16 February 2026 (Navroze Bureau) : Doctors warn that widespread misunderstandings about the HbA1c test are pushing many Indians toward delayed diagnosis, poor control, and unnecessary anxiety. Here are four common myths—and the medical facts that debunk them.
Myth 1: HbA1c shows today’s blood sugar
Fact: HbA1c reflects average blood glucose over the past 2–3 months, not a single day.
Why it matters: People panic after one “high” reading or feel falsely reassured after a “good day.” HbA1c smooths daily ups and downs to show long-term control.
Myth 2: Fasting isn’t needed, so HbA1c alone is enough
Fact: While fasting isn’t required, HbA1c doesn’t replace all tests.
Why it matters: Fasting plasma glucose and post-meal readings reveal daily patterns and hypoglycaemia risks that HbA1c can miss—especially when medications are adjusted.
Myth 3: HbA1c is always accurate for everyone
Fact: Several conditions can distort HbA1c results, including anaemia, haemoglobin variants, chronic kidney disease, pregnancy, recent blood loss or transfusions.
Why it matters: India has a high prevalence of anaemia; relying blindly on HbA1c can misclassify control. Doctors may use alternative markers (like fructosamine) when needed.
Myth 4: One ‘normal’ HbA1c means diabetes is ruled out
Fact: Early diabetes or rapid glucose swings can still exist with a near-normal HbA1c.
Why it matters: Symptoms, family history, waist size, and other tests matter. A single value should never override clinical judgment.
What Doctors Recommend Instead
- Use HbA1c as a trend, not a standalone verdict.
- Combine tests: HbA1c + fasting and post-meal glucose.
- Individualise targets: Elderly patients, children, and those with comorbidities need personalised goals.
- Recheck regularly: Typically every 3 months when therapy changes, 6 months when stable.
The Bottom Line
HbA1c is a powerful tool—but misreading it can derail diabetes care. Understanding its limits helps patients and clinicians make smarter, safer decisions.
Summary
Doctors debunk four major HbA1c myths—about accuracy, fasting, daily sugar reflection, and diagnosis—warning that misunderstanding the test can delay detection and worsen diabetes control in Indians.