Quantitative Clinical Tests
In diabetes management, there are 3 routinely measured tests that are used to evaluate a person's level of blood glucose control and health in relation to type 2 diabetes. These are known as Glycosylated Hemoglobin or HBA1C, Blood Pressure (BP) and measurement of LDL cholesterol. These values, often called targets, are used by the clinical team to determine how clients are doing in their self-care management strategies. The stakeholder team determined that these measures can be used in combination with qualitative data such as surveys and focus groups to decipher if program interventions are meeting the program outcomes. A brief description of each of these targets is below.
Hemoglobin A1C
This is a test of glucose control over the previous three months. The term describes the slow and irreversible binding of glucose to the hemoglobin molecule. The rate of formation of glycosylated hemoglobin is directly proportional to the blood glucose level during the preceding 120 days which is the average life cycle of the red cell (Conway, 2010). Measurement is done in the laboratory and compliments the daily self monitoring of blood glucose (SMBG) that clients perform themselves. Routine measurement is recommended for all people with type 1 and 2 diabetes every 3-6 months and target is less than 7% (O'Grady, 2006).
Blood Pressure
High blood pressure (> 130/80 mmHg) must be aggressively treated to reduce the risk of long-term complications such as heart attack, stroke, kidney disease and retinopathy. Ideally measured at each diabetes related visit, most clients with diabetes will require medication to control blood pressure in partnership with lifestyle modifications (O'Grady, 2006).
Cholesterol
Like blood pressure, control of cholesterol level is vital to prevent complications such as heart attack and stroke in the person with diabetes. The primary target is Low Density Lipoprotein (LDL) cholesterol. Readings less than 2.0 mmol/L are considered to be at target and similar to blood pressure management, most people will require medication and lifestyle modifications to achieve this target (O'Grady, 2006).