For patients with type 1 diabetes, the HbA1c we measure in clinic is often the scariest thing about coming to see the team. HbA1c is a measure of how much glucose is stuck to your red blood cells, therefore reflecting what blood glucose levels have been like for the last 3 months (which is the lifespan of a red blood cell). This average is not actually your average blood glucose level- for example an HbA1c of 7% reflects an average blood glucose level of about 8.6mmol/L. We measure this level in clinic because currently it is the best way for us to predict the likelihood of getting complications later in life. We know that if you keep your HbA1c below 7%, the chance of getting diabetes related complications is very low.
We have recently set up an HbA1c working party, tasked with the mission of lowering the overall HbA1c across all patients and clinics run by PMH. The first part of this was to establish a target. After looking at the science, we have determined our target to be less than 7%. This is the message you will hear in clinic from now on. Then we looked at all aspects of our service to find ways that we can enhance our service to improve clinical outcomes. These aspects are:
- Focussing on diabetes management in toddlers
- Interpreting insulin pump downloads, and giving consistent advice to patients on how to make changes
- Encouraging newly diagnosed patients to begin carbohydrate counting when they are discharged from their first admission
- Tighter blood glucose control at diagnosis while in hospital
- Review of newly diagnosed clinics
- Determining a pathway for improving HbA1c in patients with poor glycaemic control
- Ongoing discussion with our Consumer Engagement group
We look forward to taking you on this journey as we strive towards better outcomes for patients with type 1 diabetes. Join us, as we challenge everyone to reach 7% HbA1c.