Until this year, the figures showing control of type 1 diabetes on the UK had been displaying a worrying trend.
The target HbA1c for people with type 1 diabetes is 48 mmol/mol (6.5%), with a wider target of 58 mmol/mol (7.5%) offered for people at higher risk of having severe hypos.
Despite having improved technology, including more accurate and sophisticated blood glucose meters and increasing (albeit slowly) number of pump users, from 2009 to 2012, the number of people reaching HbA1c targets decreased year on year. The trend also showed that more and more people with type 1 were recording HbA1c numbers above 86 mmol/mol (10%).
We can only speculate why control became worse over this time period but some possible factors include restrictions on availability of blood glucose testing strips, a lack of referrals to diabetes education courses and cuts in numbers of diabetes specialist nurses.
Now, the good news
Take a look at the table below and it’s all looking gloomy for the first few years until, at last, an improvement in control in 2012-2013.
Higher percentages mean more people were getting HbA1c values below the different grade boundaries. Lower percentages mean more people were failing to hit those grade boundaries.
| HbA1c | 2009-10 | 2010-11 | 2011-12 | 2012-13 |
| < 48 mmol/mol (6.5%) | 7.1% | 6.8% | 6.5% | 7.5% |
| ≤ 58 mmol/mol (7.5%) | 28.7% | 28.1% | 27.0% | 27.3% |
| ≤ 86 mmol/mol (10.0%) | 83.2% | 82.4% | 81.9% | 83.0% |
Again, we can only speculate why control has started to improve. One reason could be the higher number of people now on insulin pumps. Another factor could be down to improvements in care in a number of regions.
Trials on Continuous Glucose Monitors have become more widely available in some parts of the country allowing patients, and their doctors, to get a much clearer idea of how blood sugar levels are behaving.
It remains to be seen whether the improvements are a one off or whether the improved numbers will continue over the next few years.
If you’re struggling with control
If you’re struggling with control, consider testing your sugar levels more often to better identify why your sugar levels may be running too high or low at times.
It’s well worth asking your diabetes team for help. If you’ve not been on a carbohydrate counting course, or at least not for a number of years, ask to be put on one.
It’s also well worth asking if it’s possible to be put onto a CGM trial. A CGM trial usually lasts for around a week and after the trial is complete, a member of your diabetes team will go through the results with you and identify changes that can improve your control.
Insulin pumps have been shown to significantly improve diabetes control and pumps can be especially useful for children, teenagers and young adults.There can be long waits for insulin pumps but many people find the wait to be well worth it once they get the pump.
