Red blood cells have an average lifespan of a few months, and the glycation of hemoglobin is irreversible, and that process occurs more at higher blood glucose levels.
As such, it has been found that the proportion of red blood cells that have already been glycated is a fairly decent indication of average glucose levels over a few months.
It’s important to understand that a1c tests don’t measure instantaneous glucose levels, they’re measuring the fraction of blood cells that have undergone physical changes in the presence of glucose.
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