Ace your tests

Diabetes by numbers

A review of a simple memory device – the ABCs – will help you manage your diabetes:

A is for A1c. Short for HbA1c, this blood test is a measure of your average blood glucose levels (BGLs) during the past two to three months. Persistent high blood glucose levels can lead to diabetes-related complications such as heart, eye, kidney and nerve damage. Keeping blood glucose levels in your target range can help reduce the risk of developing these complications.

B is for blood pressure.

Blood pressure is a measure of the force of circulating blood on the walls of your blood vessels. High blood pressure increases the risk of heart disease, stroke, eye damage and kidney damage. This means that managing blood pressure is just as important as managing blood glucose levels when it comes to preventing diabetes-related complications.

C is for cholesterol. A blood test for cholesterol will usually measure the different types of fats in your blood, including LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides (TG). As with high blood pressure, high blood fats can increase the risk of heart disease, stroke and other diabetes-related complications. Because diabetes increases the risk of heart disease, it’s recommended that people who have diabetes keep their levels even lower than someone without diabetes.

AA1c (HbA1c or Glycosylated haemoglobin)

Procedure: Blood test, either by blood draw or fingerstick; no fasting required.

How often: Generally 2-4 times a year, depending on the type of diabetes you have, how it is managed and your results. Target: Under 7 per cent (53mmol/mol) as a guide, but it depends on factors such as age and diabetes type. Discuss your HbA1c target with your doctor. Protects: All key body systems, from the heart to the feet. Keeping BGLs in target helps to prevent or minimise the risk of diabetes-related complications. Action items: If your results are outside your target, discuss what changes you could make (lifestyle and/or medication) to manage blood glucose. Set a follow-up visit to measure the effectiveness of those changes.

BBlood pressure

Procedure: A non-invasive test performed using an inflatable arm cuff and a stethoscope to measure systolic and diastolic pressures.

The cuff must be the right size for your arm and shouldn’t be too tight before inflation. Your arm should be resting on a flat surface or held by the clinician at the level of your heart. Your feet should be flat on the floor. Target: Under 130/80 mm/Hg. Protects: The health of your blood vessels. Keeping blood pressure in check reduces the risk of having a heart attack or stroke, and of developing eye and kidney disease. Action items: If your top number is between 130 and 140, your doctor will likely suggest you try to reduce your blood pressure by making lifestyle changes (such as reducing salt intake, upping your intake of fruit and vegetables and exercising regularly) as well as losing weight, if needed. If the top number is over 140, your doctor will likely prescribe medication.

CCholesterol panel

Procedure: Blood test to measure blood lipids (fats); fasting required. How often: At least annually in most adults.

Target: Total cholesterol: under 4mmol/L, LDL: under 2mmol/L, HDL: above 1mmol/L, and Triglycerides: under 2mmol/L

Protects: Blood vessel health. Keeping blood fats within this range helps to reduce the risk of heart disease and stroke.

Action items: Lifestyle changes (including a heart-healthy diet and regular exercise) are the first steps to improving blood fats, but some people will also need cholesterol-lowering medications, such as statins. If LDL levels are above target, try switching saturated fats (found in animal foods, palm and coconut oil) for the healthier monounsaturated and polyunsaturated fats (found in nuts, seeds, avocados, fish and olive oil) and increase your intake of soluble fibre, from foods such as barley, oats and legumes. If you have high triglycerides, up your intake of omega-3 fats (found mostly in oily fish, but also plant foods such as chia and linseeds), avoid or limit alcohol and mimimise added sugars. Losing weight, if you are carrying extra weight, can also help to improve blood fats.

A1C percentages don’t compare easily with the numbers on your meter, says diabetes educator Marcia Draheim. For example, an HbA1c of 7 per cent (53mmol/mol) translates to an average blood glucose level of 8.5mmol/L.