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LIVINGLIVING

THE LAW OF

AVERAGESWhy is there such tyranny about HbA1c? Do you sometimes

feel that you are a number and not a person? The good news is

that you should soon be talking more about Time In Range.

By Sue Marshall

bA1c has been used

since the mid-1970s

as a quantifier of how

someone is doing in

terms of their diabetes

control. Over the years many diabetics

feel that it has often been used as a

stick to beat them with, that it is more

important than other factors involved

in their diabetes control. But it is also

the case that many doctors as well as

diabetics have been calling for broader

ways to assess diabetes control. The

phrase that is gaining credibility now is

'time in range' (TIR). In this article I'll look

at what this is, how it is assessed, and

whether it should be used instead of, or

as well as, the HbA1c measurement.

It's stating the obvious, but HbA1c

(see glossary at end for the science) is

one of the least patient-friendly references

around - it's not even a phrase. Over in

the US they call it A1c, and sometimes

given a slightly more palatable 'glycated

haemoglobin' (yeah, slightly). Most

diabetics understand it as being an

average of the last three-months of blood

glucose levels and it's been the core factor

in our care for most of our diagnosed lives.

It is presented as the be-all and end-all of

our control, and we may feel judged as to

our success based on this one figure. But

is it the best tool for assessing us?

HbA1c is blood test bingo on a larger

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