Many patients check a fasting sugar before every clinic visit, eat carefully for two days beforehand, and get a reassuring number. The reassurance is not real. One reading describes one morning.
What HbA1c measures
Glucose sticks to haemoglobin in your red blood cells, and those cells live about three months. Measuring how much is stuck gives an average of your blood sugar over that whole period — no fasting, no preparation, and nothing you can tidy up the week before.
- Below 5.7% — normal
- 5.7% to 6.4% — prediabetes; this is the stage where diet and walking still change the outcome
- 6.5% and above — diabetes
- Under treatment — most adults are aimed at under 7%, though your doctor may set a different target for your age and other conditions
Why the number matters more than it feels
Diabetes does its damage quietly. By the time there are symptoms, the kidneys have often lost function, the retina has changed, or nerve damage in the feet has set in. Each of those is far easier to slow than to reverse. That is why a diabetic review is never just a sugar test — it should also look at:
- kidney function: creatinine, urea, electrolytes and urine protein
- cholesterol, because heart disease is what most diabetic patients are actually at risk from
- the feet, examined for sensation and circulation
- the eyes, checked by an ophthalmologist
How often
HbA1c every three months while treatment is being adjusted, every six months once it is stable. Kidney and cholesterol checks at least yearly.
Our Diabetic Care Package brings the sugar, HbA1c, kidney, cholesterol and ECG checks into one visit, and our medicine and endocrinology consultants sit most afternoons. If you have had diabetes for years and have never had your kidneys checked, start there.
