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Please don't laugh..... but what is Hba1C?

T

TROUBR

Well-Known Member
Messages
203
Type of diabetes
Type 1
Sorry but this is going to seem really dense but what is a Hba1C measurement? I am assuming that this is different from my BG readings that I do every time before I inject but can't seem to work out what it actually means. I am getting so confused about all the different numbers - and I am usually good with figures!

I am due to have my first meeting with the diabetic clinic doctor on the 23rd (the first doctor I have seen since I was in hospital with DKA in April) I had blood tests last Monday in preparation for this (was one of these Hba1C?)but I wanted to try understand as much as possible before I go.

I didn't really ask the doctors much when I was in hospital - probably becuase I was still in a state of shock about the whole "nearly dying" thing and because I was unable to read any of the leaflets they gave me at the time as my eyes were in a bad way - I couldn't even read the dial on my pen and had to get them to check it for me! I was so glad to get hold of a magnfying glass when I got home!

I am also putting together a list of questions for the doctor and would appreciate any suggestions as to what it would be useful to know.

Many Thanks - sorry for being thick!
 
Thanks chaps, I think I get it now! How often do type 1's normally have to see the doctor and get Hba1C's done then? I have appointments for diabetes type things coming out of my ears at the moment, I assume that this will die down at some point to an annual / bi- annual check - is that the case?
 
I get one a year done as the consultant says I'm good at my glucose control :D , my last one was 6.2, So I supose it depends on your readings how often they test. You do have lots of appointments at first and lots of blood tests but these do die down once they know your ok and can control things yourself.
 
Hi Louise,
As Stabatha said, it depends on how good your BG control is. If your GP feels it is not well controlled then he will probably want to re-test every 2 months. If not quite so bad but still not under control, then every 3 months. Once under control it is usually every 6 months but if you have shown good control for 6 months or more then it could be once a year.

I believe that GPs are supposed to check all diabetes patients at least once a year.
 
The HbA1c test is important for all of the reasons given above, but the rationale for testing - particularly the relatively infrequent testing - can be confusing. Also, there are a few wrinkles in interpreting the results of this test, of which you should be aware.

Haemaglobin (Hb), or Hemaglobin (Hgb) if you are American, is the stuff that makes blood red. It is a molecule that is found in "red blood cells", and it conveys oxygen from your lungs to the rest of your body. There are several variants of Haemaglobin - by far the most common and important is "Haemaglobin alpha 1" (HbA1). When Haemaglobin is exposed to glucose it occasionally binds to it in a chemical process called glycosylation to form a substance called "glycosylated haemaglobin" (which for HbA1 is called HbA1c). Since everyone's blood contains glucose, everyone has some HbA1c, but since diabetics blood is likely to contain more glucose than non-diabetics (unless the diabetes is very well controlled) then they are likely to have more HbA1c. The test simply measures the percentage of red blood cells that contain HbA1c.

The levels of glucose in the blood are always going up and down, and all that a Blood Glucose test will give you is a snap shot at a particular moment in time. Because the glycosylation process only occurs gradually the HbA1c levels don't change on a day to day basis. Therefore there is no point in doing the test very frequently. Red blood cells live for 3-4 months, they then die and are continually being replaced. For this reason, the HbA1c gives you a fairly good estimate of your average glucose levels over the previous few months. Typically, monitoring it once every 3 months will give you a good estimate of how effectively the diabetes is under control. An uncontrolled diabetic may well have an HbA1c of over 15%. You should probably aim for an HbA1c well under 6%, and some people manage to get it a fair bit lower. A non-diabetic has an HbA1c of about 5%, and the closer you can get to that the better.

Although HbA1c tends to be most doctors favourite means of monitoring long term diabetes control, it does have some drawbacks. Under some circumstances (usually in people with the very early stages of diabetes) it is possible for blood glucose to fluctuate such that it is too high and too low for equal amounts of time - which can cause the average (and hence the HbA1c) to be normal, even though blood sugars are swinging up and down in a potentially damaging way. Another problem is that some dietary supplements (such as large doses of vitamin C) and some illnesses can cause misleadingly low HbA1c readings.

That said, one of the main reasons that doctors give the HbA1c test so much credence is that it has proved to be a very good indicator of diabetic complications. The higher your HbA1c figures are, the more likely that you will suffer some of the more horrible consequences of diabetes.

In short, do your best to keep it low - certainly worry if it is above about 7%. However, don't get complacent just because you have a low HbA1c - it is still good practice to regularly test blood glucose, just to make sure that something else isn't giving you misleading HbA1c results.
 
Thanks Diabetic geek. I actually understood that! It should be interesting to see what my results are, not expecting great things as I have only been diagnosed for 2 months and was really poorly leading up to diagnosis which should have knocked my average up a few notches. I have been pretty good since though and I suppose I need to bear in mind that this is my starting point on which to improve as I gain better control and more knowledge.
 
Hi Guys,
It is possible to turn things around pretty quickly, but it has been hard work!.
I was diagnosed with type 2 in January and put on oral medication, my cholesterol was 10 and put on statins, my blood pressure was 170/100 and put on medication, having never taken a tablet in my life before and to get to 52 it was a shock. I had also developed erectile dysfunction.
My cholesterol is now 2 and my blood pressure is 110/70, Hba1c is 6. Now I need to concentrate on losing weight, most importantly things have improved down below!!! Iam sick of appointments!!!
Regards
Scouse Bob.
 
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