Last updated on 12th Sep 2022 - By Dwayne Michaels

Why is my hba1c high or low?

The hba1c results are interpreted along with the results for glucose, random blood glucose, ppbg, insulin and c peptide to help diagnose disease severity. So let's know about all these tests and let's try to know the real cause of your disease.

After reading this article thoroughly you will be able to self-diagnose your disease

Before understanding the different glucose tests like HbA1c, fasting blood glucose, insulin resistance score and adiponectin, let's look at some of the causes of abnormal blood sugar levels.

Some causes of low blood sugar level:

  • Heart failure
  • Chronic kidney failure
  • Insulin overdose
  • Starvation
  • Tumors that produce insulin (insulinomas)
  • Adrenal insufficiency
  • Drinking excessive alcohol
  • Liver disease
  • Short supply (deficiency) of one or more of the pituitary hormones.
  • Underactive thyroid
  • Infections
  • Deliberate use of glucose-lowering products

Some causes of high blood sugar level

  • Acute stress (response to trauma, heart attack, and stroke for instance)
  • Acromegaly
  • Pancreatitis
  • Chronic kidney disease
  • Pancreatic cancer
  • Cushing syndrome
  • Overactive thyroid

If you need our help diagnosing the severity of your illness and want to get your glucose level back to normal, you can upload your blood report here. Upload blood test report now

Prediabetes :

When a person has higher than normal blood sugar levels, a doctor could diagnose them with prediabetes. Prediabetes means that blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. One possible sign of prediabetes is darkened skin on certain parts of the body. Affected areas can include the neck and armpits

3 types of diabetes :

Type 1 diabetes results from failure of the pancreas to produce enough insulin due to loss of beta cells. The loss of beta cells is caused by an autoimmune response. The cause of this autoimmune response is unknown. Although Type 1 diabetes usually appears during childhood or adolescence, it can also develop in adults.

Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses, a lack of insulin may also develop. Type 2 diabetes is more common in older adults, but a significant increase in the prevalence of obesity among children has led to more cases of type 2 diabetes in younger people. The most common cause is a combination of excessive body weight and insufficient exercise.

Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels. In women with gestational diabetes, blood sugar usually returns to normal soon after delivery. However, women who had gestational diabetes during pregnancy have a higher risk of developing type 2 diabetes later in life.

The classic symptoms of untreated diabetes are unintended weight loss, polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes, while they usually develop much more slowly and may be subtle or absent in type 2 diabetes.

Several other signs and symptoms can mark the onset of diabetes although they are not specific to the disease. In addition to the known symptoms listed above, they include blurred vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. Long-term vision loss can also be caused by diabetic retinopathy. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.

All forms of diabetes increase the risk of long-term complications. These typically develop after many years (10–20) but may be the first symptom in those who have otherwise not received a diagnosis before that time.

The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves. Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness.

Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation.

Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes. The symptoms can include numbness, tingling, sudomotor dysfunction, pain, and altered pain sensation, which can lead to damage to the skin.


The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes. If you're living with diabetes, the test is also used to monitor how well you're managing blood sugar levels.

A person who does not have diabetes: A1c result less than 5.7% (39 mmol/mol)

Diabetes: A1c level is 6.5% (48 mmol/mol) or higher

Increased risk of developing diabetes in the future (pre-diabetes): A1c of 5.7% to 6.4% (39-46 mmol/mol)

An A1C test result reflects your average blood sugar level for the past two to three months.

Persistent elevations in blood sugar (and, therefore, HbA1c) increase the risk of long-term vascular complications of diabetes, such as coronary disease, heart attack, stroke, heart failure, kidney failure, blindness, erectile dysfunction, neuropathy (loss of sensation, especially in the feet), gangrene, and gastroparesis (slowed emptying of the stomach). Poor blood glucose control also increases the risk of short-term complications of surgery such as poor wound healing.

Glycated hemoglobin testing is recommended for both checking the blood sugar control in people who might be prediabetic and monitoring blood sugar control in patients with more elevated levels, termed diabetes mellitus. For a single blood sample, it provides far more revealing information on glycemic behavior than a fasting blood sugar value. However, fasting blood sugar tests are crucial in making treatment decisions.

Meta-analysis has shown probiotics to cause a statistically significant reduction in glycated hemoglobin in type 2 diabetics.

Fasting blood glucose:

This measures your blood sugar after an overnight fast (not eating). This test may be used to screen for and diagnose prediabetes and diabetes in people with signs and symptoms.

A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have prediabetes, and 126 mg/dL or higher indicates you have diabetes. In some cases, there may be no early signs or symptoms of diabetes, so an FBG may be used to screen people at risk of diabetes.

Glucose Tolerance Test

This measures your blood sugar before and after you drink a liquid that contains glucose. You’ll fast (not eat) overnight before the test and have your blood drawn to determine your fasting blood sugar level. Then you’ll drink the liquid and have your blood sugar level checked 1 hour, 2 hours, and possibly 3 hours afterward. At 2 hours, a blood sugar level of 140 mg/dL or lower is considered normal, 140 to 199 mg/dL indicates you have prediabetes, and 200 mg/dL or higher indicates you have diabetes.

The Oral Glucose Tolerance Test does not distinguish between insulin resistance in peripheral tissues and reduced capacity of the pancreas beta-cells to produce insulin. The OGTT is less accurate than the hyperinsulinemic-euglycemic clamp technique (the "gold standard" for measuring insulin resistance), or the insulin tolerance test, but is technically less difficult.

Random Blood Sugar Test

A random blood glucose may also be used to screen for diabetes.

This measures your blood sugar at the time you’re tested. You can take this test at any time and don’t need to fast (not eat) first.

However, if a random glucose result is abnormal, it is typically followed by a fasting blood glucose test or a glucose tolerance test (GTT) to establish the diagnosis. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.


Lower-than-normal adiponectin levels are associated with Type 2 diabetes.

Clinical and experimental studies suggest that low adiponectin levels contribute to the development of obesity-linked illness. Adiponectin has been associated with insulin resistance and linked with type II diabetes, as well as glucose and lipid metabolism. Adiponectin may have relevance for energy metabolism through the regulation of fatty acid oxidation.

If you need our help diagnosing the severity of your illness and want to get your glucose level back to normal, you can upload your blood report here. Upload blood test report now