Fasting and queuing to prick your finger in the morning is a monthly routine annoyance for many people with diabetes. But what if I told you there is a key test that does not require fasting and is not easily “gamed” — would you feel relieved?

At 6:30 a.m., Old Zhang arrived at the hospital fasting, ready to have his blood glucose measured. The nurse told him, “Today we’re measuring glycated hemoglobin; it’s okay if you’ve already had breakfast.” Old Zhang was stunned — you don’t have to be hungry to test blood glucose?

This magical test is glycated hemoglobin (HbA1c), hailed as the “stabilizer” and “honest recorder” of blood glucose. Today, let’s unveil its mystery.

1. Why does measuring glycated hemoglobin not require fasting?

It records a “history,” not a “moment”

。

Imagine that fasting blood glucose is like an instant photograph, capturing the blood glucose value at the single moment of blood draw. Glycated hemoglobin, on the other hand, is like a three-month documentary of one’s life.

Its detection principle is very unique:

Glucose binds to hemoglobin in red blood cells

Once bound, it "stays attached" throughout the red blood cell's 120-day lifespan

The test result reflects the average blood glucose level over the past 2–3 months

So whether you ate breakfast this morning has a negligible effect on this "long-term documentary."️

Four "not worried" points tell you about its reliability

Not worried about "last-minute control before testing"

Some people start strict dieting a week before measuring fasting blood glucose, resulting in a "false pass." Glycated hemoglobin doesn't fall for that—it records long-term performance.

Not worried about a "single fluctuation"

Had a spike in blood glucose at yesterday's gathering? As long as your usual control is good, this one-time fluctuation won't significantly raise your HbA1c.

Not worried about the "time of blood draw"

Measured in the morning, afternoon, before a meal, or after a meal—the results are essentially the same. No more rushing to get in line early! ⏰

Not worried about "stress effects"

Many people become nervous as soon as they go to the hospital, leading to stress-induced hyperglycemia. Glycated hemoglobin is not affected by such short-term emotional fluctuations.

2. What level of glycated hemoglobin is considered controlled?

General standard: glycemic targets for most people

According to the "Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition)":

Control Level

Glycated Hemoglobin Value

Interpretation

Ideal

< 6.5%

Well controlled, significantly reduced risk of complications

General

6.5% - 7.0%

Basically meets standards, but there is room for optimization

Needs improvement

7.0% - 8.0%

Control inadequate, treatment plan needs adjustment ⚠️

Poor

> 8.0%

Poorly controlled, with a significantly increased risk of complications

Individualized target: what suits you is best

⚠️

⚠️ Important reminder: The above are general standards; specific targets should be determined by a physician based on the individual’s situation:

Young, short disease duration, no complications: can be strictly controlled below 6.5%

Elderly, those with cardiovascular or cerebrovascular disease: can be relaxed to 7.0%–8.0% to avoid hypoglycemia risk

Pregnancy-related diabetes patients: have stricter control requirements (usually <6.0%)

Everyone's "target threshold" is tailor-made!

3. What to do if glycated hemoglobin is high? Four scientific steps to lower it

Step 1: Dietary adjustment — the cornerstone of stabilizing blood glucose

Control both the "quality" and "quantity" of carbohydrates

Choose low glycemic index staple foods: brown rice, oats, buckwheat instead of refined white rice and wheat flour

Portion control: about one fist-sized serving of staple food per meal

The plate "3-2-1" rule

On the plate: 1/2 vegetables, 1/4 protein (fish, legumes, eggs), 1/4 staple food

Eat vegetables first, then protein, and staple food last

Regular meals, no extra meals or snacks

Eat at set times and in fixed amounts to avoid large blood glucose fluctuations

Step 2: Scientific exercise—nature’s “antidiabetic” ♂️

Combine aerobic exercise with resistance training

At least 150 minutes per week of moderate-intensity aerobic exercise (brisk walking, swimming)

2–3 strength training sessions per week (dumbbells, resistance bands)

Seize the optimal exercise timing

Exercising 30–60 minutes after a meal is most effective

Each exercise session should last at least 10 minutes, accumulating to meet the target

Avoid the "weekend warrior" pattern

Distribute exercise time evenly; avoid being inactive during the week and overexerting on weekends

Step three: medication optimization — the physician's area of expertise

If glycated hemoglobin remains uncontrolled after lifestyle interventions:

Timely follow-up: test glycated hemoglobin every 3–6 months

Adjust per medical advice: do not change medications on your own

Consider newer drugs: if necessary, the physician may recommend GLP-1 receptor agonists, SGLT2 inhibitors, and other medications with cardiovascular benefits

Step 4: Monitoring and Recording — the "Navigator" for Glucose Control

Do not stop blood glucose monitoring

Even if HbA1c is at target, continue regular fingertip blood glucose testing

Focus on fasting and 2-hour postprandial blood glucose

Record a "blood sugar management diary"

Record diet, exercise, and blood glucose values

Regularly review to identify patterns and problems

Technology-assisted

Consider using a continuous glucose monitor (CGM)

Use a health app to track data

4. Special reminder: Limitations of glycated hemoglobin ⚠️

Although glycated hemoglobin is important, it is not a “universal indicator”:

Cannot reflect glucose variability: two people may both have an HbA1c of 7.0%, but one has stable glucose while the other has wide fluctuations

Not applicable to all populations: results may be inaccurate in patients with anemia or hemoglobin abnormalities

Must be combined with other indicators: evaluation should include fasting and postprandial glucose measurements

Glycated hemoglobin is like a mirror that honestly reflects blood glucose control over the past two to three months.

Blood glucose control is not a 100-meter sprint but a marathon. Do not become overly anxious about a single fluctuation in values, nor become lax because of short-term target attainment. Establish a long-term cooperative relationship with your physician and find a lifestyle that suits you; that is the lasting way to control blood glucose.

Remember: that "stabilizer" value you can measure without fasting is quietly telling the story of your daily efforts. And every sensible dietary choice and every deliberate step you take adds a better annotation to that number.