The short answer
HbA1c measures how much sugar has stuck to your red blood cells, which shows your average blood sugar over roughly the last two to three months. Below 42 mmol/mol (6.0%) is normal; 42 to 47 (6.0 to 6.4%) means high risk of type 2 diabetes; 48 (6.5%) or above is the level the WHO uses to diagnose diabetes, usually confirmed with a second test. On treatment, NICE suggests a target of 48 (6.5%) for many people, or 53 (7.0%) on a medicine that can cause low sugar. In Lagos, the home diabetes and blood pressure panel, which includes HbA1c, is ₦95,000.
Diabetes care with your own GPMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Reading your result
Results come in mmol/mol, in %, or both. As a guide:
- Below 42 mmol/mol (below 6.0%): normal
- 42 to 47 mmol/mol (6.0 to 6.4%): high risk of type 2 diabetes, which NICE says calls for help with weight, food and activity
- 48 mmol/mol (6.5%) or above: diabetes, by the WHO's criterion, confirmed by a repeat test unless you have symptoms and a high blood sugar
- A result below 48 does not rule out diabetes found on other sugar tests
Your target on treatment
NICE suggests 48 mmol/mol (6.5%) for adults with type 2 diabetes managed by diet or by medicines that do not cause low sugar, and 53 mmol/mol (7.0%) on a medicine that can. Above 58 (7.5%), your treatment should be reviewed. Targets are relaxed for some older or frail people. Agree yours with your doctor.
When HbA1c can mislead: genotype and blood conditions
HbA1c depends on normal red blood cells. NICE advises that it should not be used when a haemoglobin variant or haemolysis is present, and that other measures, such as fasting glucose or fructosamine, are used instead. In Nigeria this matters: tell your doctor and the laboratory your genotype, and mention anaemia, a recent blood transfusion or heavy bleeding, or kidney disease. A result that does not match your sugar readings should be looked into, not ignored.
How often to have it
With type 2 diabetes, NICE advises an HbA1c every 3 to 6 months until it is stable on unchanging treatment, then every 6 months. You do not need to fast for HbA1c on its own; if the same visit includes a fasting sugar or cholesterol test, follow the laboratory's instructions.
Getting it done
In Lagos, the home diabetes and blood pressure panel collects the sample at home and adds a fasting sugar, cholesterol, kidney function and a urine test, for ₦95,000. Elsewhere, a doctor on Mezo can order HbA1c at a partner laboratory, priced before you pay.
Go to a hospital now
A test result can wait for a doctor. These cannot. Go to an emergency department for:
- Vomiting, deep or fast breathing, drowsiness or confusion with high sugar
- A low sugar that does not improve after taking sugar
Common questions
What is a normal HbA1c level?
Below 42 mmol/mol, or below 6.0%.
Is an HbA1c of 6.5% diabetes?
By the WHO criterion, 6.5% (48 mmol/mol) or higher is diabetes, usually confirmed by a second test. A doctor should go through it with you.
Do I need to fast for an HbA1c test?
Not for HbA1c on its own. Fasting is needed if the same sample is also used for a fasting sugar or cholesterol test.
Can a doctor explain my HbA1c result by video?
Yes. A GP on Mezo can go through the result, your other tests and your treatment by video, and order a repeat or another test where needed.
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A result means most with a doctor who follows it
With a named GP on Mezo, your HbA1c is repeated on the NICE schedule, read against your target, and acted on: treatment adjusted, tests ordered, a specialist brought in when needed.
See diabetes careSources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. World Health Organization, 2011. Clinical guideline.
- Type 2 diabetes: prevention in people at high risk (PH38). National Institute for Health and Care Excellence (NICE). Clinical guideline.
- Type 2 diabetes in adults: management (NG28), blood glucose management. National Institute for Health and Care Excellence (NICE). Clinical guideline.
Links last checked 29 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.