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Layout
The HbA1c Tracker has eleven parts:
- Info box
- Body
- 3 drag and drop HbA1c (%) headings
(tight, medium, loose)
- 3 drag and drop Glucose (mg/dl) headings
(tight, medium, loose) for plasma blood glucose readings
- 3 drag and drop Glucose (mg/dl) headings
(tight, medium, loose) for whole blood glucose readings
Capacity
The body of the HbA1c Tracker is divided
into 120 rows, one row per glucose reading. At an average of 4 readings
per day, one printout covers one month. At 8 per day, two printouts cover
one month. The headings and body are divided into 12
columns. The 10 center columns (marked by a yellow band on the headings)
define the range of readings covered for tight, medium and loose control.
Each of the 10 center columns covers an equal range of readings.
|
Plasma Blood Glucose
(Newer Home Glucose Meters) |
|
|
|
Color code |
Glucose
control level |
Interval and
maximum predictive accuracy |
Covered
range |
| Blue |
Tight |
7
mg/dl, 0.2% HbA1c |
97-167
mg/dl, 4.9-6.87% HbA1c |
| Green |
Medium |
18
mg/dl, 0.5% HbA1c |
83-260
mg/dl,
4.5-9.47% HbA1c |
| Red |
Loose |
36
mg/dl, 1.0% HbA1c |
65-420
mg/dl,
4.0-13.97% HbA1c |
|
|
|
Whole Blood Glucose
(Older Home Glucose Meters) |
|
|
|
Color code |
Glucose
control level |
Interval and
maximum predictive accuracy |
Covered
range |
| Blue |
Tight |
6
mg/dl, 0.2% HbA1c |
87-146
mg/dl, 4.9-6.87% HbA1c |
| Green |
Medium |
15
mg/dl, 0.5% HbA1c |
75-224
mg/dl,
4.5-9.47% HbA1c |
| Red |
Loose |
30
mg/dl, 1.0% HbA1c |
60-359
mg/dl,
4.0-13.97% HbA1c |
The first and twelfth columns collect
"overflow" readings not covered in the ten center columns.
First time setup
Open in Microsoft Word. Type name and
start date in info box. The HbA1c Tracker is set to open the first time
with the medium control headings for HbA1c and plasma blood glucose in place.
If your meter tests whole blood glucose, replace the glucose heading with the
medium whole blood glucose heading. If you are unsure which type of
readings your meter gives, check your instruction book or contact the
manufacturer.
Drag all unconnected HbA1c and glucose headings
to second page. Print page 1.
Record readings from glucose
monitor as dots
Keep your Tracker sheet with you.
Whenever you test your blood record the reading as dot on the chart.
To record a reading simply find the column where
the reading falls and use a pencil or pen to make a dot on a red cross in that column.
Each row should contain only
one glucose reading. Always start a new printout with the row closest to the glucose heading.
Stack readings to form
histogram (for more on histograms see HbA1c Tracker overview)
Shade the cells within columns to construct histogram.
For every dot in a column one cell should be shaded. However, not every
cell with a dot will be shaded. This is because dots are spread out in the tracker, but shaded cells are
stacked. For example, the column in the diagram (which is turned sideways)
has dots in rows 1, 14, 32, 53 and 74. To form this column's portion of the
histogram, collapse readings to the first five cells (starting with the
cell closest to the glucose scale).
Readings can be stacked as dots are entered,
stacked when all rows are filled, or stacked in batches at anytime in-between.
Interpreting first histogram
At the end of the month, analyze
completed histogram.
Size up the shape and tightness- Does histogram have an identifiable "shape"? Is it symmetrical
(like a bell curve)? Do most readings cluster in just one of the ten
center columns? Do they pile up in one or both "overflow"
columns? Compare to model shapes and troubleshoot as indicated.
Estimate the first month's HbA1c range- In a
symmetrical histogram with a pronounced central bar, the range of the central
bar corresponds to the most likely HbA1c range over the previous month. Of
course, this assumes the histogram is made up of glucose tests that are both
accurate and representative, and that a large enough readings sample has been
included.
If a user's first month histogram prediction is
materially different from her most recent lab result, she should review the histogram with
her health care professional before starting a new one or
adjusting goals.
Setting goals and improving
control
The layout of the HbA1c Tracker and the
tool's monthly frequency lend themselves to incremental goal setting and the
notion of continuous improvement. For some users it may be beneficial at the
start of a new sheet to draw in lines representing "must hit" goals:
- Line(s) representing upper (and/or lower)
glucose limits
- HbA1c range
In the case of glucose limits, the cause of
each reading outside the goal should be explained and noted by hand on the
tracker.
In order to get the most from setting goals for
continually improving, users should:
- Set realistic goals-- goals that can be
reached, but require increased effort
- Tighten goals each month
- Always involve their health
care
provider
- Never set goals that jeopardize other
aspects of their diabetic therapy or endanger their health
Predicting HbA1c
Prior to a lab test average the estimated HbA1c for the
preceding three months to determine your overall estimate. For
example, suppose there are these estimates: Month One 6.7 to 6.87 HbA1c, Month Two
6.5 to 6.67, and Month Three 6.3 to 6.47. Add the lower members and divide by
3. Then add the higher members and divide by 3. This gives the
3 month estimate. So, (6.7 + 6.5 + 6.3) / 3 = 6.5 and (6.87 + 6.67 +
6.47) / 3 = 6.67. The three month HbA1c estimate is 6.5 to 6.67.
A number of factors can cause actual HbA1c
to differ from the estimate. Users should always review with their health
care professional any disparity between an HbA1c result and the estimate
obtained from the Readings Tracker. When analyzing results with their
health care provider, users should also provide their completed Tracker sheets. This documentation
will assist the provider in spotting underlying problems.
Day to day tracking
The HbA1c Tracker may be used to follow
movement in day to day glucose readings. Dots may be connected to form a time series,
color coded to compare readings from different times of day, or easily
partitioned to show changes from day to day or week to week.
How the HbA1c Tracker is used in this regard
depends on the nature of the logs and charts are already kept by users.
The Tracker visually demonstrates changes from range to range (column to
column), but does not capture individual readings. It is not meant to
replace logging and tracking individual glucose reading numbers.
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