At a Glance
This is not a blood sugar measurement. It is your HbA1c put through a fixed equation and reported in the units a glucose meter uses. No separate sample is drawn, no glucose is measured, and nothing is tested that the A1c did not already test.
The conversion comes from the ADAG study, which compared A1c against continuous and fingerstick glucose monitoring in 507 people and published the formula laboratories have used ever since:
eAG (mg/dL) = 28.7 × A1c − 46.7 · eAG (mmol/L) = 1.59 × A1c − 2.59
So your eAG and your A1c are one result wearing two outfits. If you have both on a report, they cannot disagree, and neither one is a second opinion on the other.
How to read your result
The range stored on this record is 68 - 114 mg/dL (3.77 – 6.33 mmol/L). Put those two numbers back through the ADAG equation and they correspond to an A1c of 4.0% and 5.6% — the usual non-diabetic span.
That correspondence is worth knowing, because it tells you what being flagged actually means here:
| Your eAG | The A1c behind it | Where that sits |
|---|---|---|
| below 68 mg/dL | below ~4.0% | below the usual range — see the low-result section |
| 68 – 114 mg/dL | 4.0 – 5.6% | within the usual non-diabetic range |
| 117 – 137 mg/dL | 5.7 – 6.4% | the band ADA defines as prediabetes |
| 140 mg/dL and above | 6.5% and above | at or above ADA's diabetes diagnostic threshold |
A high flag on this record therefore begins at roughly the prediabetes threshold, not at some arbitrary line. That is useful. What it is not is a diagnosis. Diagnosis rests on clinical assessment and on confirmatory testing, and an A1c and the eAG calculated from it are one result, not two — they cannot confirm each other. A single flagged line on a dashboard is not a diagnosis.
One exception runs the other way. If you have symptoms of high blood sugar — heavy thirst, passing a lot of urine, blurred vision, unexplained weight loss — that is a reason to be seen promptly rather than to wait for a repeat test.
Read the figure against your own report's reference range, which may differ from the one stored here, and against the A1c printed beside it.
What the number is good for
A1c, and therefore eAG, reflects glucose exposure over roughly the preceding two to three months. Its value is that it is hard to game: a single fasting glucose tells you about one morning, while this tells you about a season.
For some people the glucose units are simply easier to think in. An A1c of 7.0% is abstract; 154 mg/dL is a number you can compare with what your meter shows. That translation is the entire reason eAG exists — the ADAG authors compared it to reporting creatinine as an estimated GFR.
The estimate has a width, and it is about the wrong quantity to read precisely
The equation describes a population, not you. In the ADAG study it explained most but not all of the variation — R² = 0.84 — and the paper is specific about the spread: "The correlation has an SD of prediction error of 15.7 mg/dl (0.87 mmol/l)", with about 90% of samples falling within 15% of the calculated figure.
What that spread is about matters. It describes how far your measured average glucose can sit from the figure the equation predicts. It is not a statement about how precisely your A1c was measured, and it does not blur the line between one A1c result and another: an A1c of 5.6% and an A1c of 5.8% are genuinely different measurements.
So: your real average glucose can differ from this estimate, sometimes substantially. A borderline result is interpreted through the A1c it came from and the follow-up your clinician judges appropriate, not by reading the estimate to more precision than it has.
When A1c — and therefore eAG — may be misleading
Because eAG is A1c rescaled, anything that makes an A1c wrong makes the eAG exactly as wrong, and there is no extra information in the eAG to reveal it. Whether any of the following actually affects a given result depends on the condition, on the assay the laboratory used, and on the clinical picture — these are reasons to interpret carefully, not automatic invalidations.
ADA states that "Factors that affect hemoglobin or red blood cells may affect A1C", and lists conditions that "can interfere with the accuracy of A1C": anemias, G6PD deficiency, recent blood transfusion, drugs that stimulate red cell production, end-stage kidney disease and pregnancy. On hemoglobin variants it is blunter — "A1C cannot be measured in individuals with sickle cell disease (HbSS) or other homozygous hemoglobin variants." Where A1c is unreliable, ADA says "alternative approaches to monitoring glycemic status should be used."
The ADAG study itself never included these people: subjects with erythrocyte disorders and with chronic renal or liver disease "were excluded from the study", and on children and pregnant women the authors wrote that "additional data in these groups are needed to confirm the established relationship." Their own summary is that "the current results are only directly applicable to this population."
If you wear a continuous glucose monitor
Your sensor reports an average too, and it often will not match your eAG. Some difference is expected.
They are different estimates built from different data. ADA says of the A1c-to-eAG conversion table that "It is unclear how generalizable these estimates are to mean glucose measurements obtained using modern CGM systems", and describes the glucose management indicator your sensor app reports as a "Calculated value approximating A1C (not always equivalent)."
They are also two different quantities: a sensor's mean glucose is an average of measured readings, while the glucose management indicator an app reports is a calculated stand-in for A1c. Comparing the wrong pair accounts for some apparent mismatches on its own.
A small difference is unremarkable. A large or persistent one is worth raising, because it can reflect the periods being compared, glucose that has been changing, limits of either measurement, or a stable non-glycemic factor affecting the A1c. That last possibility matters: an analysis of A1c against continuous monitoring warns that failing to recognize such a factor "may lead to chronic under- or overtreatment" where A1c guides management.
If you remember only one thing
eAG and A1c are the same result in different units, so this number adds no new measurement — but the units make it readable, and the stored range here corresponds to an A1c of 4.0 to 5.6%.
Two people, same result
Two people are both reported at 154 mg/dL, from an A1c of 7.0%.
