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HbA1c – Long-term blood sugar

HbA1c shows your average blood sugar over the last two to three months and is used to detect elevated blood sugar, prediabetes, and diabetes. The test does not require fasting.

What is HbA1c?

HbA1c measures what percentage of the haemoglobin in the blood has sugar bound to it. Since red blood cells live for about 120 days, the value reflects blood sugar over a longer period, unlike a fasting glucose test which only shows the moment the sample was taken.

Why is HbA1c measured in a health check?

Elevated blood sugar rarely causes symptoms early on. HbA1c is therefore one of the most valuable tests in a health check, especially in cases of overweight, family history of diabetes, high blood pressure, or a sedentary lifestyle.

High and low values

High value: A rising HbA1c indicates insulin resistance, prediabetes, or diabetes, and should be assessed by healthcare providers together with fasting glucose.

Low value: Low values are uncommon and can be seen in anaemia or conditions where red blood cells break down faster than normal, which can also make the value difficult to interpret.

Reference ranges differ between laboratories, sexes and ages and are stated in your result. The information here does not replace medical assessment.

How HbA1c is measured in a health check

HbA1c is taken as a standard blood test and requires no fasting, which makes it practical in a health check where you may want to take the sample in the afternoon anyway. If the same health check includes fasting glucose or blood lipids, however, fasting applies to those tests, and the whole sample is then taken in the morning.

The value reflects blood glucose over the past two to three months, with the greatest weight on the most recent weeks. This means a single party or a stressful week barely shows up, while a period of changed eating habits or more sedentary behaviour does. This makes HbA1c a stable measure that can be tracked over the years in repeated health checks.

Why elevated blood glucose is detected so late

Insulin resistance often develops over many years without symptoms. The body compensates by producing more insulin, and blood glucose is kept at a level that causes neither thirst nor fatigue. By the time symptoms appear, the condition has often been present for a long time. A health-check blood test with HbA1c is therefore one of the few ways to catch the development while it can still be slowed with lifestyle changes.

Prediabetes is particularly important to catch: here blood glucose is elevated but not yet in the diabetes range, and in many cases the risk can be significantly reduced through diet, weight loss and regular physical activity.

Who benefits most from checking HbA1c?

All adults benefit from knowing their long-term blood glucose, but some have stronger reasons to check it regularly.

  • Family history of type 2 diabetes in a parent or sibling
  • Overweight, especially abdominal obesity, or an increasing waist measurement
  • High blood pressure or high blood lipids
  • Previous gestational diabetes
  • Sedentary work and little regular physical activity
  • Previous test results in the borderline range

What to do with the result

A normal HbA1c with no risk factors suggests a new check every other year is enough. If the value is in the borderline range, it's reasonable to repeat the test within three to six months while also reviewing diet, sleep, alcohol and activity level — changes in daily habits are often visible already at the next measurement. A clearly elevated value should always be assessed by a doctor, who will add fasting glucose and an overall assessment before any diagnosis is made.

Since HbA1c is based on the lifespan of red blood cells, the value becomes difficult to interpret in anaemia, significant bleeding or certain blood disorders. This is why it's an advantage for a full blood count to be included in the same health check.

Frequently asked questions about HbA1c

Do I need to fast before an HbA1c test?

No. HbA1c measures an average over several months and is not affected by what you ate before the test. However, if fasting glucose is included in the same health check, fasting applies to that test.

What is the difference between HbA1c and glucose?

Glucose shows the blood sugar at the moment the sample was taken, while HbA1c shows the average blood sugar over the last two to three months. They complement each other.

How often should long-term blood sugar be checked?

With normal values and no risk factors, a check every one or two years is usually sufficient. In the case of overweight, family history, or previously elevated values, more frequent checks are reasonable—discuss the interval with a healthcare provider.

Can you lower your HbA1c?

Yes. Regular physical activity, fewer fast carbohydrates and weight loss often lower the value measurably within three to six months. Check with a new test to see the effect.

How quickly does a lifestyle change show in HbA1c?

Since the value reflects two to three months, you should wait at least twelve weeks before repeating the test, otherwise you risk measuring your old period.

Which health checks include HbA1c?

HbA1c is included in the broad health checks and in packages focused on metabolism and cardiovascular risk. All tests that include the marker are listed further down the page.

Health checks that include HbA1c

HbA1c is included in 9 of Labkollen's health checks. Analysis name in the result: HbA1c (långtidsblodsocker).

  • Man +

    49 markers

    Labkollens mest omfattande kontroll för män – inklusive testosteron, PSA och hjärt-kärlmarkörer.

    2 195 krMed prenumeration (årlig hälsokontroll): 1 756 kr

    See the test

  • Kvinna +

    44 markers

    Labkollens mest omfattande kontroll för kvinnor – inklusive järnstatus, sköldkörtel och hormoner.

    2 195 krMed prenumeration (årlig hälsokontroll): 1 756 kr

    See the test

  • Standard

    37 markers

    Bred hälsokontroll över blodsocker, blodfetter, blodvärde, lever, njurar, sköldkörtel och vitaminer.

    1 895 krMed prenumeration (årlig hälsokontroll): 1 516 kr

    See the test

  • Seniorkollen

    32 markers

    Anpassad kontroll för dig över 65 med fokus på hjärta, njurar, sköldkörtel och näringsstatus.

    1 399 krMed prenumeration (årlig hälsokontroll): 1 119 kr

    See the test

  • Gravid

    26 markers

    Kontroll under graviditet – blodvärde, järn, sköldkörtel, vitaminer och hCG.

    1 199 krMed prenumeration (årlig hälsokontroll): 959 kr

    See the test

  • Hjärtkollen

    22 markers

    Blodfetter, ApoB och blodsocker för att bedöma risk för hjärt-kärlsjukdom.

    499 krMed prenumeration (årlig hälsokontroll): 399 kr

    See the test

  • Uthållighetssport

    16 markers

    För löpare, cyklister och simmare – järnstatus, energiomsättning och återhämtning.

    1 599 krMed prenumeration (årlig hälsokontroll): 1 279 kr

    See the test

  • Lagsport

    16 markers

    För lagidrottare – energi, järn, återhämtning och stresshormon.

    1 599 krMed prenumeration (årlig hälsokontroll): 1 279 kr

    See the test

  • Sockerkollen

    3 markers

    Långtidsblodsocker, glukos och C-peptid vid misstanke om förhöjt blodsocker.

    549 krMed prenumeration (årlig hälsokontroll): 439 kr

    See the test

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Guides covering HbA1c

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Responsible for the content: Mathias Khemiri, Oftamed Sverige AB.

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