Diabetes: Blood Sugar Levels
Topic Overview Keeping your blood sugar in a target range reduces your risk of problems such as diabetic eye disease , kidney disease , and nerve disease . Some people can work toward lower numbers, and some people may need higher goals. For example, some children and adolescents with type 1 or type 2 diabetes, people who have severe complications from diabetes, people who may not live much longer, or people who have trouble recognizing the symptoms of low blood sugar may have a higher target range. And some people, such as those who are newly diagnosed with diabetes or who dont have any complications from diabetes, may do better with a lower target range. Work with your doctor to set your own target blood sugar range. This will help you achieve the best control possible without having a high risk of hypoglycemia. Diabetes Canada suggests the following A1c and blood glucose ranges as a general guide.Continue reading > >
Why Test Blood Sugar Levels
If you take certain medication, like insulin or sulphonylureas, checking your blood sugars is a vital part of living with diabetes. It can help you work out when you need to take more medication, when you need to eat something or for when you want to get up and move around more.
Routine checks can help you know when you might be starting to go too low or too high . Its a way of getting to know your body and how it works. It can help you and your healthcare team spot patterns too. Do you write your results down? You might find that helpful.
But importantly, it will help you stay healthy and prevent serious diabetes complications now and in the future. By complications, we mean serious problems in places like your feet and your eyes. This happens because too much sugar in the blood damages your blood vessels, making it harder for blood to flow around your body. This can lead to very serious problems like sight loss and needing an amputation.
The higher your blood sugar levels are and the longer theyre high for, the more at risk you are.
Hba1c Test For Diabetes Diagnosis
An HbA1c test does not directly measure the level of blood glucose, however, the result of the test is influenced by how high or low your blood glucose levels have tended to be over a period of 2 to 3 months.
Indications of diabetes or prediabetes are given under the following conditions:
- Normal: Below 42 mmol/mol
- Prediabetes: 42 to 47 mmol/mol
- Diabetes: 48 mmol/mol
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What Are Normal Blood Sugar Levels In Healthy Individuals
Blood sugar levels can either be normal, high, or low, depending on how much glucose someone has in their bloodstream. Glucose is a simple sugar thats present in the bloodstream at all times. Blood glucose levels can be measured at any time, for example, when someone fasts , before they eat, or after theyve eaten. A normal blood glucose level for adults, without diabetes, who havent eaten for at least eight hours is less than 100 mg/dL. A normal blood glucose level for adults, without diabetes, two hours after eating, is 90 to 110 mg/dL.
Many factors affect blood sugar levels throughout the day:
- Type of food consumed, how much, and when
- Physical activity
- Menstrual periods
An ideal blood sugar level for anyone without diabetes or prediabetes, regardless of age, in the morning should be less than 100 mg/dL. Remember, blood sugar levels can fluctuate throughout the day as a result of the factors previously mentioned.
Target Blood Sugar Ranges For Pregnant People With Diabetes
Blood sugar targets during pregnancy are lower due to hormonal influences. The ADA, AACE, and Joslin Diabetes Center have slightly different guidelines for target blood sugar levels during pregnancy. In general, pregnant women with diabetes will want to follow individual guidelines provided by their endocrinologist.
The ADA recommends maintaining blood sugar levels of 95-140 mg/dL for pregnant women. However, some providers recommend an even tighter goal of blood glucose levels below 89 mg/dL before a meal and below 120 mg/dL after a meal.
To keep close tabs on levels, most diabetes specialists recommend that women with diabetes during pregnancy check their blood sugar:
- First thing in the morning
- Before all meals
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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 Canadas population continues to age.
What Abnormal Results Mean
If you had a fasting blood glucose test:
- A level of 100 to 125 mg/dL means you have impaired fasting glucose, a type of prediabetes. This increases your risk of developing type 2 diabetes.
- A level of 126 mg/dL or higher usually means you have diabetes.
If you had a random blood glucose test:
- A level of 200 mg/dL or higher often means you have diabetes.
- Your provider will order a fasting blood glucose, A1C test glucose tolerance test , depending on your random blood glucose test result.
- In someone who has diabetes, an abnormal result on the random blood glucose test may mean that the diabetes is not well controlled.
Other medical problems can also cause a higher-than-normal blood glucose level, including:
- Overactive thyroid gland
- Swelling and inflammation of the pancreas ( pancreatitis
- Stress due to trauma, stroke, heart attack, or surgery
- Rare tumors, including
- Weight loss after weight loss surgery
- Vigorous exercise
Some medicines can raise or lower your blood glucose level. Before having the test, tell your provider about all the medicines you are taking.
For some thin young women, a fasting blood sugar level below 70 mg/dL may be normal.
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Postprandial Or Reactive Hyperglycemia
This type of hyperglycemia occurs after eating .
During this type of hyperglycemia, your liver doesnât stop sugar production, as it normally would directly after a meal, and stores glucose as glycogen.
