Katie Hettinger, PharmD
Resident Pharmacist, Topeka Pharmacy
Team Lead, Team Indiana Cohort 2
According to the Centers of Disease Control and Prevention (CDC), 34.2 million Americans have been diagnosed with diabetes. That is 1 in 10 Americans. Furthermore, 1 in 3 Americans, or 88 million people, have prediabetes. These patients are in and out of the pharmacy, sometimes multiple times per month, and oftentimes with medication changes to help manage their diabetes. Pharmacists are well positioned to offer counseling to patients about what their A1c can tell them and how it can help them understand their diabetes. If the pharmacy has a Clinical Laboratory Improvement Amendments (CLIA) waiver, they can even provide the A1c test on site!
Here are a few talking points for counseling on A1cs:
1. What is an A1c? An A1c is the average measure of the blood glucose over the last 3 months.
Normal A1c: Less than 5.7%
A1c indicating prediabetes: 5.7%- 6.4%
A1c indicating diabetes: 6.5% or above
2. What is the difference between A1c and a random blood glucose (RBG) check? A RBG level correlates to what your blood glucose is now, whereas an A1c shows what your blood glucose has been on average over the course of the past 3 months.
3. How often should someone get an A1c? Most primary care providers take an A1c at least twice a year. If a patient has newly diagnosed diabetes, has made medication changes, or has prediabetes, they may want to have their A1c taken more often.
4. What is the suggested target range A1c for patients with diabetes? For patients with diabetes, most primary care providers set a goal of 7% or lower. However, managing diabetes is very individualized, and their primary care provider may set a different goal for them!
The American Diabetes Association (ADA) has a great 1-page handout with explanations for most of the questions above that can help aid you in counseling your patients on their A1cs. This handout also includes a chart that shows patients what their average blood glucose level is compared to their A1c!
You can access the ADA's A1c handout here:
Whether you provide the A1c test yourself or obtain an A1c level from the patient's primary care provider's office, you can make a huge difference in making sure your patients understand what their A1c means!
References:
National Diabetes Statistics Report 2020. Centers for Disease Control and Prevention. Accessed May 10th, 2021.
This was a really great quick summary of A1c! I have noticed that patients do not always know or remember this information, which means that they do not fully understand their health or condition. Pharmacists can definitely help to combat the gap of knowledge by counseling patients. I also really like the idea of more pharmacies offering A1c testing, because that's a great way for pharmacists to make a difference!