Still talking a lot more sense than I've experienced from the NHS
Blood glucose, blood pressure, height and weight - your care team collect lots of different data when they monitor your health. But do you really understand what your health results mean?
Knowing and understanding what these numbers mean can be an important step towards better self-management of your health. Here's a beginners' guide to what those terms mean and why they're important:
BMI [kg/m2]
'Body Mass Index' or BMI is an assessment of your weight relative to your height. It gives an indication of whether you are underweight, normal weight, overweight or obese. You can calculate yours here:
http://www.nhs.uk/tools/pages/healthyweightcalculator.aspx
If you're overweight or obese, there are major health benefits to be gained from losing even a small amount of weight. Excess weight makes it hard for your body to use insulin properly, so losing weight will also help you to control your blood glucose levels. BMI is limited though as it doesn't tell us anything about where on the body any excess fat is stored, which is important in relation to our health.
Waist size [cm]
Waist size is a measurement taken midway between your lower rib and hip bone. A waist circumference of 88cm or more in women, and 102cm or more in men, can indicate serious health risks. Carrying excess weight around your middle makes it harder to control your blood glucose levels, and increases your risk of developing heart disease.
Blood glucose [mmol/L]
Blood glucose levels give an indication of the amount of glucose in your blood – but only at the time when the blood sample is taken. Readings can be taken when fasting, pre-meal or 2 hours after a meal in order to monitor blood glucose in the absence or presence of food. A level of 7.0mmol/L or over when fasted, or of 11.1mmol/L or more after food, is the diagnosis criteria for Type 2 diabetes.
HbA1C or 'glycated haemoglobin' [mmol/mol]
This blood test measures the amount of glucose that's being carried by the red blood cells in the body. This gives an indication of the average level of glucose in your blood over the last 2-3 months. It can be a good indicator of how well your diabetes is being controlled.
An HbA1c level of 42-47 mmol/mol (6 – 6.4%) indicates pre diabetes whereas 48mmol/mol (6.5%) or above is diagnostic of diabetes.
Blood pressure [mmHg]
Blood pressure (BP) is the amount of force your blood exerts against the walls of your blood vessels. The first and largest number (systolic BP) is the pressure when the heart pumps the blood into the vessel. The second and smaller number (diastolic BP) is the pressure when the heart is at rest. Ideal BP is considered to be between 90/60 and 120/80 (as in the figure below). High blood pressure is 140/90 or higher, and low blood pressure 90/60 or lower.
Cholesterol [mmol/L]
Cholesterol is a waxy, fatty substance that is essential to life. It's made in the liver but can also be found in some foods. Cholesterol cannot mix with the blood, and so it is carried through the body by protein transporters called lipoproteins. If the levels of these transporters become unbalanced your risk of heart disease and stroke increases. Cholesterol can be measured through a simple blood test, but total cholesterol on its own is not a useful measure of health and it is more important to assess the levels of cholesterol in the different transporters (LDL and HDL described below).
HDL or high density lipoprotein [mmol/L]
HDL are particles that mop up excess cholesterol in the blood and carry it back to the liver, where it's either broken down or passed out of the body as a waste product. Having more HDL is therefore better, and the ideal level is 1mmol/L or above. Lower levels can increase your risk of heart disease. HDL levels increase with regular physical activity, consuming natural fats and through reducing carbs in your diet.
LDL or low density lipoprotein [mmol/L]
LDL carry cholesterol to where it is needed in your body. When these particles become small and dense, they become unstable and can drop their load (the cholesterol) causing a build-up of fatty deposits in the blood vessel walls. This increases the risk of heart disease and strokes. Large LDL are less harmful, as they are more stable transporters of cholesterol. There is no standard UK test to measure LDL size, but raised triglyceride levels and low levels of HDLs are thought to cause the problem.
Triglycerides
Triglycerides are a type of fat. Having raised levels of triglycerides in the blood can increase your risk of heart disease. Consuming too much carbohydrate and alcohol can increase your levels of triglycerides – but losing weight can help to reduce them.
Kidney function tests [ACR, eGFR]
Your kidneys filter blood, removing waste and water to make urine. There are two main kidney function tests conducted to judge how well your kidneys are working. The first test, known as the 'Albumin to Creatinine Ratio' (ACR) test, assesses how much protein is leaking into your urine.
The second test, known as the 'Estimated Glomerular Filtration Rate' (eGFR), measures how much blood your kidneys are filtering. The normal value is 90-120ml/min. A value below 60ml/min suggests there may be some kidney damage.
Liver function test [GGT]
Gamma-glutamyl transpeptidase (GGT), an enzyme found in the liver, is a marker for liver disease or excess sugar or alcohol consumption. This test provides a good indicator of the presence of diseases like fatty liver. Recommended levels of GGT are 11-50iu/L for men and 7-32 iu/L for women.
CVD disease 10 year risk score
The CVD risk score is a short questionnaire that uses a number of factors to calculate your risk of having a stroke or heart attack in the next 10 years. You can try this for yourself online here:
https://qrisk.org/2016/
In summary...
You and your healthcare team may use some or all of these tests to help them monitor your health and wellbeing. Remember – the results they collect are
your health results! Don't be afraid to ask what the numbers mean to you, and feel free to write them down and ask questions