For those that are new to Gatekeeping and Type 1 Diabetes, welcome to the holy grail test for Type 1’s. They say the best way we can learn things, is through self experience. And while I almost 100% agree with this sentiment, there’s no harm in reading the prologue first!
HbA1c (also referred to as A1C) stands for glycated hemoglobin. It develops when haemoglobi, a protein in red blood cells that carries oxygen throughout your body joins with glucose in the blood, becoming ‘glycated’. (It also gives blood its red colour). Red blood cells last for about 120 days before they are recycled in the spleen. During the red blood cells lifespan, glucose will stick to the hemoglobin, depending on how high or low the blood sugar level is. For example, glucose attaching to the lens in the eye can lead to cataracts developing, or attaching to soft tissue in the shoulder can lead to frozen shoulder. So in short, the test measures how much glucose is ‘stuck’ to the hemoglobin.
Because of the red blood cells lifespan, the HbA1c test is taken every 3 months. Most often, the endocrinologist will send your Warrior for the test just before the consultation. The test itself is not a huge rigmarole, you’re even able to use your own pricker/lancet to draw the blood – which the nurse will then take from their finger with the test strip and insert it into a little machine to obtain the reading. The result is almost immediate and you will discuss this in detail with your doctor. Fasting for the blood test is not necessary.
The proof is in the pudding
The HbA1c test is like a certificate you get every 3 months. Its become the ‘gold standard’ of assessing diabetes control. There have been times where we’ve celebrated Eva’s result with a glass of bubbly and there have been times where we’ve needed to go back to the drawing board. In the past I’ve found myself getting quite worked up about it, subconsciously using it as representation of how good a parent I am. Silly I know, so let me save you the time and energy, there’s no reason to fear this thing! With time, I began to see the test rather as a really important tool that equipped us to achieve the best average blood glucose level we wanted for the next time.
Interpreting the results
HbA1c test results are measured differently to normal sugar readings and therefore need to be understood independently. For example, if you check blood glucose 100 times in a month, and your average result is 10.5 mmol/l this would lead to an HbA1c of approximately 8.2%. (but don’t worry the machine does this calculation for us). The more glucose in the blood, the higher the percentage of glycated HbA1c cells there’ll be, and the higher the result. The diagram below show’s the approximate HbA1c result against the average sugar reading, over a 3 month period:
Move on and do better next time
So you got your Warrior’s result and now you want to stick your head in a hole like an ostrich. Remember one blood glucose check in isolation will not tell you the whole story. This is why self-monitoring sugar levels is so valuable. Getting the results is one thing, but knowing what to do with them is key. If your’e not happy with your Warrior’s result – use it to help you to make better decisions and adjustments. Remember you’ve got this. YOU are in the driver’s seat, not T1D!
Thanks for reading. Remember we’re all in this together. Without community, we’re alone. And managing this condition alone is very challenging and lonely! Please feel free to browse my blog for other articles and if there’s any topic you’d like to know more about-do let me know and I’ll try to feature it in my next post! You can also find me on Facebook and Instagram. Or simply subscribe below and keep up to date with my latest discoveries on this condition 🙂