Some people with chronic inflammation and certain blood and pancreas conditions might have normal blood sugar readings on standard A1c tests, even though their actual blood sugar is high — because...

If someone with type 2 diabetes has red blood cells that don't live as long as usual, their A1c test might show better blood sugar control than they actually have — meaning doctors could miss signs of high blood sugar over time.

If someone with type 2 diabetes has red blood cells that don’t live as long, their A1c test might be giving a lower number than their real blood sugar levels — meaning the test could be misleading for them.

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.

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.

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.