Medically reviewed by Dr. Hafiz Muhammad Haseeb, M.B.B.S., F.C.P.S. (Haematology), Consultant Haematologist, Al-Nasar Lab & Diagnostic Centre. Updated August 2026.
Quick answer: HbA1c is a blood test that shows your average blood sugar over the past two to three months. A result below 5.7 percent is normal, 5.7 to 6.4 percent indicates prediabetes, and 6.5 percent or above indicates diabetes. No fasting is required, and you can take the test at any time of day.
Book an HbA1c test: call 0300 0341944, or arrange home sample collection anywhere in Lahore on 0309 1166944.
What is the HbA1c test?
HbA1c stands for glycated haemoglobin. When sugar circulates in your blood, some of it attaches to the haemoglobin inside your red blood cells. The more sugar there has been, the more haemoglobin becomes coated. Because red blood cells live for around 120 days, measuring how much of your haemoglobin is coated gives an average of your blood sugar over roughly the previous three months.
This is what makes the test so useful. A fasting glucose test is a photograph of a single moment, and that moment can be affected by what you ate yesterday, how you slept, or whether you are unwell. HbA1c is closer to a summary of the whole season.
What is a normal HbA1c level?
| HbA1c result | What it means | What usually happens next |
|---|---|---|
| Below 5.7% | Normal | Routine screening, especially if you have risk factors |
| 5.7% to 6.4% | Prediabetes | Diet and lifestyle changes, repeat testing, sometimes medication |
| 6.5% and above | Diabetes | Confirmation and a treatment plan with your doctor |
For people already diagnosed with diabetes, the goal is different. Most adults are advised to keep HbA1c below 7 percent, though your doctor may set a higher or lower target depending on your age, how long you have had diabetes, and other health conditions. Always read the reference range printed on your own report.
Why does HbA1c matter so much in Pakistan?
Pakistan has one of the highest rates of diabetes in the world, and a very large share of cases go undiagnosed for years. The condition is often silent in its early stages, quietly damaging blood vessels, kidneys, eyes and nerves before any symptom appears.
Because HbA1c needs no fasting and can be taken at any time, it removes the single biggest practical barrier to getting tested. For many people it is the difference between finding the problem at the prediabetes stage, when it can often be reversed, and finding it years later after complications have started.
Do you need to fast for an HbA1c test?
No. This is one of the main advantages of the test. You can eat and drink normally, and attend at whatever time suits you. Fasting is only necessary if your doctor has combined HbA1c with other tests such as a lipid profile or fasting glucose, so check your full prescription.
When can an HbA1c result be misleading?
This is important and often overlooked. Because the test measures haemoglobin, anything that changes your red blood cells can distort the result. Tell your doctor and the laboratory if any of the following apply to you:
- Anaemia, particularly iron deficiency anaemia, which is very common
- Thalassaemia or other haemoglobin disorders, which are notably common in Pakistan
- A recent blood transfusion or significant blood loss
- Chronic kidney disease or liver disease
- Pregnancy, where different tests are generally preferred for diagnosing gestational diabetes
In these situations HbA1c may read falsely high or falsely low, and your doctor may rely on fasting glucose, a glucose tolerance test, or home monitoring instead. If you know you carry a thalassaemia trait, mention it before testing.
How often should you have an HbA1c test?
- If you have diabetes and your sugar is well controlled: usually every six months
- If your sugar is not yet controlled or your treatment has changed: usually every three months, since that matches how long the test looks back
- If you have prediabetes: generally once a year, or as your doctor advises
- If you have risk factors but no diagnosis: a family history of diabetes, excess weight, high blood pressure or a history of gestational diabetes all justify regular screening
HbA1c testing at Al-Nasar Lab
Al-Nasar Lab & Diagnostic Centre has provided laboratory testing in Lahore since 1996 and holds ISO 15189:2022 accreditation from the Pakistan National Accreditation Council. HbA1c is available at our main Johar Town campus and at every collection centre across the city, with home sample collection and same day digital reports.
Because HbA1c requires no fasting, home collection is particularly convenient. Find your nearest collection centre, browse our full list of laboratory tests, or contact us to book.
Frequently Asked Questions
What is a normal HbA1c level?
Below 5.7 percent is considered normal. Between 5.7 and 6.4 percent indicates prediabetes, and 6.5 percent or higher indicates diabetes.
Can HbA1c be lowered?
Yes. Because the test reflects the previous two to three months, sustained changes to diet, physical activity, weight and medication will show up in your next result. Expect to see the effect at your following test rather than immediately.
Is HbA1c better than a fasting sugar test?
They answer different questions. HbA1c shows a long term average and needs no fasting, which makes it excellent for diagnosis and monitoring. Fasting glucose captures a single moment and is still useful, especially where HbA1c may be unreliable.
Can I have a normal HbA1c and still have diabetes?
It is possible in certain conditions, particularly some forms of anaemia or haemoglobin disorders, which is why your doctor interprets the result alongside your symptoms and other tests rather than in isolation.
Does HbA1c need a fasting sample?
No. You can eat and drink normally before the test.
This article is for general information and is not a substitute for medical advice. Please discuss your results with a qualified doctor.
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