What is HbA1c and why does it matter?
HbA1c (glycated haemoglobin) is a form of haemoglobin that has glucose permanently bound to it. Because red blood cells live approximately 120 days, HbA1c reflects your average blood glucose levels over the past two to three months — making it far more reliable than a single fasting glucose reading.
The American Diabetes Association uses HbA1c as the primary diagnostic marker for diabetes and pre-diabetes worldwide. It's also the standard measure for monitoring how well glucose control is being managed over time.
ADA reference ranges and what they mean
The ADA defines three key thresholds. An HbA1c below 5.7% is considered normal and indicates good long-term glucose control. Results between 5.7% and 6.4% indicate pre-diabetes — meaning increased risk of progression to type 2 diabetes. An HbA1c of 6.5% or higher is diagnostic of diabetes.
These thresholds apply regardless of whether you have been recently diagnosed or have lived with diabetes for years. They represent the same physiological reality: the percentage of haemoglobin molecules that have become glycated.
Why dried blood spot is better for diabetes monitoring
Traditional HbA1c testing requires a venipuncture (needle draw from the vein) in a clinic or pathology laboratory. This creates friction: patients must schedule appointments, travel, wait in clinics, and coordinate time off work. For people managing diabetes, this barrier often leads to testing less frequently than clinically recommended.
Dried blood spot HbA1c changes this entirely. A single finger-prick produces enough blood for testing. The sample is dried and stable at room temperature during postal transit. Masdiag's DBS HbA1c test uses high-performance liquid chromatography (HPLC) on a Bio-Rad D-10 analyser — the same gold-standard method used in most clinical laboratories — but eliminates the need for a clinic visit.
The analytical method: HPLC on Bio-Rad D-10
HPLC separates HbA1c from other haemoglobin variants by passing the blood sample through a liquid column. The D-10 system is recognised globally as a reference method for HbA1c measurement and is widely used in clinical and research laboratories.
From a dried blood spot, the same precision is achieved as from venous plasma. The sample requires only a small volume, making it ideal for remote collection and large-scale screening programmes.
Who should consider HbA1c testing?
Anyone with a family history of diabetes, those overweight or sedentary, or with other diabetes risk factors should consider baseline screening. Women with a history of gestational diabetes are at elevated risk and benefit from periodic monitoring.
For those already diagnosed with type 1 or type 2 diabetes, regular HbA1c monitoring is essential — typically every three months during medication changes and every six months when stable. Dried blood spot makes frequent monitoring more practical, supporting better medication and lifestyle adherence.
Remote monitoring and population health
Healthcare systems increasingly recognize that frequent, convenient testing improves outcomes. Dried blood spot HbA1c enables workplace screening programmes, remote patient monitoring for distributed populations, and large epidemiological studies without requiring centralised clinic infrastructure.
For wellness brands serving multiple geographies, this test makes it possible to offer professional-grade glucose control assessment alongside other metabolic biomarkers.
Frequently asked questions
What does HbA1c actually measure?
HbA1c (glycated haemoglobin) measures the percentage of haemoglobin molecules that have glucose bound to them. Because red blood cells live about 120 days, HbA1c reflects your average blood glucose over the past 2-3 months, making it more reliable than fasting glucose for assessing long-term glycaemic control.
What are the ADA HbA1c thresholds?
The American Diabetes Association defines HbA1c categories as: below 5.7% is normal, 5.7-6.4% indicates pre-diabetes risk, and 6.5% or higher indicates diabetes diagnosis. These thresholds are used globally and are independent of units (mmol/mol conversions also apply).
How often should I test my HbA1c?
For diabetes monitoring, HbA1c is typically tested every 3 months during active treatment or after medication changes, and every 6-12 months once stable. For pre-diabetes screening, annual testing is appropriate. Dried blood spot testing makes frequent monitoring more feasible since you can test from home.
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