If someone with diabetes has blood sugar numbers that don't match their A1c test, it might be due to a hidden blood condition — even if their blood tests look mostly normal. In those cases, a special...

If someone has certain blood conditions like sickle cell trait, their A1c test might show lower blood sugar levels than they actually have, which could trick doctors into thinking diabetes is under control when it's not — especially if they don't also check regular blood sugar tests.

If someone with diabetes has confusing blood sugar and A1c results, a special blood test called hemoglobin electrophoresis can help find rare blood conditions that might be messing with their A1c, even if their regular blood tests look mostly normal.

HbA1c might not give a true picture of blood sugar control in people with diabetes because things like how often blood sugar swings, different ethnic backgrounds, and other health problems can affect the results.

Sometimes, blood sugar tests that don’t use HbA1c might give a better picture of how well someone’s diabetes is managed—especially if things like blood disorders or other health issues make the standard HbA1c test less reliable.

HbA1c tells you how much sugar has been sticking to your blood cells over the past few months — it's like a long-term blood sugar report card.