1.2 Read your report without panic

WHAT YOU WILL LEARN
Tell the difference between fasting glucose, after-meal glucose and HbA1c, and prepare useful questions about a report.

THE SIMPLE EXPLANATION
A glucose reading is a photograph of one moment. HbA1c gives a longer view of recent glucose exposure, roughly the previous three months. Neither tells the entire health story. Record when a sample was taken, whether you had eaten and whether you were ill. A home meter helps daily decisions but does not by itself establish a diagnosis.

For a laboratory HbA1c, below 5.7% is commonly classified as the normal range, 5.7–6.4% as prediabetes, and 6.5% or above as the diabetes range. A laboratory fasting plasma glucose of 126 mg/dL or above is in the diabetes range. Diagnosis normally needs confirmation unless there are clear symptoms or an unequivocal clinical situation. Let the clinician interpret results rather than diagnosing yourself from a single number. Pregnancy uses different testing arrangements.

YOUR PERSONAL TARGET IS A SEPARATE QUESTION
A diagnostic threshold is not automatically your treatment target. Age, medicines, pregnancy, complications and risk of low glucose affect the plan. Ask your clinician to write your own targets. Anaemia, some haemoglobin conditions, recent transfusion and some kidney problems can make HbA1c misleading. Tell the clinician about these.

AN INDIAN HOME EXAMPLE
Savitri checks after breakfast on one day and before lunch on another. Comparing the two readings as if they were taken under the same conditions may cause unnecessary worry. A small note beside the number makes the record more useful. This is a fictional teaching example.

YOUR PRACTICE
Create five columns: date/time; glucose and unit; relation to food; medicine/activity/illness; symptoms. Keep the record on paper if that is easier. Do not keep testing every few minutes out of fear unless your care team has told you to do so.

ASK AT YOUR APPOINTMENT
What is my HbA1c goal? When should I test at home? Which reading means I should call? When should the laboratory test be repeated?

REMEMBER
Bring the actual report and medicine list. A screenshot of one ‘good’ value is not a remission certificate.

Sources and further reading

• https://www.niddk.nih.gov/health-information/diagnostic-tests/a1c-test/
• https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/diabetes/diabetes-prediabetes