Raising HbA1c awareness
Measuring diabetes
HbA1c is a measure of how well your diabetes is being controlled and an important indicator for your doctor or nurse as to how well you are managing overall. It is a term you have probably heard of before but you may not be aware of what it means.
What does HbA1c mean?
- Over time, glucose in your blood slowly attaches to a protein called haemoglobin that is in your red blood cells
- This is called ‘glycosylated haemoglobin’ or HbA1c
- Once attached, the glucose will stay there for the life of the red blood cell, which is around 120 days
- The higher your blood glucose levels, the higher the HbA1c level will be
- HbA1c changes slowly so it provides an indication of the average glucose level in the 2-3 months before your HbA1c measurement is taken
During 2009 a new type of measurement was introduced for measuring you average blood glucose level. This will measure your HbA1c in mmo/mol (millimoles per mol) rather than as a percentage (%).
It may seem a little confusing at first as you may receive two readings but, don’t worry, they mean exactly the same thing! For example:
If your HbA1c reading is 7%, you should also be given a second reading of 53 mmol/mol.
Eventually, everyone will be using the new way of measuring blood glucose (in mmol/mol) as this is a more consistent and reliable way of making these measurements.
| mmol/mol | 42 | 53 | 64 | 75 | 86 | |
| HbA1c | 6 | 7 | 8 | 9 | 10 |
Good Warning Bad
How often should HbA1c be measured?
- Your HbA1c will be measured when your diabetes care team feel it is necessary, generally every 6 months (but it may be more frequent that this if needed, for example if you are changing your diabetes treatment).
My last HbA1c reading was…………………………………….. Date of reading……………………….
My current HbA1c reading is……………………………………… Date of reading………………………
My target HbA1c reading is* ……………………………………..
- Your HbA1c target will be set by your diabetes care team.
If I have an HbA1c test regularly do I still need to self monitor?
It depends. If you are have type 2 diabetes then it is unlikely unless your care team want you to keep a very close eye on your glucose levels. If your diabetes care team recommends self monitoring they will let you know. HbA1c readings should complement, and not replace, self-monitoring glucose readings. HbA1c provides you with your average reading over the last 2-3 months whereas self monitoring provides you with an instant picture of your blood glucose level at the precise moment in time.
It is important that you understand that these readings may appear to be providing different results! The table below should help clarify how the average daily glucose levels compare to HbA1c levels.
| Average daily blood glucose level (mmol/L) | HbA1c (%) |
HbA1c (mmol/mol) |
|
| 7.0 | 6 | 42 | } Good |
| 8.6 | 7 | 53 | |
| 10.2 | 8 | 64 | }Warning |
| 11.8 | 9 | 75 | |
| 13.4 | 10 | 86 |
} } Bad |
| 14.9 | 11 | 97 | |
| 16.5 | 12 | 108 |
It is essential that you know how important it is to try to hit your target HbA1c level.
Inadequate blood glucose control which is reflected in elevated HbA1c levels increases the risk of late diabetes complications such as diabetic eye and kidney disease.
Any reduction in HbA1c levels (and therefore, any improvement in control), is considered to have beneficial effects on the onset and progression of complications. For example in type 2 diabetes a 1% decrease in HbA1c has been associated with a decrease in risk by:
37% for kidney and eye disease
43% amputations and peripheral vascular disease
21% deaths related to diabetes
14% heart attacks
Please print and then write below your plans for reducing your HbA1c to achieve your personal target
Suggested date for next diabetes review ______________________________________
Notes
I should take control and be able to reduce my overall Hba1c, (glucose levels) by ….
(example – taking a half an hour walk every day or cutting out biscuits)
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