Living with diabetes and understanding the HbA1c check

25 November 2019
Since 2010, I’ve been included in the growing number of people living with diabetes in the UK, a serious and lifelong condition which now affects 1 in 15 of the UK population*.

And just like the 4.7 million people living with the condition in the UK*, I’ve had to follow a twice-yearly ritual of getting an HbA1c test taken. Thankfully, the results from my first test of 2019 showed my management of the condition had improved.

What’s an HbA1c check?

I like to look at the HbA1c check (also known as Haemoglobin A1c) as an M.O.T for people who have diabetes. Just as you would get your car M.O.T done each year to check its roadworthiness, people with diabetes get a half-yearly but sometimes yearly check to give their Diabetic Nurse and GP an idea of how well they’re managing their condition.

Put simply, HbA1c is your average blood glucose (sugar) levels for the last two to three months. In medical terms HbA1c is known as glycated haemoglobin. Glycated haemoglobin is produced when the glucose in your body attaches to your red blood cells. Because people with diabetes are unable to produce enough, or sometimes any insulin, to stabilise glucose levels within the body, more glucose starts to stick to the red blood cells. Over time if there’s too much glucose in the blood, it can damage blood vessels leading to serious long-term health problems.

The HbA1c result can be presented either as a percentage but this is less common now. The current standardised UK method of presenting a HbA1c result is as a mmol/mol.  All that means is that it’s a number rather than a percentage.

A question I get a lot is what’s a ‘normal’ reading for someone who doesn’t have Type 1 or Type 2 diabetes?

A question I get a lot is what’s a ‘normal’ reading for someone who doesn’t have Type 1 or Type 2 diabetes? Well they’d typically have an HbA1c reading of below 42 mmol/mol (below 6.0%). Someone with prediabetes (when someone’s health condition means that their blood sugar level is higher than normal, but not yet high enough to be diagnosed with diabetes) will typically have a reading of 42 to 47 mmol/mol (6.0% to 6.4%) and someone with diabetes will likely see HbA1c readings of 48mmol/mol (6.5%) or more.

It can be a daily struggle to keep glucose levels at an optimum level. Stress, diet, and exercise to name a few, can all impact one’s glucose levels. And over time this will impact an HbA1c reading. So it’s normal to see movement in an HbA1c reading from one check-up to the next. My readings tell me that even though life can get in the way, the importance of managing my condition should never be an afterthought.

Why does HbA1C matter when buying life insurance?

Our Diabetes Life Cover, which is Life Cover designed specifically for people with Type 1 or Type 2 diabetes, it uses a shorter, more tailored application process and has a different underwriting philosophy, improving the experience of buying life insurance.  

Another benefit of our cover is that if the latest HbA1c test reduces and falls into lower band then your client’s monthly payment could be reduced.

BandYour initial result
%mmol/mol
1 Less than 7.0% Less than 53.0
2 7.0% - 7.99% 53.0 - 63.8
3 8.0% - 8.99% 63.9 - 74.8
4 9.0% - 9.99% 74.9 - 85.7
5 10.0% - 10.99% 85.8 - 96.6
6 11.0% or greater 96.7 or greater

For example, let’s say I took out Diabetes Live Cover when I was first diagnosed. My HbA1c reading was 60mmol/mol (7.6%), putting me into band 2. But the following year my reading was 50mmol/mol (6.7%) so a drop from band 2 to band 1. The good news is this would mean a reduction in my monthly payment.

But my HbA1c result soon increased – so what would that have meant? Well our cover has capped reviewable premiums. This means that while your clients are rewarded for lowering their HbA1c, if their condition worsens and their HbA1c increases, their monthly payment will never increase above the starting amount. Even if that result pushes them into a higher band.

As my next HbA1c check-up is just around the corner, I’m hoping to see a continued improvement in the result. Good news for my health and good news for my pocket as well. So, why not have a think if you have any clients who might also benefit?

I recently ran a webinar to help advisers better understand the features and benefits of Royal London’s Diabetes Life Cover. You can watch the webinar here. There’s also a lot of information and useful tools to use on the Royal London website to help you discuss this cover with those clients who have diabetes.

*Source: Diabetes UK annual diabetes prevalence figures (published January 2019)

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About the author

Gregor Sked

Protection Development and Technical Manager

Gregor’s exposure to financial services began back in 2011. Most of his early career was spent at Standard Life where he was a presenter in the workplace pension engagement team. He joined Royal London in 2018 to spend more time on protection in the Intermediary market. Gregor is involved in developing adviser facing content, presenting, writing articles and commenting for the press. Gregor is also studying towards a Diploma in Financial Planning through the CII. Even though he spends most weeks travelling the length and breadth of the UK for business, in his spare time he loves travelling the world and planning future adventures. He also loves cooking, running and when he’s not travelling can be found on the golf course patching up all the divots he’s made.

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The Royal London Mutual Insurance Society Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. The firm is on the Financial Services Register, registration number 117672. It provides life assurance and pensions. Registered in England and Wales number 99064. Registered office: 55 Gracechurch Street, London, EC3V 0RL.