A1C (Hemoglobin A1c)

Your A1C reflects the average percentage of your hemoglobin that has been glycated — coated with glucose — over the past 2 to 3 months. A higher number means higher average blood sugar. Below 5.7% is normal; 5.7 to 6.4% indicates prediabetes; 6.5% or above meets criteria for type 2 diabetes. For metabolic optimization, SPOKEmed targets A1C below 5.5%, alongside fasting insulin below 8, as markers of truly healthy blood sugar regulation.

Yes — and this is extremely important. Fasting insulin can be elevated (indicating insulin resistance) while A1C remains normal. The pancreas is simply compensating by producing more insulin to keep glucose in range. This compensated insulin resistance will not appear on A1C until the pancreas begins to fail to keep up. This is why SPOKEmed tests both A1C and fasting insulin — fasting insulin identifies insulin resistance earlier and more sensitively than A1C alone.

Because A1C reflects a 2 to 3 month average, meaningful changes in blood sugar regulation require at least that timeframe to show up in A1C. Significant dietary interventions, GLP-1 therapy, and exercise can produce measurable A1C reductions within 3 months. SPOKEmed monitors A1C at 3-month intervals during active metabolic treatment to track and refine protocol effectiveness.