What level should my HbA1c be?
The guidelines for HbA1c targets vary but are slowly becoming more standardised. If you have diabetes, your target should be slighlty higher than someone who doesn't, to avoid low blood sugar (hypoglycaemia). The International Diabetes Federation (IDF) now recommends a HbA1c target of six and a half per cent for people with diabetes. There is evidence that HbA1c goes up with age, which may account for why it seems high in some elderly patients when compared to their blood glucose test results.
If you can sustain an HbA1c value of less than eight per cent, your risk of long-term health complications will be considerably less. People with a lower HbA1c usually experience better levels of psychological well-being. They report improved self-confidence and a better quality of life, with less anxiety and depression. It is a good idea to set your own personal HbA1c goal with your diabetes healthcare team. Setting a goal will improve your chances of hitting your target. It is important to remember that even if your blood glucose control is improving and your self-testing is revealing lower results, it will take some time for this to show in your HbA1c.
How reliable are HbA1c tests?
HbA1c reflects an average of your blood glucose level over a period of time. This means you can get an acceptable HbA1c reading with a combination of very high and low blood glucose values. However, you may be able to tell if you have good blood glucose control because you will tend to feel better if your blood glucose level is relatively even. Also, any medical problem that shortens the life of your red blood cells may artificially reduce your HbA1c percentage.
How often should I check your HbA1c?
You should check your HbA1c at least every three months. This will give you a good indication of how your blood glucose control has been throughout the year.
After a visit to your diabetes healthcare team, you may feel more motivated to keep your blood glucose readings low. Use this motivation to address with your healthcare team any lifestyle factors preventing you from managing your diabetes properly. They will then be able to advise you about appropriate changes to your diet, physical activity levels, medication or insulin regimes.