Hemoglobin A1c (HbA1c) with 24-hour urine collection for albumin excretion rate (UACR)

The HbA1c test is one of the most important tools for understanding your blood sugar health over time. Unlike a daily glucose check, it reflects your average levels over the past two to three months, helping your doctor detect prediabetes or diabetes early and monitor how well your current treatment plan is working.

HbA1c reflects average blood sugar levels over the past 2–3 months, while the urine albumin test checks for early kidney damage. Together, they provide a clearer picture of diabetes-related risks beyond just current blood sugar numbers.

The HbA1c test measures the percentage of hemoglobin in your red blood cells that has sugar attached to it. Because red blood cells live for about three months, this measurement reflects your average blood sugar over that period. A small blood sample is drawn from a vein in your arm or collected through a finger stick and analyzed in a laboratory.

Your blood is drawn to measure HbA1c, and a 24-hour urine sample is collected to measure albumin excretion. Both tests are analyzed separately but are interpreted together for a fuller picture.

Unlike many other blood tests, the HbA1c test usually does not require fasting, so you can eat and drink normally before your appointment. Keep taking your regular medications unless your doctor gives you different instructions. Be sure to mention any conditions, such as anemia or a recent blood transfusion, since these can affect the accuracy of your results.

No special preparation is needed for the blood test, but for the urine test, collect all urine for 24 hours in a clean container. Drink plenty of water to help urine flow, but avoid excessive caffeine or diuretics.

Your results are reported as a percentage. A lower percentage indicates better blood sugar control over the past few months, while a higher percentage suggests your average glucose has been elevated. Your doctor will interpret your number alongside your age, medical history, and treatment goals to determine whether any adjustments to your care plan are needed.

HbA1c results are typically reported as a percentage (e.g., 6.5% means average blood sugar was higher than normal over time). Urine albumin results are often reported as a ratio (e.g., mg/g) or compared to a reference range. Higher albumin in urine may signal kidney strain.