Home Blood Glucose (Sugar) Monitoring, Hemoglobin A1c Testing, and Fructosamine Tests
Daily home blood glucose (sugar) monitoring tells you what your blood glucose level is at that very moment. Hemoglobin A1c tests tell you and your healthcare provider how your blood glucose control has been over the past two to three months. The fructosamine test is a tool for measuring how well your diabetes treatment program is working that is somewhere between home blood glucose monitoring and Hemoglobin A1c.
Each type of test has its advantages.
Home blood glucose monitoring
Home blood glucose monitoring provides a "snapshot" of how your blood 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 blood glucose in a healthy range. It's vitally important to tell you if the symptoms you are experiencing - sweats, feeling faint, etc. - are the result of a low blood glucose reaction (hypoglycemia) so you can treat this problem swiftly. Home blood glucose monitoring is also vitally important when you are sick, or under stress, as it provides you with information you need to make adjustments immediately in your treatment program to keep your blood glucose level from going too high or too low. By keeping track of blood glucose level 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.
Hemoglobin A1c testing
While home blood glucose monitoring is like a snapshot, hemoglobin A1c testing is more like a full length movie - it provides a view of how your blood glucose level has been doing over a period of two to three months. Usually conducted through a lab, it also suffers less from the problems posed by having an individual measure their own blood glucose -- too little or too much blood on the test strip, or an inappropriately adjusted meter that provides less than accurate results. 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 blood glucose control.
Of course, a normal hemoglobin A1c test does not mean that your blood glucose has been under control continuously for the past 2-3 months. In fact, people with swings in blood glucose levels — lots of highs and lows — would also have a normal hemoglobin A1c. This is why daily blood glucose readings are also important. The target A1c level is below 7. An A1c above 7 and below 8 for more than 6 months, or and A1c over 8, requires treatment plan changes.
A fructosamine test has been available through laboratories since the early 1980s. 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 blood 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. Currently, this test must be ordered and performed by your healthcare provider.