Diabetes And The Hemoglobin A1c Test
The hemoglobin A1c test , is an important diabetes blood test used to determine how well your diabetes is being controlled. This diabetes test provides an average of your blood sugar control over a six- to 12-week period and is used in conjunction with home blood sugar monitoring to make adjustments in your diabetes medicines. The HbA1c level can also be used to diagnose diabetes if a value of equal to or greater than 6.5% is found.
How Do I Check My Blood Glucose Levels
Refer to your blood glucose meters instructions on how to monitor your blood glucose levels.
Your doctor or Credentialled Diabetes Educator will help you decide how many checks are needed and the levels to aim for. When and how often you should check your blood glucose levels varies depending on each individual, the type of diabetes and the tablets and/or insulin being used. Blood glucose levels are measured in millimoles per litre of blood .
Keeping a record of your blood glucose levels can be very helpful for you and your doctor or Credentialled Diabetes Educator. You can keep a diary or use a mobile phone app or website to record your levels.
Benefits Of Intermittent Fasting
A few small studies have shown that intermittent fasting can have health benefits for people with diabetes.
The benefits include:
- Daytime sleepiness
- Low energy levels that may impact your ability to exercise, which is important for people with diabetes
- A much higher risk of low blood sugar
- High blood sugar which can happen if the liver responds to fasting by releasing stored glucose
More research is needed to understand how common and how severe these side effects could be.
Some side effects, like hyperglycemia or hypoglycemia, could be dangerous for people with diabetes. Talk to your healthcare provider before you start any type of IF diet.
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Key Messages For People With Diabetes
- Try to keep your blood glucose as close to your target range as possible. This will help to delay or prevent complications of diabetes.
- Target ranges for blood glucose and A1C can vary and depend on a person’s medical conditions and other risk factors. Work with your diabetes health-care team to determine your target A1C and blood glucose target range .
Can I Do A Fasting Blood Sugar Test At Home Instead
There are kits that allow you to test your blood sugar at home. But they should not be used to diagnose diabetes.
The results are often not as accurate as tests by a healthcare provider. Several factors can affect accuracy, such as:
- Environmental conditions.
- Unclean skin on the finger being pricked.
- Expired or damaged test strips.
- Not enough blood in the testing sample.
At-home blood testing kits are intended to help people who have already been diagnosed. They help people with diabetes manage the condition and understand what factors affect their blood sugar.
A note from Cleveland Clinic
Fasting blood sugar is a simple, common blood test to diagnose prediabetes, diabetes or gestational diabetes. Before the test, you shouldnt have anything to eat or drink for 8 to 12 hours. Talk to your healthcare provider about whether you need a fasting blood glucose test.
Last reviewed by a Cleveland Clinic medical professional on 10/17/2021.
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Living With Type 1 Diabetes:
Life with type 1 diabetes poses lifelong challenges for every member of the family.
People with type 1 diabetes should:
- Test blood glucose levels three or more times per day and adjust their insulin through injections or an insulin pump.
- Ensure insulin doses are balanced with food intake and level of daily activity. People with type 1 diabetes may experience low and high blood sugar levels, which should be carefully monitored and managed.
While living with type 1 diabetes requires a certain amount of daily structure, newer pumps and insulin products have provided more flexibility in the management of this condition.
A healthcare provider can provide advice to help properly manage blood glucose levels.
Which Fasting Plan Is Best
The term intermittent fasting does not refer to a single well-defined practice. Several different approaches fall under the intermittent fasting umbrella. The three most common and well-studied are known as time-restricted eating, alternate-day fasting, and the 5:2 diet.
The first of thesetime-restricted eatinginvolves squeezing all of your days calories into a single feeding window of six to eight hours. For example, someone on this diet may eat between noon and 6 p.m. each day, and avoid all caloric foods and drinks for the other 18 hours of the day. Meanwhile, someone on an alternate-day-fasting diet eats normally one day, but the next day consumes few or no calories. Finally, the 5:2 diet involves eating normally five days a week but fasting on the other two days.
There are many variations of each of these plans. At this point, its unclear which of these, if any, is optimal for people with Type 2 diabetes. I think time-restricted eating is probably the most common, followed by fasting two days a week, Horne says. But at the moment, I would say there is not one plan that stands out as a best option. The right plan, he adds, is the one a patient will stick with. Even if the more intense fasting programs turn out to be most beneficial, that doesnt really matter if people cant adhere to it.
