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Background: Hemoglobin A1c (HbA1c) is an indicator for metabolic control among diabetic patients. The objective of this study is to describe the distribution of HbA1c levels in a nationally represented sample of US men and women participating within the National Health and Nutrition Examination Survey (NHANES): 1999-2006. Methods: The mean HbA1c, as well as the proportion of individuals with HbA1c <7%, 7-8% and >8%, were determined for both diabetic and non-diabetic adults using the NHANES. Mean HbA1c levels (± standard error) were also determined according to obesity status, where obesity class 1 was defined as BMI of 30.0-34.9, obesity class 2 as BMI of 35.0-39.9, and obesity class 3 as BMI of >40.0kg/m3. Statistical differences between group means were analyzed using two-tailed t-tests.Results: There were 2894 individuals with diabetes (13.6%) among 21205 participants. Among the 2894 diabetics, 23% had mean HbA1c greater than 8%, 17% had mean HbA1c between 7-8%, and 60% had mean HbA1c less than 7%. Overall, diabetic individuals had a 2% higher mean HbA1c than non-diabetics (7.2% vs. 5.2%, p<0.0001). Stratifying by obesity status, mean HbA1c was 7.2±0.1, 7.0±0.1 and 7.2±0.1 for obesity class 1, 2, and 3, respectively. Conclusions: Diabetes is prevalent in the U.S. Our results indicated that nearly one-quarter of individuals with diabetes have poorly controlled glucose levels and 25% have a BMI>35. Since bariatric surgery is an effective therapy for type II diabetes in the severely obese, our data suggests that alternative treatments, such as bariatric surgery, should be explored for severely obese individuals with diabetes or within a research setting, mild or moderately obese individuals with poorly controlled diabetes.