The HbA1c shows the average amount of glucose in the blood over a period of 3 months. Sugar in the bloodstream can become attached to the hemoglobin in red blood cells (glycosylation). Once the sugar is attached, it stays there for the life of the red blood cell, which is about 120 days. The higher the level of blood sugar, the more sugar attaches to red blood cells. The HbA1c is formed in a non-enzymatic pathway by hemoglobin's standard exposure to elevated plasma levels of glucose. HbA1c is tested to monitor nephropathy and retinopathy in diabetes mellitus.