How to read glucose and HbA1c results
Other platforms explain it with text and video. In VMS you practice it on the patient.
Glucose results guide insulin doses at the bedside and diagnose diabetes in the clinic. Low values need action in minutes.
What you need
- Glucose meter and test strips
- Lancet
- Alcohol swab
- Gloves
Step by step
Check a fingerstick correctly
Clean the finger and let the alcohol dry. Prick the side of the fingertip and use a good drop of blood without squeezing hard. [1]
Read it against the meal
Note whether the value is fasting, before a meal or after eating. Timing changes what counts as high. [2]
Act on low glucose
Under 70 mg/dL is low and under 54 mg/dL is clinically significant. Treat at once with fast sugar or IV dextrose per protocol and recheck in 15 minutes. [2]
Read diagnostic values
Use the table below. Without clear symptoms, a diabetes result should be confirmed with a repeat test. [2]
Understand HbA1c
A1c shows the average glucose over about 3 months. It is less reliable with anemia, recent blood loss or transfusion, some hemoglobin variants, pregnancy and kidney disease. [2]
Explain the result
Tell the patient what the number means for them and confirm understanding with teach-back. [3]
Common errors
- Testing with alcohol still wet on the finger.
- Diagnosing diabetes from one borderline result without symptoms.
- Trusting an A1c in a patient with a recent transfusion.
Diagnostic thresholds for adults (ADA) [2]
| Test | Prediabetes | Diabetes |
|---|---|---|
| Fasting glucose | 100 to 125 mg/dL | 126 mg/dL or more |
| HbA1c | 5.7 to 6.4% | 6.5% or more |
| 2-hour glucose after 75 g drink | 140 to 199 mg/dL | 200 mg/dL or more |
| Random glucose with symptoms | Not used | 200 mg/dL or more |
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- NCCPA PANCE Content Blueprint
- AHRQ Health Literacy Universal Precautions Toolkit (Teach-Back)
- AAMC Core Entrustable Professional Activities (Core EPAs)
Facts and steps follow AAMC Core Entrustable Professional Activities (Core EPAs); NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.