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Random Blood Sugar Test
This measures your blood sugar at the time youre tested. You can take this test at any time and dont need to fast first. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.Random Blood Sugar Test
|140 mg/dL or below||N/A|
*Results for gestational diabetes can differ. Ask your health care provider what your results mean if youre being tested for gestational diabetes.Source: American Diabetes Association
If your doctor thinks you have type 1 diabetes, your blood may also tested for autoantibodies that are often present in type 1 diabetes but not in type 2 diabetes. You may have your urine tested for ketones , which also indicate type 1 diabetes instead of type 2 diabetes.
How To Start Intermittent Fasting
The first step, always, is talking with your physician or care team. They should be able to help you weigh the benefits and risks, identify dietary approaches to avoid nutritional deficiencies, and, if necessary, adjust any medications youre taking to avoid problems. Safety must come first, Horne says.
However, dont be surprised if your health care provider isnt enthusiastic about fasting diets. These plans are still relatively new, and theyre generally not taught in medical school. People may encounter pushback, or their physician may not be very familiar with these regimens, Horne says. If your doctor says that fasting isnt right for you, thats one thing. But if she or he seems dismissive of fasting diets in general, it may be worth seeking a second opinion from a provider who has experience with these plans.
Intermittent fasting can be risky for some. But there is now evidence that it may be a helpful, or even superior, alternative to classic weight-loss plans for people with Type 2 diabetes.
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High Blood Sugar Symptoms
Hyperglycemia is the medical term for high blood sugar. Hyperglycemia happens when the body doesnt have enough insulin or when it cant use insulin correctly. Many things can cause high blood glucose levels like Type 1 diabetes, Type 2 diabetes, stress, illness, or the dawn phenomenon. If you have hyperglycemia or suspect you may have it, talking with a healthcare provider is always a good idea. A doctor can help you determine whats causing your high blood sugar levels and help you lower it to a healthy range.
Here are some of the most common symptoms that may indicate hyperglycemia:
- Fruity-smelling breath
- Vision loss
Your healthcare provider will give you a treatment plan that indicates when you should seek immediate medical attention.
When patients experience any of these accompanied by elevated blood sugar levels, diabetic patients are advised to go directly to the ER to avoid diabetes-induced coma, says Vikram Tarugu, MD, a gastroenterologist and the CEO of Detox of South Florida. Patients who have elevated blood sugar may also present with frothy, ketone-like smelling breath.
Here are some lifestyle changes and medical treatments that can help treat hyperglycemia:
What Are The Blood Glucose Targets For Elderly People With Type 2 Diabetes
February 9, 2018 by Diabetes Care
Blood glucose targets for elderly people with type 2 diabetes are generally the same as other adults with type 2 diabetes.
In fact, the Diabetes Canada clinical practice guidelines recommend that otherwise healthy elderly people with diabetes whether they have type 1 or type 2 should also be treated to achieve the same blood pressure and cholesterol targets as younger people with diabetes.
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Blood Glucose And A1c Targets For Frail Elderly People
The Diabetes Canada clinical practice guidelines were recently updated to recommend different blood glucose targets in the frail elderly. These are seniors who have three or more of the following conditions:
- Unintended weight loss of more than 4.5 kilograms during the past year
- Constant fatigue or exhaustion
- Weakness in their arms and legs
- A slow walking speed
- Low levels of physical activity
In these people, the A1C target is 8.5% , and pre-meal blood sugar levels should be 5.0 to 12.0 mmol/L .
One of the main reasons why blood sugar and A1C targets are higher for frail elderly people is that studies have shown that tighter blood sugar control is associated with mortality in this population. The Action to Control Cardiovascular Risk in Diabetes study a very large trial of more than 10,000 adults with type 2 diabetes found that very tight glycemic control in older patients was associated with an increased risk of death.
As well, frail elderly adults are more inclined to suffer from moderate to severe hypoglycemia. This is because they may not be eating a nutritionally balanced diet they are also more likely to have other ailments for which they take medications that may contribute to episodes of hypoglycemia.
How Do Carbs Affect Blood Sugar
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
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What Is Diabetic Ketoacidosis
If you think you may have low blood sugar, check it even if you dont have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
- Fast, deep breathing.
- Nausea and vomiting.
- Stomach pain.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, . DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who havent yet been diagnosed. People with type 2 diabetes can also develop DKA, but its less common.
