Patient information leaflets
See the leaflet below, or an accessible format underneath it.
Knowing your numbers
Know your target
We all know that long term health in type 1 diabetes can only be achieved by good control, but what is good control and how do you know that you and your child are achieving it?
HbA1c is a marker of the stickiness of the blood. The stickier the blood the greater the risk of the short and long-term complications of diabetes. In people without diabetes HbA1c is around 30 mmol/mol.
Research and national recommendations suggest that in patients with diabetes, aiming for an HbA1c of 48mmol/mol is associated with the best long-term outcome and increased survival into adult life.
HbA1c is only measured every 3 months in clinic - it is therefore important that on a weekly basis you are able to recognise whether or not you are on track to achieve your target HbA1c, in order to keep you or your child as healthy as possible.
HbA1c is closely linked to average blood glucose (bG). In patients doing the recommended 5 bG readings per day, or more, looking at the average bG on your meter once per week can give you a good indication of how you are doing, or indicate the need for some changes.
It is important to agree at clinic or with your specialist nurse what a realistic target is - not everyone can achieve a target of 48 mmol/mol, but the lower the better.
The table below shows how HbA1c relates to average bG:
|
HbA1c (mmol/mol) |
Average Blood Glucose (bG) |
|
48 |
7.7 |
|
53 |
8.5 |
|
58 |
9.3 |
|
63 |
10 |
|
68 |
10.5 |
|
75 |
11. |
The AVERAGE of your bG will be the middle number of all your readings, worked out by adding up all of their values, and then divided by how many there are: Example: 8.5 + 11.2 + 4.3 ÷ 3 = 8 mmol/mol
However, no need to worry, as the meter will work this out for you. Below is what to do, in four easy steps.
The meter displays your bG averages for the time range you choose (7, 14, 30, 60, or 90 days).
Find it via: Main Menu > My Data > Reports > bG Averages
The meter displays a pie chart illustrating your bG records as “Above,” “Within,” “Below,” and “Hypo” for the time range you choose (last 7, 14, 30, 60, or 90 days).
Main Menu > My Data > Reports > Target
Last 7 Days = time range
Overall = meal selection
Above/Within/Below/Hypo = blood glucose test result categories
Pie Chart = represents the percentages for the blood glucose test result categories
Simply scrolling through readings on your meter is rarely helpful in recognising patterns or keeping track. We appreciate that life is busy, but many families find it helpful to spend 15 minutes, once per week to check the meter and make a plan for the week ahead.
The following 2 easy checks can help to know if you are on track or whether something needs to change.
- What is my average bG level? Is it above or below the target I agreed?
- What is the pattern of my bG level? Am I having more high or low bG levels than I would like?
As a rough guide, aiming for half of all bG levels to be between 4 - 7, with less than 10% of bG levels being below 4 is a good place to start.
You should agree this pattern with your diabetes team.
There are many ways to get support in sorting high bG levels:
- Spend some time looking in more detail at patterns. Write out the bG levels by time of day, or ask to be trained in uploading your meter to diasend (the system we use in clinic) if you prefer a screen to paper
- Ring the diabetes team on 01254 732 558
- Email or text your specialist nurse for advice
If bG levels aren't in target and you don't know why, then please get in touch. Your team are there for you, to achieve your aims, and to keep you healthy now and in the future.
Paediatric Diabetes Specialist Nurses Office: 01254 732 558
Carol Wade Mobile: 07866 441 041
Vicky Phillips Mobile: 07973 315 298
Clair Kneale Mobile: 07713 089 470
Karen Smith Mobile: 07943 579 965
Sarah Hilton Mobile: 07943 580 088
Paediatric Diabetes Dietitians
Julie Wood and Alison Ashworth office: 01254 732 463
