People with diabetes have a higher chance of developing other problems such as heart attacks, damage to the kidneys, nerves and eyes. Over the past few years a lot of research has shown that you are at greater risk of developing diabetic complications if you have a high HbA1c measurement.

The good news is that the risk of developing diabetic complications is very much reduced by lowering your HbA1c levels. This is the case when you inject insulin, take tablets or manage your diabetes by diet alone. This is why it is so important to have your HbA1c measured regularly.

What is HbA1c? The red cells in your body are made of protein and contain haemoglobin. A special form of haemoglobin is called HbA1c. Haemoglobin takes oxygen from your lungs to all the muscles and tissues in the body. Each blood cell only lives for 8 - 12 weeks.

The food you eat is changed into glucose (sugar) and is taken by the blood to all the cells in your body to give you energy. This glucose sticks to the proteins in your body, including the red blood cells. Because the red blood cell only lives for 8 to 12 weeks, we can measure how much glucose has stuck to it and this can tell us how well controlled your diabetes has been over the last 2 to 3 months. In this way haemoglobin may be thought of as being like a magnet that attracts glucose. As haemoglobin gets older, more and more glucose will get stuck to it. Your HbA1c is a measure of the overall amount of glucose that has stuck to your haemoglobin over the last 8 - 12 weeks.

What is the normal level of HbA1c?

The normal level of HbA1c in the blood is up to 6.1% for non-diabetics. For people with diabetes, the level will often be a higher reading of 7.5% or below is acceptable. You will be able to discuss the best level for your with the diabetes team at the clinic you attend.

How often do I need to have my HbA1c measured?

How will my HbA1c be measured?

A sample of blood will be taken from the vein in your arm. The sample will be sent to the hospital laboratory to be analysed. Your result will be ready for you on the day of your clinic appointment.

What are the complications? How does diabetes cause damage?

As we have discussed under HbA1c, the glucose in your blood sticks to the proteins in your body. This not only happens with the red blood cells but also the proteins which made up the walls of all the blood vessels in your body. In turn this can damage the blood vessel walls, particularly the smaller blood vessels at the back of your eyes, in your feet and kidneys and also the small arteries supplying blood to the heart muscle. However, you are less likely to have damaged blood vessels if your diabetes is well controlled. The lower the glucose levels are in the blood, the less there is to stick to the rest of the proteins in your body.

Heart disease (cardiovascular disease)

Damage to the heart and blood circulation caused by fatty deposits on the linings of your blood vessels. This restricts the flow of blood around your body and can cause heart attacks, strokes and limb disease.

What can I do to help myself? 

Eye disease (retinopathy)

Diabetic retinopathy affects the blood vessels supplying the retina - the seeing part of the eye. Blood vessels can become blocked, leak or grow haphazardly. People with diabetes are at risk of developing blindness. Retinopathy is a progressive condition - it develops over time.

What can I do to help myself? 

Nerve damage (neuropathy)

Diabetes can cause nerve damage called neuropathy, e.g. loss of sensation in your feet. Again this is caused by the glucose sticking to the nerves which are made of protein. There are different types of neuropathy depending on which type of nerve is affected.

Signs of neuropathy are:

What can I do to help myself? 

Kidney disease (nephropathy) 

Diabetes can cause damage to the kidneys which is known as nephropathy. If detected early, the condition can be treated successfully in many cases. Kidneys disease (nephropathy) is caused by damage to the tiny blood vessels which supply the kidneys. The walls of these vessels become thickened or irregular and this means they are unable to filter waste products out of the blood into the urine properly.

What can I do to help myself? 

If detected early, kidney disease can usually be well managed.

Helpful hints to prevent complications 

The key to complications is early detection - the earlier they are detected the easier they are to treat.