Measuring your glucose control at clinic

Measuring control in clinic

We will download your blood glucose meter in clinic so that we can look at the results in more detail with you. You should also be able to do this yourself at home. We encourage all patients to set up an account with Glooko and download their meter on weekly basis. You can send your weekly Mysugr reports to your educator as well.

A long term marker of diabetes control is the HbA1C test

This is also a finger prick check carried out at each clinic appointment. It measures the amount of glucose attached to the red blood cells in the blood over the last 6 to 12 weeks. The higher the amount of glucose in your blood, the higher the HbA1C result will be. It is measured in mmol/mol.

The recommended HbA1C level is 48mmol/mol or under, anything higher than this means your long term health may be affected. Your diabetes team is there to help you achieve this level. Please ask if you are not sure what to do.

HbA1c or glycated haemoglobin

HbA1c or glycated haemoglobin is an indication as to what your blood glucose levels have been over the last 6 to 12 weeks.

What does this measure?

Haemoglobin (Hb) is present in everyone’s red blood cells. This is what makes your blood red. Glucose sticks to red cells and the more glucose there is around in the blood, then the more red cells have glucose attached. The average lifespan of a red cell is 120 days and therefore if we measure how many red blood cells have glucose attached to them. It gives us a guide to the glucose levels in your blood over the last 120 days (3 months).

What it does not measure?

This can be the confusing bit. It is not a measure of blood glucose as you would get if you are doing a finger prick and checking your blood glucose with a meter. It does not measure sudden changes in your blood glucose and it will not reflect a single poor day or week.

What does it matter?

Small blood vessels run throughout the body and get damaged by high blood glucose levels which lead to long-term complications of diabetes such as kidney and eye problems. An HbA1c target level of 48 mmol/mol (6.5 percent) or lower is ideal to minimise the risk of long-term complications. This requires hard work to achieve, but is worth it.

It is important to note that if HbA1c levels are above the ideal target of 48mmol/mol or less, any reduction in HbA1c level reduces the risk of long-term complications. We will support children and young people with Type 1 Diabetes and family members to safely achieve and maintain their individual agreed HbA1c target level.

How often is it measured?

We aim to measure HbA1c at every clinic visit, at least every 3 months. If it is above 69mmol/mol (9 percent), we will arrange more frequent appointments or hospital admission to provide you with additional support (as covered by our improving HbA1c pathway).

Average blood glucose levels and meter downloads at home

The HbA1c level effectively represents average glucose levels over a period of 6 to 12 weeks. A way of monitoring how you are doing between clinic visits is by looking at your average blood glucose levels over 1 to 2 weeks and you can do this on your glucose meter.

In order to meet the national target for an HbA1c of 48mmol/mol or less, we would suggest that you aim for a weekly average blood glucose level of 8mmol/L or less (It is important to note that the average blood glucose level is useful only if at least 4 blood glucose tests are done per day).

If your blood glucose average is regularly above 8mmol/L or if you are having hypos more than 10 percent of the time please contact the clinic so that we can help to see if any changes need to be made to insulin doses or timing.