The HbA1c cut-offs in % and mmol/mol from the ADA's Standards of Care 2026 and the NIDDK, side by side, with what changes how the number reads, the target if you already have diabetes, Egypt's screening initiative, and the questions to ask your doctor.
An HbA1c below 5.7% is called normal by the NIDDK (last reviewed April 2018), and for people who are not pregnant the American Diabetes Association’s (ADA) Standards of Care in Diabetes—2026 (published 8 December 2025) list 5.7% to 6.4% (39 to 47 mmol/mol) as prediabetes and 6.5% (48 mmol/mol) or higher among the criteria for diabetes. The range printed on your report, and your doctor, govern.
The NIDDK is the US National Institute of Diabetes and Digestive and Kidney Diseases. This page sets those tables out in plain words and lists what to ask. It does not read your result, tell you it is normal, or diagnose anything. HbA1c reflects your average blood sugar over the past two to three months (MedlinePlus, updated 20 May 2025).
In short:
- ADA 2026: 6.5% (48 mmol/mol) or higher is among the diabetes criteria; 5.7% to 6.4% (39 to 47 mmol/mol) is prediabetes. “Normal” for below 5.7% comes from the NIDDK (April 2018) and MedlinePlus (May 2025), not the ADA’s tables.
- % and mmol/mol are two ways of writing the same test: check the unit beside your number.
- One number is not a diagnosis: the NIDDK says that without symptoms, a result in the diabetes or prediabetes range should be repeated on a different day, and some blood conditions change how HbA1c reads.
- HbA1c needs no fast (NIDDK, April 2018; ADA 2026).
Last checked: 23 October 2026, on the pages listed under Sources. Guidelines and pages change, so confirm with your doctor.
What is the normal range for HbA1c?
| Band | HbA1c in % | HbA1c in mmol/mol | Where this comes from |
|---|---|---|---|
| Normal (below the prediabetes range) | Below 5.7% | Below 39 (derived, see note) | NIDDK (April 2018); MedlinePlus (20 May 2025) |
| Prediabetes | 5.7% to 6.4% | 39 to 47 | ADA Standards of Care 2026, Table 2.2 |
| Diabetes (one of the criteria) | 6.5% or higher | 48 or higher | ADA Standards of Care 2026, Table 2.1 |
ADA tables: criteria for nonpregnant individuals, Diabetes Care 2025;49(Suppl 1), read 23 October 2026. Neither the NIDDK page nor MedlinePlus prints mmol/mol, so “below 39” is derived: it is where the ADA’s prediabetes row starts, not a published “normal” figure. The range printed on your report, and your doctor, govern.
The ADA’s tables define prediabetes and diabetes, not “normal”. The ADA (Standards 2026) says the test should be done with a method certified by the National Glycohemoglobin Standardization Program (NGSP). The NIDDK (April 2018) says that if you have no symptoms but the result is in the diabetes or prediabetes range, you should have a repeat test on a different day to confirm it. The diagnosis is your doctor’s.
Is an HbA1c of 5.5% normal?
In those tables, 5.5% is below 5.7%: inside the band the NIDDK labels normal, and under the point where the ADA’s prediabetes row begins. That says where a number falls in two published tables, not whether your own result is normal. MedlinePlus (updated 20 May 2025) calls its ranges “just a guide” and says what is normal for you depends on your health, age and other factors. Your report’s printed range and your doctor decide, together with anything about your blood that changes how the test reads (see below).
% or mmol/mol: which unit is on my report?
The ADA prints both units side by side, so 6.5% and 48 mmol/mol are the same line. The NIDDK page and MedlinePlus give percentages only. Reading a mmol/mol number against a percentage table, or the reverse, would put it in the wrong band, so check the unit beside your number. This page cannot say which unit your lab uses, and the Egyptian official page we read does not say.
Does HbA1c need fasting?
No. The NIDDK says you do not have to fast before the blood is drawn (last reviewed April 2018), and the ADA’s table calls it a nonfasting test (Standards 2026). Other sugar tests can need a fast (NIDDK, April 2018): which blood tests need fasting sets them side by side.
When might the HbA1c number not mean what it usually does?
