What is it about an HbA1c that makes you nervous?
Thursday, 27 May 2021
Many people comment that having their HbA1c (glycosylated haemoglobin) pathology test done causes them stress and/or anxiety. Before we look at what causes this anxiety, let’s first look at what the test is.
What is an HbA1c?
The HbA1c is a routine diabetes blood test your doctor will request if you’re living with diabetes. It’s done at least every six months and provides an average of your blood glucose levels over a period of time.
Haemoglobin is a protein in your red blood cells. Its main job is to carry oxygen around your body. When moving throughout the body, the glucose in blood sticks to the haemoglobin and becomes glycated (covered with glucose). The glucose remains stuck there for the life of the red blood cell. This is around 8 to 12 weeks. The more glucose that’s stuck to the haemoglobin, the higher your HbA1c.
For most people, the target HbA1c is 7 percent or 53 mmol/mol.
On your blood tests result report, you will see two numbers: a percentage (old way of showing the result) and a number which is the new way and now more internationally recognised/used.
Targets are individualised for each person. Generally, the higher the HbA1c the greater the risk of diabetes complications developing.
To help you understand the HbA1c the table below shows what your average blood glucose level would be at a certain HbA1c.
|HbA1c||Average blood glucose level|
|7% (53 mmol/mol)||8.6|
|8% (64 mmol/mol)||10.1|
|10% (86 mmol/mol)||13.3|
|12% (108 mmol/mol)||16.5|
Now that you have some more information regarding the test itself, here’s two of the most common reasons you might feel anxious about your HbA1c and getting it monitored.
Worry that your doctor may think you’ve done a bad job of managing your diabetes
Although your doctor gives you a target to aim for it’s not always possible to get to that target.
Several things can affect the HbA1c result such as stress, illness, pain and steroid medications. When there are outside influencing factors such as these it becomes very hard to keep your blood glucose levels in target range.
In these situations, it’s important to address the underlying problem(s) which will then help your diabetes management.
Also, it’s important to remember that diabetes is a progressive condition, meaning that despite your best efforts to manage your diabetes it can progress due to other factors outside your input such as age and genetics.
Over time, blood glucose level numbers may creep up due to no fault of your own. It does not mean that you have done a bad job.
Concern that having a high HbA1c will lead to diabetes complications
If your HbA1c is elevated for a long time then the risk of complications increases. There are many other factors aside from the HbA1c which can affect the risk of developing complications. These factors include high blood pressure, smoking, high cholesterol and little physical activity.
If you think of an HbA1c as a guiding tool, not a test which you pass or fail, then your relationship with your HbA1c will improve.
It’s not there to shame you or make you feel bad if you don’t meet your target. It can guide treatment decisions and provide a record of how your diabetes is going. If the HbA1c is above target then changes to diabetes management may be made. These could include food choice or portion changes, activity, medication review or a few changes at once.
Be kind to yourself and don’t automatically blame yourself when things don’t go exactly to plan.
If you are wanting to speak with a diabetes educator regarding the HbA1c call the NDSS helpline on 1800 637 700.