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What is a normal HbA1c?

GLP Guidebook teamUpdated 5 Oct 202614 sourcesWritten from published sources
The short answer

The normal HbA1c range is below 5.7% (under 39 mmol/mol). The American Diabetes Association (2026) calls 5.7% to 6.4% (39–47 mmol/mol) prediabetes and 6.5% (48 mmol/mol) or higher diabetes. India's ICMR and RSSDI use the same % lines for adults of every age. Indian experts (RSSDI-ESI) add that HbA1c should not be the only test for diagnosing diabetes.

What do the HbA1c ranges mean?

Below 5.7% is normal, 5.7% to 6.4% is prediabetes, and 6.5% or more is in the diabetes range under the ADA's 2026 standards.1

ResultHbA1c (%)mmol/mol
NormalBelow 5.7Below 39
Prediabetes5.7 to 6.439 to 47
Diabetes6.5 or more48 or more
Common target with diabetesBelow 7Below 53

Source: ADA Standards of Care 2026, sections 2 and 6.1,2 The target row is for many nonpregnant adults with diabetes, not a rule for everyone.

HbA1c measures sugar stuck to haemoglobin, the protein in red blood cells.1 It reflects your average blood sugar over about 2 to 3 months.2 You don't need to fast before the test.1,8

Risk doesn't stop at a line. The ADA says risk "is continuous, extending below the lower limit" of the prediabetes range.1 One high result is not a diagnosis either. Unless sugar is clearly very high, the ADA asks for 2 abnormal results.1 Our longer post, What does your HbA1c number mean?, covers the test.

Is the normal HbA1c range different in India, or by age?

No. India's ICMR workflow and RSSDI's recommendations, both from 2022, use the ADA's lines for every adult, whatever their age.4,10

RSSDI and ESI (2020) call 6.5% the "optimal level" for diagnosing diabetes in Indians.5 But they say HbA1c "cannot be used as 'sole' measurement" in India.5 They suggest pairing it with a fasting sugar test.5

Some Indian lab websites print "normal by age" charts. Suburban Diagnostics calls 5.7% to 6.5% normal at 60 and over.12 Dr Lal PathLabs gives 6.5% as the maximum at 60 plus.13 None of the guidelines we read (ADA, ICMR, RSSDI, WHO) has age bands.1,4,6,10 So 5.7% to 6.4% is prediabetes at any adult age. Older people with diabetes may get a looser treatment target, which is a different thing.4

Some sites give a normal range of 4% to 5.5% (Dr Lal) or 4% to 5.6% (WebMD, US).13,14 The guidelines draw lines only at 5.7% and 6.5%.1,4 UK guidance (NICE) calls 42 to 47 mmol/mol (6.0% to 6.4%) high risk. That is why some UK pages use 42, not 39.11

What can make an HbA1c result wrong?

Anaemia, inherited haemoglobin differences such as thalassaemia, and pregnancy can all make an HbA1c result higher or lower than your true blood sugar.1,3,7

The ADA prefers blood sugar tests with some haemoglobin variants, HIV, or G6PD deficiency (an inherited enzyme condition).1 It says HbA1c may not suit people with anaemia or on dialysis.1 In pregnancy, red blood cells are replaced faster, so HbA1c falls.3

Anaemia is common in India. NFHS-5 (2019–21) found it in 57% of women and 25% of men aged 15 to 49.9 In a Delhi study, iron-deficiency anaemia pushed HbA1c up. The 62 people with anaemia averaged 5.5%, against an average of 4.9% in 60 healthy people.7 After 3 months of iron, 14 of 20 people in the prediabetes range moved back to normal.7

RSSDI-ESI says anaemia "must be excluded" before diagnosing on HbA1c.5 If HbA1c and sugar readings don't match, the ADA advises checking for interference.1

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What HbA1c target do people with diabetes aim for?

For many nonpregnant adults with diabetes, the ADA's target is below 7% (53 mmol/mol), but the target is set for each person.2

Below 6.5% may suit some healthy people at low risk of hypos (low sugar). Looser goals may suit people who are frail or very unwell.2 India's ICMR workflow uses 7.0% or lower, but accepts a higher target for older people and those with serious illness.4

Both the ADA and ICMR suggest testing about every 3 months while sugar is above goal.2,4 Where GLP‑1 medicines fit alongside other diabetes treatment is in our type 2 diabetes path.

Read the full picture

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Sources

  1. American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes 2026. Diabetes Care 2026;49(Suppl 1):S27-S49. Tables 2.1, 2.2; recommendations 2.3, 2.4. US guideline. doi:10.2337/dc26-S002 · full text (PMC)
  2. American Diabetes Association Professional Practice Committee. 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes 2026. Diabetes Care 2026;49(Suppl 1). Recommendations 6.2, 6.3a, 6.4, 6.5. doi:10.2337/dc26-S006 · full text (PMC)
  3. American Diabetes Association Professional Practice Committee. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes 2026. Diabetes Care 2026;49(Suppl 1). doi:10.2337/dc26-S015 · full text (PMC)
  4. ICMR and Department of Health Research, Ministry of Health and Family Welfare. Standard Treatment Workflow: Diabetes Mellitus Type 2 (ICD-10-E11), July 2022. icmr.gov.in (PDF)
  5. Chawla R, Madhu SV, Makkar BM, et al. RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020. Indian J Endocrinol Metab 2020;24(1):1-122. Indian guideline. doi:10.4103/ijem.IJEM_225_20 · full text (PMC)
  6. World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. Abbreviated report of a WHO consultation, 2011 (WHO/NMH/CHP/CPM/11.1). iris.who.int (PDF)
  7. Madhu SV, Raj A, Gupta S, Giri S, Rusia U. Effect of iron deficiency anemia and iron supplementation on HbA1c levels: implications for diagnosis of prediabetes and diabetes mellitus in Asian Indians. Clin Chim Acta 2017;468:225-229. doi:10.1016/j.cca.2016.10.003 · PMID 27717800
  8. National Institute of Diabetes and Digestive and Kidney Diseases (US). The A1C Test & Diabetes (page last reviewed April 2018). US source. niddk.nih.gov
  9. Ministry of Health and Family Welfare and IIPS. National Family Health Survey (NFHS-5), 2019-21: India fact sheet, rows 95 and 97. dhsprogram.com (PDF)
  10. Research Society for the Study of Diabetes in India. RSSDI Clinical Practice Recommendations 2022, summary document: Diagnosis and classification (slides 8-9). rssdi.in (PDF)
  11. National Institute for Health and Care Excellence. Type 2 diabetes: prevention in people at high risk (PH38), recommendations 1.5.3-1.5.4. UK guidance. nice.org.uk
  12. Suburban Diagnostics. HbA1c Normal Range: Levels, Age Chart and Diabetes Risk (blog, India; a lab that sells the test; cites no sources). suburbandiagnostics.com, checked 5 Oct 2026.
  13. Dr Lal PathLabs. What Is Normal HbA1c? (blog, India; a lab that sells the test; cites no sources; updated 21 Mar 2024). lalpathlabs.com, checked 5 Oct 2026.
  14. WebMD. Hemoglobin A1c (HbA1c) Test for Diabetes. US consumer site. webmd.com

Last checked 5 Oct 2026 · Next review due 5 Oct 2027 · Report an error

How this answer was made. Written by the GLP Guidebook team from the sources above. It's general information, not medical advice. Talk to a qualified doctor about your own HbA1c result and before starting, stopping or changing any medicine. How we write