The A1c, a blood test showing overall blood glucose control, is sometimes known as glycated hemoglobin or HbA1c. This test is usually done in medical labs, though some medical offices, pharmacies and diabetes education clinics have portable machines. The A1c measures the amount of glucose attached to a protein called hemoglobin, found in red blood cells. Once the glucose is attached, it stays there for 90 to 120 days - the life of a red blood cell.
A1c is measured in a percentage and can be compared to blood glucose levels. If blood glucose levels are within the goal range of 4 to 7 mmol/L, then the A1c should fall between four to six per cent. A difference may emerge between blood glucose levels recorded over the last three or four months and the A1c result. In this case, glucose testing should be done more often or testing times varied to isolate possible highs and lows throughout the day. Canadian Diabetes Association guidelines recommend that the A1C should ideally be less than six per cent if safely possible, or in most cases less than seven per cent. The test gives a valuable measure of blood glucose control.
Blood pressure is the second part of the ABC formula. It is measured with a sphygmomanometer, more commonly called a blood pressure cuff. The measurement is presented in two numbers. The upper number is 'systolic,' measuring pressure in the arteries when the heart is contracting. The lower 'diastolic' number measures pressure in the arteries when the heart is between beats or at rest.
Blood pressure changes through the day in response to rest, activity and stress. Normal blood pressure is about 120/80. Recommended blood pressure for those with diabetes is less than or equal to 130/80. Many studies show that tighter blood pressure control decreases the risk of stroke, heart attack, diabetes eye disease (retinopathy), and kidney disease related to diabetes (nephropathy).
Blood pressure can be measured in your doctor's office and diabetes education clinics. As well, you can drop by a local pharmacy or purchase your own home blood pressure monitor.
Cholesterol is a soft waxy substance found in the blood. This type of fat is important in cell development and hormone production. Most cholesterol in the blood is made by the liver, with only 20 per cent coming from the food we eat. If these excess fats build up in the blood, they can accumulate on the walls of the arteries, causing blockages.
Cholesterol is measured by a lab blood test called a cholesterol or lipid panel. This test shows total cholesterol, which can be broken down into LDL (low-density lipoprotein) and HDL (high-density lipoprotein). The results also check triglycerides, another type of fat found in the blood.
LDL is often called 'bad' cholesterol as it builds up on the walls of the blood vessels. HDL is the 'good' cholesterol. It helps carry LDL cholesterol away from the artery walls back to the liver. There, it is broken down and removed from the body. Diabetes often causes higher LDL cholesterol and triglycerides and lower HDL cholesterol, which must be treated.
Careful management of the ABCs helps reduce the risk of cardiovascular disease. For some the ABCs can be managed with lifestyle changes involving nutrition, exercise and stress management. For others, medication can be prescribed to help target problem areas. If you have diabetes, discuss these tests and medications with your family doctor, diabetes educator or local pharmacist. Keep informed and aim for good management of your diabetes. Short-term changes can result in long-term benefits by decreasing the risk of complications such as cardiovascular disease. Watch your ABCs!