If your blood glucose level 1-2 hours after eating is above 180mg/dL, that signals postprandial or reactive hyperglycemia.
However, itâs not just people with diabetes who can develop hyperglycemia. Certain medications and illnesses can cause it, including beta blockers, steroids, and bulimia. This article will focus on hyperglycemia caused by diabetes.
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
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Normal Sugar Level In Healthy Individuals
Blood glucose levels, also known as blood sugar levels, can be normal, high, or low. The sugar levels are generally measured after 8 hours of eating.
A normal blood sugar range for a healthy adult after 8 hours of fasting is > 70 mg/dL. and < 100 mg/dL.
While a normal sugar level in a healthy person after 2 hours of eating is between 90 to 100 mg/dL.
Blood glucose levels change throughout the day. Major factors affecting such change in the blood glucose levels are as follows:
How Do You Know What Your Blood Glucose Level Is
For the most part, you cant feel what your blood glucose level is unless its fairly high or its low. You may not even always have symptoms of either high or low blood glucose.
The best way to know your blood glucose level is to check it with a glucose meter. This means doing a fingerstick with a lancet and getting a drop of blood onto a test strip, then inserting the strip into the meter for a reading. Your doctor may be able to give you a meter free of charge, but youll likely need to pay for test strips and lancets. But check with your health plan, as there are likely one or two preferred meters that they want you to use.
Another way to know what your glucose levels are up to is to use a continuous glucose monitor, or CGM, which reads glucose in the interstitial fluid about every 5 minutes. Continuous glucose monitoring is expensive and may or may not be covered by your health plan.
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A1c Goals Should Be Individualized
A1c goals should be individualized based on the individual capabilities, risks, and prior experiences, explains Gary Scheiner, MS, CDE, founder of Integrated Diabetes, and author of Think Like a Pancreas.
For example, we generally aim for very tight A1c levels during pregnancy and more conservative targets in young children and the elderly.
However, Scheiner highlights important factors that could justify aiming for a higher A1c, like hypoglycemia unawareness, which is described as when a person with diabetes no longer feels the oncoming warning signs of low blood sugar. This can put you at significant risk for severe low blood sugars resulting in seizures or death. To reduce that risk, you would aim for higher target blood sugar ranges.
Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively, adds Scheiner. And certainly, someone who has been running A1cs in double digits for quite some time should not be targeting an A1c of 6% better to set modest, realistic, achievable goals.
Is Hyperglycaemia Serious
The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you’re likely to experience hyperglycaemia at some point.
It’s important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated.
Occasional mild episodes aren’t usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods.
Very high blood sugar levels can cause life-threatening complications, such as:
- diabetic ketoacidosis a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma this tends to affect people with type 1 diabetes
- hyperosmolar hyperglycaemic state severe dehydration caused by the body trying to get rid of excess sugar this tends to affect people with type 2 diabetes
Regularly having high blood sugar levels for long periods of time can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels.
If you experience hyperglycaemia regularly, speak to your doctor or diabetes care team. You may need to change your treatment or lifestyle to keep your blood sugar levels within a healthy range.
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When Things Go Awry
When we eat food, the pancreas goes to work, releasing enzymes that help to break down food and hormones that help the body handle the influx of glucose. One of these hormones is insulin, and it plays a key role in managing glucose levels in the blood.
And here is where things can go wrong. If the pancreas doesnt make enough insulin or stops making it altogether, in the case of type 1 diabetes glucose levels in the blood can rise too high. Another scenario is that the pancreas makes enough insulin but the cells have trouble using it properly, causing blood glucose levels to rise. This is called insulin resistance and is the hallmark of type 2 diabetes.
In the short term, high blood glucose levels can make you feel downright bad. Thirst, frequent trips to the bathroom, fatigue, and weight loss are all symptoms of high blood glucose . If not treated, more serious issues can occur, such as diabetic ketoacidosis . Chronic high blood glucose levels can lead to complications such as heart, kidney and eye disease, as well as nerve damage. So, its all about the blood glucose.
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How To Do A Finger
Your healthcare team will show you how to do it the first time, but these are the key steps:
- Wash your hands with soap and warm water. Dont use wet wipes as the glycerine in them can affect the test result. Make sure your hands are warm so its easier to get blood and wont hurt as much.
- Take a test strip and slot it into the meter to turn it on. Some meters will have tests strips built in.
- Remove the cap from your finger prick device and put in a new lancet. Then put the cap back on and set the device by pulling or clicking the plunger.
- Choose which finger to prick but avoid your thumb or index finger . And dont prick the middle, or too close to a nail. Place the device against the side of your finger and press the plunger. Use a different finger each time and a different area.
- Take your meter with the test strip and hold it against the drop of blood. Itll tell you if the test strip is filled, usually by beeping.
- Before you look at your reading, check your finger. Use a tissue to stop bleeding, then use it to take out the lancet and throw it away in your sharps bin.
- You can use the same tissue to take out the test strip and throw that away too. Taking out the strip will usually turn the meter off.