An Overview of Estimated Average Glucose (eAG)

Person having a blood test
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Estimated average glucose (eAG) or "average glucose" is a newer term you may see reported by your doctor. The American Diabetes Association (ADA) introduced this term to help you translate your A1c tests into numbers that would more closely represent your daily glucose meter readings.

Making Sense of Estimated Average Glucose

To understand eAG, you'll need to begin with the A1c test (also known as glycated hemoglobin or HbA1c). The A1c test measures the percentage of hemoglobin (a protein in your red blood cells) that has glucose attached to it; also known as glycated hemoglobin. Your A1c tells you what your average blood glucose level has been for the past two to three months.

The problem is that the A1c test reports a percentage of total hemoglobin that is glycated hemoglobin. In other words, an A1c of 7 percent means that 7 percent of the total hemoglobin has glucose attached to it. But your glucose meter measures glucose directly in the blood in milligrams per deciliter (for example, 154 mg/dl). The two types of numbers are confusing and few people would be able to easily translate one into the other.

Researchers discovered an accurate way to calculate estimated average glucose levels from the A1c results. This way you can use the same numbers you are accustomed to seeing on your daily glucose meter readings.

Your eAG is basically a snapshot of your average blood glucose levels taken over 2 to 3 months, converted into a unit you're used to seeing on your glucometer (mg/dl).

Why It's Useful

Here's how knowing your eAG can help with diabetes management:

  • Can confirm self-monitoring tests or practitioner-ordered blood tests
  • Gives you an overall look at how a treatment plan is working
  • Illuminates how healthy lifestyle choices can have an impact on blood sugar control

Quick Reference Chart for Hemoglobin A1c to eAG

The exact formula for converting hemoglobin A1c to eAG is as follows: 28.7 X A1C – 46.7 = eAG.

Below is a quick reference guide that will help you calculate your estimated average blood glucose level from your A1c result.

A1c (percentage) eAG (mg/dl)
6.0% 126 mg/dl
6.5% 140 mg/dl
7.0% 154 mg/dl
7.5% 169 mg/dl
8.0% 183 mg/dl
8.5% 197 mg/dl
9.0% 212 mg/dl
9.5% 226 mg/dl
10.0% 240 mg/dl

How to Interpret the Results

While A1c and eAG levels will differ depending on several factors, including your age, sex, activity level, etc., the American Diabetes Association recommends a target eAG of 154 mg/dl (A1c = 7%) for most adults with diabetes who are not pregnant. Be sure to work with your doctor to find the unique eAG/A1c target that's right for you.

A1c/eAG Versus Daily Monitoring

While the A1c test and your eAG level are both important for measuring your long-term blood glucose management, they can’t replace daily blood glucose tests. An A1c test or eAG won’t give your current blood sugar level. You need that important information daily or multiple times per day in order to appropriately adjust your insulin, food intake, and activity level. The A1c is a long-term management tool that should be used in addition to, and not as a substitute for, your daily blood sugar testing.

The American Diabetes Association recommends that you get an A1c test at least twice a year and preferably four times a year (quarterly).

Average Glucose Reading on Meters and eAG

Most blood glucose meters used for daily testing can quickly give you an average of all the readings over the past several weeks or months. But this average is not the same as the eAG. Even if you test your blood 10 times a day or more, you are only getting a reading of what your glucose is at that moment.

In fact, this average from your glucose meter is likely to be lower than your eAG. This is because the eAG represents an average of your glucose levels 24 hours a day and over a much longer period of time. Therefore, eAG is more accurate.

By combining your eAG number with your glucose meter’s average number you are getting a valuable and comprehensive picture of your overall diabetes management. This will help you in making healthy goals and choices to achieve appropriate glucose control.

A Word From Verywell

Testing your blood sugar levels via any method can trigger strong feelings. Be gentle with yourself and remind yourself that you are not a number. Make sure you have a supportive care team to help you reach your treatment plan goals, adjusting as needed without judgment.

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