Hemoglobin A1c on the NCLEX
A1c interpretation, goals, limitations.
A1c reflects 2-3 month average glucose. Diagnostic and monitoring tool for diabetes.
Interpretation
<5.7 normal. 5.7-6.4 prediabetes. ≥6.5 diabetes (confirmed twice).
Goal
<7% generally for most adults with diabetes. Individualized, less strict (8%) in elderly or severe comorbidity.
Limitations
Inaccurate in: hemoglobinopathies (sickle cell, thalassemia), recent transfusion, severe anemia, pregnancy (use fructosamine or self-monitoring).
Conversion
Rough: A1c × 28.7 - 46.7 = average glucose. A1c 7 ≈ 154 mg/dL average.
Frequently asked
How often check?
Quarterly until at goal, then twice yearly.
A1c 8, clinical meaning?
Average glucose ~180. Above goal. Intensify therapy.
Quick check
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