HbA1c Flashcards
What HbA1c values is considered normal?
42 mmol/L / <6.0%
What HbA1c values is considered pre diabetes?
42 mmol/L < x ≤ 47 mmol/L
6 - 6.4%
What HbA1c values is considered diabetes?
≥ 48 mmol/L / 6.5%
Why do we measure HbA1c?
It gives us an idea of how well controlled blood glucose is and therefore their diabetes
What does HbA1c measure?
It measures the avg blood glucose level over the previous 2-3 months (8-12 weeks)
our blood joins with glucose and this is directly proportional to the total amount of sugar in our system at the time.
What are the benefits of lowering HbA1c?
reduces risk of:
- retinopathy
- neuropathy
- diabetic nephropathy
less likely to suffer from:
- cataracts
- HF
- amputation
Using percentages describe what decreasing HbA1c by 1% can do.
can reduce risk of microvascular complications in those w/ diabetes by 25% and are also 43% less likely to suffer from amputation due to PVD.
For a diabetic what should they aim for HbA1c to be?
As close to 48 as possible
Focused questions to ask in terms of medication
What DM meds do they take
How long?
How and when
Any SE?
Adherence?
Injecting correctly
Monitoring glucose levels
Any other medications?
Any changes to / new meds?
When can HbA1c falsely raised?
Kidney failure
Chronic excessive alcohol intake
Vitamin B12 deficiency
When can HbA1c be falsely decreased?
Acute / chronic blood loss
Sickle cell disease
Thalassaemia
Focused questions to ask in terms of Shx
ADLs
- mood and sleep
- home circumstances
- is the disease affecting
ADLs?
Diet
- adherence to restrictions
- recent diet
- recent wt loss / tried to
Exercise
Smoking and alcohol
Other focused questions to ask
D+V / illness -> effects amount if insulin required
any ADM/IN -> hypos / DKA
DM sx?
- polyuria, polydipsia, wt loss, vision changes, neuropathy, impotence.
Disease control
Any complications (CVS, cerebrovasc, renal, visual)
Any co-morbidities
What advice can be given to help lower HbA1c in terms of dietary modification?
Awareness of snacking and sugary foods/carbs affecting the blood sugar level.
What advice can be given to help lower HbA1c in terms of physical activity?
Getting regular exercise can help stop blood sugar levels rising.
Check with doctor first because some diabetes medicines can lead to hypoglycaemia if you exercise too much.
What advice can be given to help lower HbA1c in terms of illness?
Sick day rules:
- check blood sugar more regularly (4h),
- keep taking diabetes
medications even if you
don’t feel like eating,
- contact diabetes team,
- check ketones.
What else can you suggest?
Monitor blood sugar level – spot an increase early
so you can prevent it.
Support available;
- GP, diabetes nurses,
online resources,
training courses.