The first has type 2 diabetes, takes metformin, and checks her glucose occasionally. For her the figure is a reasonable summary of a quarter, and the conversation with her clinician is about whether 7.0% is the right target for her — ADA is explicit that targets are individualized, and that less stringent goals suit some people.
The second has the same number on a panel run after a hospital admission for gastrointestinal bleeding, and he was transfused. Blood loss and transfusion both disturb the red cells A1c is measured on, so his 7.0% — and the 154 computed from it — may not describe his last three months at all. ADA lists recent transfusion among the factors that interfere with A1c accuracy.
Same figure, and for one of them it does not mean what it says. Nothing in the number marks the difference.
What this result cannot tell you
Whether you have had low blood sugar. ADA states it directly: "A1C does not provide a measure of glycemic variability or hypoglycemia." An average cannot show the swings underneath it.
What your glucose is doing today. The window is months. A change made last week is barely in it.
Whether your readings are steady or swinging. Two people with identical eAG can have very different days. This is why the page below talks about variability and why a meter or sensor answers a question this cannot.
Whether you have diabetes, on its own. Diagnosis needs confirmatory testing, and the eAG cannot serve as confirmation of the A1c it was calculated from.
Anything your A1c could not tell you. There is no independent information here. It is the same measurement, rescaled.
Common interpretation mistakes
Treating eAG as a measured glucose. No glucose was measured. LOINC encodes this in the test's own method field: estimated from glycated hemoglobin.
Comparing eAG with a fasting glucose and concluding one is wrong. A fasting result is one moment; eAG summarises months. They answer different questions and routinely differ.
Reading a low eAG as good control. It may be, and it may be the average of highs and lows cancelling out, or an A1c made falsely low by something unrelated to glucose.
Expecting eAG and a CGM average to agree, or dismissing it when they do not. Some difference is expected; a large or persistent one is worth raising.
Reading the estimate's uncertainty as uncertainty about your A1c. The spread around the conversion describes how far your measured average glucose may sit from it. Your A1c is its own measurement, with its own result.
Questions your doctor may ask
What was the A1c this was calculated from? Do you take any medication that lowers blood glucose, and has it changed recently? Any anemia, kidney disease, recent transfusion, significant blood loss, or known hemoglobin variant — each can distort the A1c this number is calculated from? Are you pregnant? Do you use a meter or a sensor, and what does it show? Is there an earlier A1c to compare with? And what decision would this number change?
Read together with
HbA1c is the measurement this value is computed from, and the one to read first. If the two ever appear to disagree, the arithmetic has gone wrong somewhere, because they cannot.
Fasting glucose samples a single moment and is part of the same diagnostic framework, with its own thresholds.
A complete blood count matters more here than people expect, because anemia and abnormal red cell turnover distort A1c and therefore this number.
Continuous glucose monitoring, where available, is what shows variability and low readings — the two things this value is structurally unable to report.
Clinical pearls
eAG is a presentation layer over A1c, not a second analyte. One result, two units.
The stored interval corresponds to A1c 4.0 – 5.6%, so the high flag begins near the prediabetes threshold.
The estimate predicts measured average glucose with real spread — a study-wide SD of 15.7 mg/dL — so it should not be read to more precision than it has.
Every A1c confounder is an eAG confounder, silently.
An average is not a safety signal: it cannot show hypoglycemia, which is the clinically urgent thing it hides.
Clinical Takeaway
Estimated average glucose is HbA1c expressed in glucose units via the ADAG regression, 28.7 × A1c − 46.7 for mg/dL. It is calculated, not measured, and LOINC 27353-2 carries that in its method field. The range stored here, 68 - 114 mg/dL, corresponds to A1c 4.0 – 5.6%, so a high flag starts near ADA's 5.7% prediabetes threshold, while a diagnosis rests on clinical assessment and confirmatory testing — and this value cannot confirm its own A1c. The estimate predicts measured average glucose with a study-wide prediction-error SD of 15.7 mg/dL, and that spread is about the measured average rather than about the A1c. It reflects two to three months of glucose exposure and cannot show variability or hypoglycemia — ADA states that explicitly. Conditions that disturb hemoglobin or red cells — anemias, G6PD deficiency, recent transfusion, erythropoiesis-stimulating drugs, end-stage kidney disease, pregnancy, hemoglobin variants — can interfere with A1c accuracy and therefore with this value, with no outward sign; whether they do depends on the condition and the assay, and the ADAG study excluded such patients. A CGM average often differs from it, and a large or persistent difference deserves review. Read it with the A1c it came from, and with whoever ordered the panel.
In one sentence
Your A1c in blood-sugar units — the same result, more readable, and no more informative.
Bottom line
If this line is flagged, the number to act on is the A1c behind it, and the question to ask is whether that A1c is trustworthy for you. If it is not flagged and you feel well, it is a reasonable summary of the last few months — and still blind to the highs and lows inside them.
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Start with my report →Frequently Asked Questions
Is eAG the same as a blood sugar test?
What A1c does my eAG correspond to?
Why does my eAG not match my glucose meter or CGM average?
My eAG is flagged high. Does that mean I have diabetes?
Is a low eAG good?
What conditions make eAG unreliable?
How accurate is the eAG estimate?
Where does the eAG formula come from?
Can my eAG be good while my diabetes control is not?
All our content is backed by peer-reviewed studies, academic research, and trusted medical sources. We’re committed to accuracy and transparency — see our editorial policy for details.
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Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2025
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Translating the A1C Assay Into Estimated Average Glucose Values
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Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026
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LOINC 27353-2 — Glucose mean value [Mass/volume] in Blood Estimated from glycated hemoglobin
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Estimating Glycemia From HbA1c and CGM: Analysis of Accuracy and Sources of Discrepancy