Understand type 1 Explainer

HbA1c explained without treating it as a grade

Written by Updated 1 January 2025 2 min read
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The 60-second answer

HbA1c is a way to see your average blood glucose over about three months. It’s not a grade; it’s a guide.

  • The NICE target for adults is 48 mmol/mol or lower. This helps reduce complications.
  • HbA1c shows trends, not daily highs and lows. It helps with long-term planning.
  • Your target may differ based on personal circumstances. Discuss this with your diabetes team.
Living with HbA1c

What it means day to day

Understanding your HbA1c can help you make informed decisions about your daily diabetes management. It’s a tool for seeing how well your overall plan is working, rather than focusing on individual readings. By tracking your HbA1c over time, you can identify patterns and make adjustments to your insulin regimen, diet, or activity level with your diabetes team’s guidance.

Setting targets

What targets mean

The NICE target for adults with type 1 diabetes is an HbA1c of 48 mmol/mol or lower. Achieving this target can help reduce the risk of complications like eye and kidney problems. However, targets can vary based on individual circumstances, such as age, lifestyle, and other health conditions. It’s important to have a discussion with your diabetes team to set a target that’s right for you.

What varies

What can affect HbA1c?

Several factors can influence your HbA1c levels. Insulin doses and carbohydrate intake directly affect glucose levels. Physical activity can move glucose either up or down, depending on your insulin levels, the timing of your meals, and the type of exercise. Stress levels can also impact glucose, often raising it, but the effect can vary.

insulin dosescarbohydrate intakephysical activitystress levels
Real-life examples

Examples of HbA1c in practice

Examples, not instructions or doses.

Checking HbA1c

You have a routine check-up and your HbA1c comes back at 50 mmol/mol. Your team suggests looking at your meal-time insulin to see if adjustments could help.

Adjusting targets

After a discussion with your team, you set a personal target of 55 mmol/mol due to other health considerations.

What to notice

Worth paying attention to

HbA1c does not show daily fluctuations.
Always discuss target changes with your diabetes team.
Regular HbA1c tests help track long-term glucose control.
What to ask your team

Questions that make an appointment useful

"What should my personal HbA1c target be?"
"How often should I check my HbA1c?"
"What factors might change my HbA1c target?"
Sources