Older Black male veterans with type 2 diabetes have similar blood sugar levels no matter which common diabetes medicine they take—like metformin, insulin, or newer drugs like Ozempic or Farxiga.

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 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.

Some people with diabetes might seem to have good blood sugar control based on standard tests, but if their red blood cells don’t live as long, the test could be misleading — and nearly 1 in 3 of these patients might actually have worse blood sugar levels than the test shows.

Doctors usually rely on the HbA1c blood test to see how well someone with diabetes has managed their blood sugar over time — but some experts are starting to question if it’s always accurate for everyone.

If someone with type 2 diabetes has good HbA1c numbers but their red blood cells don’t live as long, their blood sugar might actually be higher than the test shows — meaning the test could be giving them a too-rosy picture of their sugar control.