Some conditions change how HbA1c relates to blood sugar. The ADA (Standards 2026) says that where it is altered, including some haemoglobin variants, pregnancy and conditions that change red blood cell turnover, plasma glucose criteria should be used to diagnose diabetes, and that HbA1c may not suit people with anaemia or on haemodialysis or erythropoietin. The NIDDK (April 2018) adds iron-deficiency anaemia, sickle cell disease, thalassaemia, recent blood loss, transfusion, kidney failure and liver disease. Whether any of them changes your result is a question for your doctor.
If I already have diabetes, is my target the same table?
No. The ADA (Standards 2026, section 6) says an HbA1c goal below 7% (below 53 mmol/mol) is appropriate for many nonpregnant adults without severe hypoglycaemia or hypoglycaemia affecting health or quality of life, and that goals should sit inside an individualised, person-centred plan. MedlinePlus (updated 20 May 2025) says to ask your provider what A1C percentage is healthy for you. Your target is your doctor’s to set, and this page does not cover how to lower HbA1c.
What should I ask my doctor about my HbA1c?
- Is my result in % or mmol/mol, and what range does this lab print?
- Does this result need to be repeated, and when?
- Is anything about my blood, such as anaemia, a haemoglobin variant, sickle cell disease or thalassaemia, a recent transfusion or blood loss, or kidney or liver disease, a reason to read it differently or to use another test?
- Does the lab use an NGSP-certified method?
- Do I need other sugar tests with it, such as a fasting blood sugar?
- If I have diabetes: what is my own target, and when is the next test due?
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In Egypt: where is HbA1c measured, and which range applies?
According to a Ministry of Health and Population statement of 7 May 2026, carried on the State Information Service page (updated 9 May 2026), Egypt’s presidential initiative for early detection of chronic disease includes random and cumulative sugar tests («فحص السكر العشوائي والتراكمي»); «السكر التراكمي» is how Egyptians say HbA1c. The statement says the initiative runs through 3,601 primary care units in every governorate and targets citizens over 40, plus people from 18 with a medical history or risk factors linked to chronic disease. It describes the services as free, and the page gives the initiative’s inquiry hotline, 15335, which is not an emergency number (read 23 October 2026).
We searched on 23 October 2026 for an Egyptian Ministry page printing HbA1c ranges and found none, which does not prove none exists. The SIS page says the initiative follows guidelines from a joint committee of the Ministry and the World Health Organization but prints no HbA1c figures, so this page uses the ADA’s tables. Ask the unit or lab you use which range it applies.
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Frequently asked questions
What is the normal range for HbA1c?
The NIDDK (April 2018) calls a result below 5.7% normal. The ADA (Standards 2026) puts 5.7% to 6.4% (39 to 47 mmol/mol) in the prediabetes range and lists 6.5% (48 mmol/mol) or higher among the diabetes criteria. The range printed on your report, and your doctor, govern.
Is an HbA1c of 5.5% normal?
It is below 5.7%, which is the band the NIDDK labels normal, and under the point where the ADA’s prediabetes row begins. Whether it is right for you is for your doctor to say, with the range printed on your report.
Does HbA1c need fasting?
No, says the NIDDK (April 2018); the ADA calls it a nonfasting test (Standards 2026).
What is the difference between % and mmol/mol?
They are two units for the same test. The ADA’s tables print both: 6.5% is 48 mmol/mol. Check the unit beside your number.
Medigize is a non-diagnostic navigation tool. This is general information, not medical advice. In an emergency, call an ambulance or go to the nearest emergency department.
Sources
- American Diabetes Association Professional Practice Committee: 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026, Diabetes Care 2025;49(Suppl 1):S27–S49 (doi 10.2337/dc26-S002), published 8 December 2025, read 23 October 2026
- American Diabetes Association Professional Practice Committee: 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes—2026, Diabetes Care 2025;49(Suppl 1):S132–S149 (doi 10.2337/dc26-S006), published 8 December 2025, read 23 October 2026
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): The A1C Test & Diabetes, last reviewed April 2018, read 23 October 2026
- MedlinePlus (US National Library of Medicine): Hemoglobin A1C (HbA1c) Test, updated 20 May 2025, read 23 October 2026
- Egypt’s State Information Service (SIS): early detection of kidney disease and chronic-disease screening initiative, carrying a Ministry of Health and Population statement of 7 May 2026, page updated 9 May 2026, read 23 October 2026
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