Causes Of Impaired Fasting Glycaemia
IFG develops if your body becomes unable to control glucose levels. Your body may be unable to use insulin properly or produce less insulin. There are a number of factors that may make you more likely to develop IFG. If youre black or South Asian and over 25, or if youre white and over 40, and you have one or more of the following risk factors, then you may be at risk of IFG:
- one of your parents, brother or sister has type 2 diabetes
- youre overweight or you carry extra weight around your middle rather than your hips and thighs
- you have high blood pressure or you have had a heart attack or stroke
- you have polycystic ovary syndrome and you are overweight
- you have had diabetes during pregnancy
- you have severe mental health problems
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Interested In Learning More Read About Normal Blood Glucose Numbers Getting Tested For Type 2 Diabetes And Using Blood Sugar Monitoring To Manage Diabetes
Want to keep track of your blood glucose readings to help you better manage your condition? With our free printable diabetes logbook sheets, youll be able to monitor the effects of food, exercise, medicines and more. One sheet tracks levels for a week. Download your free blood sugar logbook today to start analyzing your patterns!
The Benefits Of Intermittent Fasting
While intermittent fasting may present risks for some, it could also provide benefits over and above other approaches. A 2017 study in the World Journal of Diabetes found that just two weeks of intermittent fasting led to significant weight loss as well as improvements in glucose levels. Its possible that intermittent fasting could lead to reduced insulin resistance, says Kerry Mansell, co-author of that study and a professor in the College of Pharmacy and Nutrition at the University of Saskatchewan in Canada.
Research supports this hypothesis. Some work on people with diabetes has found that intermittent fasting may increase insulin sensitivity and also reduce insulin levels in the blood. This is a big deal. Essentially, fasting is doing what we prescribe diabetes medications to do, which is to improve insulin sensitivity, Horne says. At least one small trial found that adopting an intermittent fasting diet allowed diabetes patients to stop taking their insulin drugs altogether. That studys findings still need to be replicated in a larger group. However, these sorts of results are encouraging. Insulin resistance is associated with higher levels of inflammation and other risk factors for cardiovascular disease. Even when people arent losing weight on a fasting regimen, some research has found that insulin sensitivity improves markedly, Horne says. This is something you typically dont see with other caloric-restriction diets.
What Is Type 2 Diabetes
Type 2 diabetes occurs when the body no longer produces enough insulin, or has difficulty using the insulin it produces, causing sugar to build up in the blood.
Over time, this damages blood vessels and nerves and can result in severe complications including: blindness, heart disease, stroke, kidney failure, nerve damage, amputation, and erectile dysfunction.
Adopting a healthier lifestyle can help prevent or control type 2 diabetes, and can significantly reduce your risk of heart disease, and stroke. It can also contribute to your overall well-being and quality of life.
Did You Know?
Nine out of ten Canadians with diabetes have type 2 diabetes. Seniors represent almost 45 per cent of the total number of people with the disease, and this number is expected to rise as Canada’s population continues to age.
Target Blood Sugar Levels In Children With Diabetes
Children younger than 6 years old Blood sugar in mg/dL Bedtime 110-200
Children under 6 years of age should have blood glucose levels that range from about 80 to 200 mg/dL each day. This range is considered healthy, and the amount of glucose in a childs body will fluctuate from the time they wake up to after theyve eaten meals and again before bedtime. For this reason, kids with diabetes or hypoglycemic episodes may have to have their blood sugar levels tested in the middle of the night by their parents. Many children with type 1 diabetes wear a continuous glucose monitor , which displays glucose levels all the time and mostly eliminates the need for finger sticks.
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Baseline Characteristics And Metabolic Parameters Between Patient Groups
The basic characteristics of all subjects in the three subgroups are shown in Table 1. Baseline characteristics include age, BMI, systolic blood pressure and diastolic blood pressure , and hematological parameters regarding various metabolic parameters of the enrolled subject. Among the 207 subjects, 118 were male and 89 were female. The ages ranged from 20 to 60 years old . The NGT, PD, and T2D subgroup with a mean age of 45.11, 46.11, and 48.07 years, respectively. TRX, 25D levels and HOMA- index in PD subgroup, were significantly lower than that in the NGT subgroup . Similarly, TRX, 25D levels and HOMA- index in T2D subgroup, were significantly lower than that in the PD subgroup . However, significant higher values of other metabolic parameters were observed in T2D subgroup among three subgroups .
Table 1 Characteristics of Three Subgroups in This Study
For Those Diagnosed With Diabetes You Can Reduce The Risk Of Complications:
- Monitor blood glucose levels with appropriate testing and an A1C blood test every three months to measure the average amount of sugar in your blood
- If you smoke, it’s never too late to quit
- Be physically active
- Examine feet and skin every day
- Have an eye exam at least once a year
- Have a kidney function test at least once a year
- Visit your healthcare provider regularly
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