicine practitioners aim for between 4.5 and 5 (average glucose between 82 and 97).

If you're working with clients and you would like them to have the advantage of balanced blood sugar, get their HbA1C tested. They can order through Direct Labs.

For lots more details about managing your client's blood sugar, check out


With love and appreciation,


Dr. Ritamarie Loscalzo


What additional questions or comments do you have regarding the interpretation of Hemoglobin A1C? Comment below!


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