HbA1c

Question 1

Opening

Answer 1

When we’re you diagnosed?
What type?
What were your symptoms pre diagnosis?

Question 2

HPC

Answer 2

Do you know what diabetes is?
Do you know what HBA1c is?

Question 3

What is HBA1c

Answer 3

A measure of how much sugar is stuck in your RBC for the last three months. It gives an average for this duration

Question 4

SHx

Answer 4

How well is your diabetes being managed?

Current impact on: sleep, social life, work, exercise, mood

Question 5

Benefits of lowering Hba1C

Answer 5

Reduces risk of eye problems, neuropathy, kidney issues, less likely to have cataracts, heart failure and amputation

Question 6

PC

Answer 6

How are you feeling?
Have you had any recent illness or infections?
Any recent hospital admission?
Any symptoms of diabetes?

Question 7

PMHx

Answer 7

Any Cardiovascular, cerebral vascular, renal or visual changes?

Any co morbidities?

Question 8

What can HBA1c be falsely raised in?

Answer 8

Kidney failure
Excessive alcohol intake
Vitamin B12 def

Question 9

HBA1c can be falsely decreased in

Answer 9

Acute/chronic blood loss
Sickle cell
Thalassaemia

Question 10

DHx

Answer 10

What diabetes meds do you take?
Any side effects?
Are you finding this okay?
Are you injecting insulin correctly?
How are you monitoring your glucose levels?
Any other med changes?

Question 11

SHx for main history

Answer 11

How is your mood?
Are home circumstances ok?
Is it affecting your ADLs
Are you adhering to dietary restrictions
Exercise
Smoking
Alcohol

Question 12

Advice to lower HBA1c

Answer 12

Diet, exercise, take extra care when you’re sick, monitor blood glucose levels,
Support from GP, Diabetes nurse and online

Question 13

ICE

Answer 13

Concerns about being diabetic?
What are you expecting from this consultation?