HbA1c monitoring
Your diabetes team will check your HbA1c regularly during clinic visits. You should talk to your team about the target HbA1c you want to achieve given your lifestyle, activity level and age.
What is HbA1c?
HbA1c (glycosylated haemoglobin) is a measure of the amount of glucose attached to the body's red blood cells; it is present in everyone. It gives an indication of your blood glucose control over the last 2-3 months. The level of HbA1c in your body rises and falls in line with your blood glucose - the higher your HbA1c, the more glucose is attached to your red blood cells. Your HbA1c does not change rapidly because the red blood cells in your circulation last for around 3-4 months. Any increases and decreases in your HbA1c will happen over a period of at least 6 weeks.
HbA1c is recorded as mmol/mol, and sometimes as a percentage, while blood glucose is recorded in mmol/L. You may be used to seeing your HbA1c reported as a percentage, however from 1 October 2011, HbA1c changed to be given in mmol/mol. An HbA1c test is not the same as a blood glucose test.
HbA1c and blood glucose
The chart below shows the relationship between the blood glucose level that you measure yourself and your HbA1c measurements from the hospital.
|
HbA1c level (mmol/mol) |
HbA1c level (%) |
Average plasma glucose level |
|
42 mmol/mol |
6% |
7.5 mmol/L |
|
53 mmol/mol |
7% |
9.4 mmol/L |
|
64 mmol/mol |
8% |
11.3 mmol/L |
|
75 mmol/mol |
9% |
13.3 mmol/L |
|
86 mmol/mol |
10% |
15.3 mmol/L |
|
97 mmol/mol |
11% |
17.2 mmol/L |
|
108 mmol/mol |
12% |
19.1 mmol/L |
Research shows that improved control of HbA1c will decrease the risk of diabetes complications.1
Find out what your HbA1c is and keep a record of it in your blood glucose testing record diary. Remember, the better your blood glucose control specifically after eating, the more likely you are to achieve your HbA1c target.
Remember that:
- Blood glucose monitoring alone does not improve your diabetes. It is how you use the information from your glucose testing that makes the difference to your diabetes control.
- Changes in your HbA1c will happen over a period of at least 6 weeks; do not expect to see immediate changes in response to changes you make to your diabetes management.
- Improving your HbA1c control can help decrease your risk of developing complications associated with your diabetes.
- Make sure you discuss with your diabetes care team how often you need to have your HbA1c tested to help you gain control of your blood glucose.
What are the Target Ranges?
Blood glucose target ranges are set on an individual basis and depend upon several things:
- How long you have had diabetes
- What other conditions you have
- Your age and life expectancy
- Whether you have complications, especially cardiovascular disease
- Whether or not you are at risk or can recognise the symptoms of low blood glucose
- Your individual lifestyle and needs
Suggested targets:
| Diabetes UK | Int. Diabetes Federation | |
|---|---|---|
| HbA1c |
48 mmol/L (6.5%) |
8.5 mmol/L (7%) |
| Before a meal |
3.5 - 5.5 mmol/L |
3.9 - 7.2 mmol/L |
| 1-2 hours after a meal |
Less than 8 mmol/L |
Less than 10.0 mmol/L |
What do the Results Mean?
Your blood glucose numbers are a way to track how you are doing with your blood glucose management. Keep in mind that you can have strong feelings when you see a result that is outside your target range, but every result can give you information. The results help you see how food affects blood glucose, the impact of activity, how your medications are working and more.
You can review your results with your diabetes care team to see if you have a pattern of above target or below target blood glucose. A pattern tells you that it may be time for a change. This can take time, so be patient and remind yourself that blood glucose checks can help you stay healthy.
Reference:
Diabetes.co.uk website: http://www.diabetes.co.uk/what-is-hba1c.html
Diabetes.org.uk website: http://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Testing/
Diabetes.org website: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html
