3 min readNew DelhiSep 1, 2026 09:30 AM IST
Can someone have blood glucose readings of 160–220 mg/dL and still have an HbA1c below 6 per cent? That’s the Quora query we took to Dr Pranav Ghody, consultant endocrinologist and diabetologist at Wockhardt Hospitals, Mumbai Central, who clarified that when the two results don’t match, we shouldn’t automatically assume the glucometer is wrong or that the HbA1c is reassuring. “HbA1c reflects average glucose over roughly the previous two to three months, while a glucose reading is a snapshot. However, a persistent glucose range of 160–220 mg/dL is significant and deserves evaluation, especially if these readings are being seen repeatedly,” said Dr Ghody.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
Could the HbA1c itself be falsely low?
Yes, stressed Dr Ghody, adding that HbA1c depends not only on glucose but also on the lifespan of red blood cells. “If red cells are being replaced or destroyed faster than usual, they have less time to accumulate glucose, which can make the HbA1c appear lower than the person’s actual average glucose. Certain haemoglobin variants can also interfere with some HbA1c testing methods.”
What conditions do doctors look for when there is such a mismatch?
Dr Ghody noted that one would consider factors such as anaemia, recent blood loss or transfusion, conditions causing increased red-cell turnover, kidney disease and haemoglobin variants. “In India, haemoglobin variants such as HbE and other haemoglobinopathies are relevant considerations. The laboratory method used for HbA1c also matters because interference can vary between testing methods.”
Why is blood glucose high? (Photo: Quora)
What should a person do if their readings and HbA1c don’t agree?
The glucose readings should be verified using a reliable glucometer or, where appropriate, a continuous glucose monitor. “The doctor may also repeat the HbA1c using a suitable laboratory method and check blood counts and other relevant tests. If HbA1c remains unreliable, tests such as fructosamine or glycated albumin can sometimes provide an alternative assessment of shorter-term glucose control,” elaborated Dr Ghody.
Can someone with a low HbA1c safely ignore glucose readings of 160–220 mg/dL?
No, affirmed Dr Ghody. “A low HbA1c should not be used to dismiss consistently elevated glucose readings. The important thing is to understand why the numbers disagree. Persistent hyperglycaemia can have consequences even when the HbA1c appears normal, so the discrepancy should be investigated rather than simply reassuring the patient.”
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DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
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