HBA1C

Question 1

Normal level

Answer 1

Below 42 mol/mol or 6%

Question 2

Prediabetes

Answer 2

42-47 mmol.mol
6-6.4%

Question 3

Diabetes

Answer 3

48 mmol/mol
6.5% or over

Question 4

Average blood glucose to get 6%

Answer 4

7mmol/L

Question 5

How to lower result

Answer 5

Getting good sleep
Restaurant Savvy - low carb
De-stress
Regular check before and two hours after
Exercise
Avoid high carb alcohol

Question 6

Ideal diabetes control range

Answer 6

42-53

Question 7

Acceptable diabetes control range

Answer 7

53-58

Question 8

Benefits of lower HBA1c

Answer 8

Reduces the risk of retinopathy (eye problems), neuropathy (losing sensation in your feet/hands) and diabetic nephropathy (kidney issues).
o Less likely to suffer from cataracts, heart failure and amputation.

Question 9

Check up PC for diabetes

Answer 9

sk how they are feeling?
- Any recent infections/illnesses?
o D+V/illness can affect the amount of insulin required.
- Any hospital admissions for DKA/hypos?
- Any symptoms of diabetes?
o Polyuria, polydipsia, weight loss, vision changes, tingling in feet, impotence (ED).

Question 10

PMH

Answer 10

Any cardiovascular/cerebrovascular/renal/visual complications.
- Any co-morbidities.
- HbA1c can be falsely raised in –
o Kidney failure.
o Chronic excessive alcohol intake. o Vitamin B12 deficiency.
- HbA1c can be falsely decreased in – o Acute/chronic blood loss.
o Sickle cell disease.
o Thalassaemia.

Question 11

DHx

Answer 11

What diabetes medication do you take?
- How/when are you taking the medication? Any side effects?
- Are you finding this okay or are you struggling to keep up with the dose – if so, why?
- Injecting correctly (site rotation), monitoring glucose levels?
- Any other medications/changes?

Question 12

SHx

Answer 12

ADLs;
o o o
- Diet; o o
How is your mood/sleep?
Are home circumstances okay?
Do you feel like your disease is affecting your ADLs.
Adhering to dietary restrictions?
Been on a recent diet/tried to lose weight? - Exercise.
- Smoking + alcohol.

Question 13

How to lower HBA1C

Answer 13

Dietary modifications;
o Awareness of snacking and sugary foods/carbs affecting the blood sugar level.
- Physical activity;
o Getting regular exercise can help stop blood sugar levels rising.
o Check with doctor first because some diabetes medicines can lead to
hypoglycaemia if you exercise too much. - Take extra care when ill;
o “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.
- Monitor blood sugar level –
o So you can spot an increase early and take steps to prevent it.
- Support available;
o GP, diabetes nurses, online resources, training courses.