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A1c in children and teens
Children use the same A1c cut points as adults, but the test has extra limits in kids, and goals for children with diabetes are set with their own ADA recommendations.
The short answer
- Normal is below 5.7%, at any age. The ADA criteria for diabetes and prediabetes apply to children, adolescents and adults (ADA Standards 2026, sec. 2).
- A1c is not used in every child. It is not recommended for diagnosis with cystic fibrosis or with symptoms of a sudden onset of type 1 diabetes (ADA Standards 2026, sec. 14).
- The usual goal with diabetes is below 7%, set individually, and below 6.5% for some children (ADA Standards 2026, sec. 14).
Normal, prediabetes and diabetes ranges
| Category | A1c |
|---|---|
| Normal | Below 5.7% (below 39 mmol/mol) |
| Prediabetes | 5.7% to 6.4% (39 to 47 mmol/mol) |
| Diabetes | 6.5% or higher (48 mmol/mol or higher), confirmed by a repeat test unless symptoms are clear |
ADA Standards 2026, Tables 2.1 and 2.2, which the ADA says apply to children, adolescents and adults (ADA Standards 2026, sec. 2).
So there is no separate "normal A1c for a 7 year old" or for a toddler: the line between normal and prediabetes is 5.7% for everyone. For what a single value means, see the A1c chart.
When A1c is used to test children
The ADA suggests considering risk-based screening for prediabetes and type 2 diabetes from puberty or age 10, whichever comes first, in children with overweight or obesity and at least one more risk factor. If the result is normal, screening is repeated at least every 2 years, or sooner if weight is rising (ADA Standards 2026, sec. 14). A1c, fasting glucose, a 2-hour glucose tolerance test or, with symptoms, a random glucose can all be used (ADA Standards 2026, sec. 14).
The ADA notes limits here. Some studies suggest glucose tests suit children better than A1c, especially in certain ethnic groups, while a fasting glucose alone may overdiagnose diabetes in children. The ADA acknowledges limited data for A1c in children but continues to recommend it for type 2 diabetes (ADA Standards 2026, sec. 14). It does not recommend A1c for diagnosis in children with cystic fibrosis or with symptoms of a sudden onset of type 1 diabetes, and with a hemoglobin variant only an A1c method without interference is suitable (ADA Standards 2026, sec. 14). Other conditions that change red blood cells can also skew the result; see when A1c can mislead.
A1c goals for children with diabetes
| Situation | ADA A1c goal | Rec. |
|---|---|---|
| Most children and teens with diabetes | Below 7% (below 53 mmol/mol) | 14.20 (ADA Standards 2026, sec. 14) |
| Selected children, if reachable without significant hypoglycemia or undue burden | Below 6.5% (below 48 mmol/mol) | 14.23 (ADA Standards 2026, sec. 14) |
| Children who cannot describe low blood sugar, have hypoglycemia unawareness, cannot access CGM or automated insulin delivery, or cannot check glucose regularly | Below 7% or below 7.5% (below 58 mmol/mol) | 14.21 (ADA Standards 2026, sec. 14) |
| A history of severe hypoglycemia, or when treatment harms outweigh benefits | Even less strict, set individually | 14.22 (ADA Standards 2026, sec. 14) |
| Type 2 diabetes with a low risk of hypoglycemia | Below 6.5% (below 48 mmol/mol) | 14.32 (ADA Standards 2026, sec. 14) |
The ADA says A1c goals must be individualized and reassessed over time (ADA Standards 2026, sec. 14). Young children (under 6) often cannot recognize or describe low blood sugar, so hypoglycemia gets special attention. Even so, registry data show lower A1c goals can be reached in children, including those under 6, without more severe hypoglycemia (ADA Standards 2026, sec. 14). For children with diabetes, the ADA also recommends using CGM data from the most recent 14 days or longer, with or without A1c, whenever possible (ADA Standards 2026, sec. 14).
For type 2 diabetes in children and teens, glycemic status (such as A1c or CGM data) should be checked at least every 3 months (ADA Standards 2026, sec. 14). More on timing in how often to check A1c, and on adult goals in A1c goals in diabetes.
Frequently asked questions
What is a normal A1c for a child?
Below 5.7%. The ADA diagnostic criteria for normal, prediabetes (5.7% to 6.4%) and diabetes (6.5% or higher) apply to children and adolescents as well as adults. There is no separate normal range by age.
What does a high A1c in a child mean?
An A1c of 6.5% or higher is in the diabetes range and 5.7% to 6.4% in the prediabetes range. A diagnosis needs a repeat test unless symptoms are clear, and some children need other tests instead of A1c, so the result is a starting point for the care team.
What A1c goal do children with diabetes have?
The ADA says below 7% is appropriate for most children and adolescents with diabetes, with the goal set individually. Below 6.5% may suit some children, including most with type 2 diabetes who have a low risk of hypoglycemia; less strict goals suit others.
Is A1c used to diagnose type 1 diabetes in children?
Not when a child has symptoms suggesting type 1 diabetes is starting suddenly. The ADA says A1c is not recommended for diagnosis in that case, or in children with cystic fibrosis.
Sources
- American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1). doi.org/10.2337/dc26-S002
- American Diabetes Association Professional Practice Committee. 14. Children and Adolescents: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1):S297-S320. doi.org/10.2337/dc26-S014
- National Institute of Diabetes and Digestive and Kidney Diseases (NIH). The A1C Test & Diabetes. www.niddk.nih.gov/health-information/diagnostic-tests/a1c-test
Written and maintained by the controla1clevels.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-27. Spotted an error? See About.