In Singapore, an HbA1c of 6.0% or below is considered normal and means diabetes is unlikely. A result between 6.1% and 6.9% is borderline and needs a follow-up blood glucose test, while 7.0% or above is consistent with diabetes. If you already have diabetes, the usual goal is an HbA1c of 7.0% or below, though your doctor may set a different target for you.

This article explains what HbA1c measures, how to read your result, why Singapore's numbers differ from some overseas websites, and what to do next.

What does HbA1c measure?

HbA1c (glycated haemoglobin) shows your average blood sugar over the past two to three months. Sugar in your blood sticks to haemoglobin, the protein in red blood cells. Red blood cells live for a few months, so the percentage of haemoglobin with sugar attached reflects how high your blood sugar has been over that time.

This makes HbA1c different from a finger-prick or fasting glucose test, which only shows your blood sugar at one moment. One large meal or a stressful morning won't change your HbA1c much.

Two practical points:

You don't need to fast for an HbA1c test.
It is reported as a percentage (for example 6.4%). Some labs also give it in mmol/mol.

What is a normal HbA1c in Singapore?

Since 2019, the Ministry of Health has allowed HbA1c as a first screening test for diabetes, alongside the fasting glucose test. MOH's guidance sorts results into three bands:

HbA1c result	What it means	What happens next
6.0% and below	Low probability of diabetes	No further test needed if you have no symptoms. Keep up a healthy lifestyle and repeat screening in 3 years.
6.1% to 6.9%	Borderline	A fasting glucose test or an oral glucose tolerance test (OGTT) is needed to tell whether this is normal, prediabetes or diabetes.
7.0% and above	High probability of diabetes	Consistent with diabetes. Your doctor will discuss a management plan with you.

If your HbA1c is borderline, the follow-up test decides the diagnosis. A fasting glucose of 6.1–6.9 mmol/L (or 7.8–11.0 mmol/L two hours into an OGTT) means prediabetes. A fasting glucose of 7.0 mmol/L or more (or 11.1 mmol/L or more on the OGTT) means diabetes.

Why do some websites say 5.7% or 6.5%?

You may have seen different numbers online. The American Diabetes Association uses below 5.7% as normal, 5.7–6.4% as prediabetes and 6.5% or higher as diabetes.

Singapore's cut-offs (6.0% and 7.0%) come from an analysis of local population data from the National Health Survey. That is why MOH uses a borderline band with a follow-up glucose test, rather than diagnosing on HbA1c alone in that range. If your lab report or a health app uses the American numbers, don't worry — your doctor will interpret your result using the Singapore guidance.

I have diabetes. What HbA1c should I aim for?

Singapore's clinical guidance (from the Agency for Care Effectiveness, or ACE) says for most people with type 2 diabetes, an HbA1c of 7.0% or below gives a good balance between lowering the risk of complications and avoiding low blood sugar (hypoglycaemia).

Your target should be personal, and agreed between you and your doctor:

A tighter target (for example 6.5% or below) may suit younger people, those recently diagnosed, and those without significant complications.
A less strict target (for example 8.0% or below) may suit older adults, especially if frail, people who have had diabetes for many years, and those with advanced complications. For them, avoiding hypoglycaemia — which can cause falls and confusion — matters more.

So an HbA1c of 7.5% might be on target for one person and above target for another. Ask your doctor what your own target is.

How often should HbA1c be checked?

If you have diabetes, ACE guidance suggests a review:

every six months if you are doing well and meeting your goals
every three months if you are finding it hard to reach your goals
sooner when a medication is started, changed or stopped

At least once a year, your review should also include checks for complications: your eyes, kidneys and feet.

If you don't have diabetes, MOH recommends screening from age 40, or earlier if you have risk factors such as being overweight, a parent or sibling with diabetes, high blood pressure, or a history of diabetes in pregnancy. If your result is normal, repeat it every 3 years.

Can I get screened for diabetes with a subsidy?

Yes, if you are an eligible Singapore Citizen. Healthier SG Screening is the national subsidised screening programme. From age 40, it includes a blood test for diabetes and high cholesterol, along with checks for high blood pressure and weight, once every 3 years if your results are normal. It is for people who haven't already been diagnosed with these conditions.

Aged 18 to 39? Start with HealthHub's online Diabetes Risk Assessment. If it shows you are at higher risk, you'll be invited for subsidised screening.
Fees are set by the government: from $0 to $5 at CHAS GP clinics depending on your card, and $0 for eligible Singapore Citizens at the clinic they are enrolled with under Healthier SG. This includes one follow-up consultation if needed.

STAT Medical @ Hougang is a CHAS and Healthier SG clinic, so you can do your screening and follow-up with us. You can check which tests you're eligible for on HealthHub.

When might HbA1c be inaccurate?

Because HbA1c depends on your red blood cells, anything that changes how long they live can give a misleading result. MOH lists several conditions where HbA1c should not be used for screening, including:

Thalassaemia or other haemoglobin variants — common in Singapore, and many people don't know they carry a trait
Iron deficiency anaemia, or low vitamin B12 or folate (can make HbA1c falsely high)
Recent blood loss, blood donation or blood transfusion (can make it falsely low)
Chronic kidney disease or chronic liver disease
Pregnancy — HbA1c is not used to screen for diabetes in pregnancy

If any of these apply to you, tell your doctor. A fasting glucose test or OGTT may be more reliable.

Can I lower my HbA1c?

For many people, yes. Lifestyle changes can make a real difference, whether you have prediabetes or diabetes. ACE guidance highlights that losing even 5% of your body weight (3.5 kg if you weigh 70 kg) can improve blood sugar control and reduce the need for medication in people who are overweight.

Practical steps that help:

Use My Healthy Plate: fill a quarter of your plate with wholegrains, a quarter with protein and half with vegetables and fruit. At the hawker centre, ask for less rice or noodles and extra vegetables, and choose plain water or kopi/teh kosong over sweetened drinks.
Move more: aim for 150 minutes of moderate activity a week, such as brisk walking, or 20 minutes of vigorous activity on 3 or more days a week.
Sleep and stress: poor sleep and ongoing stress can push blood sugar up.
Don't smoke, and keep alcohol to no more than 1 drink a day for women and 2 for men.

You can read more in our guide to the 8 pillars of lifestyle medicine.

If you take diabetes medication, don't stop or change it on your own — speak to your doctor first, especially as your lifestyle changes start to work.

When should I see a doctor?

See a doctor if:

your HbA1c is 6.1% or above and you haven't had a follow-up test
you have diabetes and your HbA1c is above the target you agreed with your doctor
you have symptoms such as frequent urination, unusual thirst, unexplained weight loss, blurred vision, slow-healing wounds or frequent skin infections
you are over 40 and have never been screened

Seek urgent care (go to the emergency department or call 995) if you have diabetes and feel very unwell, are vomiting and can't keep fluids down, are confused or very drowsy, or are breathing fast and deeply.

At STAT Medical @ Hougang, we review HbA1c and other results as part of our chronic disease management and health screening services. If you'd like your result explained, get in touch.

Sources

This article is general health information and is not a substitute for personal medical advice. Please speak to a doctor about your own situation.

What Is a Normal HbA1c? A GP Explains