I have had my A1c checked twice, and the last level was 6.4%, but my fasting blood sugar was 123 mg/dl [6.8 mmol/L], and I am not showing any signs and symptoms of diabetes. What causes my A1c to increase? How do I treat this condition?

I think I understand the question to be, “Why is your hemoglobin A1c minimally elevated when you do not have any symptoms of diabetes.” It is important to understand that the diagnosis of diabetes is not made with the hemoglobin A1c test. It is made with the fasting glucose level from the laboratory. You need two separate fasting blood sugars greater than 126 mg/dl [7 mmol/L] to make the diagnosis. It is common to have early-onset diabetes or even prediabetes without having symptoms. This does not mean it is okay to ignore it. Rather, this is the time to address lifestyle changes to avoid diabetes or symptomatic diabetes requiring treatment with medications.

JTL

[Editor’s comment: See the Diabetes Prevention Program (DPP), at the Diabetes Monitor.

SS]