ASK DR LINJAWI

What does the three monthly HbA1c indicate?

Dr Linjawi says: Our glucose levels go up and down, and if you have diabetes, these swings can be substantial. Measuring your blood glucose level might give an idea of overall control, but is not an accurate reflection of what is really happening. Glucose binds to a molecule in your blood called haemoglobin. Most people have four types:

A1, A2, B1 and B2. Glucose binds to the haemoglobin A1 chain (HbA1) and alters it. The new compound with glucose added is termed HbA1c. The value is defined as a percentage of the total, or what percentage of your total haemoglobin has been altered by glucose, or how much is HbA1c versus HbA1, A2, B1 and B2. An HbA1c target of less than 7 means less than 7 per cent of your haemoglobin is altered by glucose rather than glucose levels. An HbA1c of 8.5 per cent sounds okay, but it means the blood sugar average is 11.5mmol/l, so your values might range from 4 to 17mmol.