Monitoring Diabetes

Home Blood Glucose Monitoring, Hemoglobin A1c Testing, and Fructosamine Tests

There are many way to monitor your diabetes and your diabetes control. Daily information is valuable to make decisions in the moment, while longer term tests like A1c and Fructosamine provide a higher level view over a longer time period. Hemoglobin A1c tests tell you and your healthcare provider what your glucose control has been on average over the past two to three months. The fructosamine test is similar to an A1c but measures your average glucose over roughly two weeks. Each type of test has its advantages.

Home Glucose Monitoring

Home glucose monitoring provides a "snapshot" of how your glucose treatment program is doing at one moment in time. This information is particularly important to help you tailor your daily eating program and medication needs to keep glucose in a healthy range. Daily monitoring is vitally important to tell you if the symptoms you are experiencing - sweats, feeling faint, etc. - are the result of a low glucose reaction (hypoglycemia) so you can treat this problem quickly. Home glucose monitoring is also important when you are sick, or under stress, as it provides you with information you need to make immediate adjustments in your treatment program to keep your blood glucose level in range. By keeping track of glucose levels over a period of weeks, you can begin to see patterns and identify ways in which food, exercise or other factors influence your blood glucose levels. Daily glucose monitoring now comes in many forms by using either a blood glucose monitor or a continuous glucose monitor (CGM). Ask your provider which method may be best for you.

Hemoglobin A1c Testing

While home glucose monitoring is like a snapshot, hemoglobin A1c testing is more like a full length movie - it provides an average view of your glucose level over a period of two to three months. Usually conducted through a lab, these results can be reported the same day in some cases. For people who have not undergone any major changes in their lifestyle or diabetes regimen, hemoglobin A1c tests provide a good assessment of long-term glucose control.

Since A1c is an average, a normal hemoglobin A1c test does not always mean that your glucose has been under control continuously for the past 2-3 months. In fact, since and A1c is an average value, sometimes people with swings in blood glucose levels — lots of highs and lows — would also have a normal hemoglobin A1c. This is why daily glucose readings are also important. The target A1c level is below 7%. An A1c above 7% requires treatment plan changes that should be discussed with your healthcare provider.

Fructosamine Test

The fructosamine test is another measure of glucose control, although it is not as commonly used. The main advantage of the test is that it can detect overall changes in blood glucose control within a few weeks, rather than months. Fructosamine levels indicate the level of glucose control over the past two or three weeks. So, when changes are being made in a diabetes treatment plan, this test can indicate in a more timely fashion than an A1c test, how well the changes are working and whether other changes should be considered. This test is usually conducted through a lab and is ordered by your healthcare provider.

Although this content is reviewed by Joslin Diabetes Center healthcare professionals, it is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.