Diabetes: Blood Sugar Levels - Topic Overview
Keeping your blood sugar in a target range reduces your risk of problems such as diabetic eye disease (retinopathy), kidney disease (nephropathy), and nerve disease (neuropathy). 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 don't 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. The American Diabetes Association (ADA) and American Academy of Pediatrics (AAP) suggest the following A1c and blood glucose ranges as a general guide.1, 2, 3, 4 Children of any age with type 2 diabetes and most adults with type 1 or type 2 diabetes (non-pregnant) Before meals: 80 to 130 milligrams per deciliter (mg/dL) 1 to 2 hours after meals: Less than 180 mg/dL Youth (younger than 18 years old) with type 1 diabetes A1c: Less than 7.5% Before meals: 90 to 130 mg/dL Women with type 1 or type 2 diabetes who become pregnant A1c: Less than 6.0% Before meals, bedtime, and overnight: 60 to 99 mg/dL 1 to 2 hours after meals: 100 to 129 mg/dL or lower Women who have gestational diabetes Before meals: 95 mg/dL or less 1 to 2 hours after meals: 120 to 140 mg/dL or lower Continue reading >>
What Are Blood Sugar Target Ranges? What Is Normal Blood Sugar Level?
Understanding blood sugar target ranges to better manage your diabetes As a person with diabetes, you may or may not know what your target ranges should be for your blood sugars first thing in the morning, before meals, after meals, or at bedtime. You may or may not understand what blood sugar ranges are for people without diabetes. You may or may not understand how your A1C correlates with your target ranges. How do you get a clear picture of what is going on with your blood sugar, and how it could be affecting your health? In this article, we will look at what recommended blood sugar target ranges are for people without diabetes. We will look at target ranges for different times of the day for people with diabetes. We will look at target ranges for Type 1 versus Type 2 diabetes. Is there a difference? We will also look at what blood sugars should be during pregnancy for those with gestational diabetes. We will look at other factors when determining blood sugar targets, such as: Age Other health conditions How long you’ve had diabetes for Stress Illness Lifestyle habits and activity levels We will see how these factors impact target ranges for your blood sugars when you have diabetes. We will learn that target ranges can be individualized based on the factors above. We will learn how target ranges help to predict the A1C levels. We will see how if you are in your target range, you can be pretty sure that your A1C will also be in target. We will see how you can document your blood sugar patterns in a notebook or in an “app,” and manage your blood sugars to get them in your target ranges. First, let’s look at the units by which blood sugars are measured… How is blood sugar measured? In the United States, blood sugar is measured in milligrams per deciliter (by w Continue reading >>
Time-in-range: What’s An Achievable Goal With Diabetes?
My approach to time-in-range goals, five key tips to spend more time-in-range each day, and what’s still to come from experts… Q: “What do you think is an attainable percent time in range? My son’s doctor is happy about his A1c around 7.1%, and I think that can lead to being complacent or thinking he is good enough. What is a good goal for percent time in range on a daily basis?” – Madeline G. Madeline – thank you for this important question! We love that you are thinking Beyond A1c. This is a big topic, so it is tackled in parts below. How do we define “time-in-range”? The diabetes research community has reached consensus that 70 mg/dl (low) and 180 mg/dl (high) are the lower and upper thresholds for measuring “time-in-range” when using CGM in studies – i.e., glucose readings between 70-180 mg/dl (3.9-10 mmol/l) are considered “in range,” while hypoglycemia is less than 70 mg/dl and hyperglycemia is above 180 mg/dl. As with anything in diabetes, however, this can be individualized. Personally, I try to aim for a tighter range of 70-140 mg/dl, in part because I have access to CGM and feel like “my best self” in this range (energy, mood, productivity, etc.). People without diabetes also typically spend most of their day in this zone, so it’s something I strive for – of course, I almost never spend 100% of any day in it. I mention this definition upfront because the person – and the circumstances surrounding that person – defines the goal. Staying in a tighter range requires more vigilance and tools, and an achievable time-in-range for a two-year old is almost certainly different from a pregnant woman or an 86 year-old with impaired hypoglycemia awareness and no access to CGM. How do I think about my own time-in-range? Do I have a s Continue reading >>
Diabetes By The Numbers
When you have type 2 diabetes, you’ve got to know your numbers. It’s not just about blood sugar. To successfully manage diabetes, there are several measurements that you should take, or have taken, on a regular basis. Keeping track of the following numbers can help you live well with type 2 diabetes and lower your risk of complications. Blood sugar levels. This is probably the type 2 diabetes measure you’re most familiar with. Testing your blood sugar regularly allows you to see how certain foods, exercise, and other activities affect your blood sugar levels on a day-to-day basis. Many people with type 2 diabetes need to test once or twice a day to make sure blood sugar levels are in target range. If your blood sugar is very well controlled, you may only need to check a few times a week, according to the National Institutes of Health. The American Diabetes Association recommends aiming for a blood sugar level between 70 to 130 mg/dl before meals and less than 180 mg/dl one to two hours after a meal. To keep your blood sugar within this range, follow a healthy, well-rounded diet and eat meals and snacks on a consistent schedule. If your blood sugar is not well controlled, talk to your doctor about adjusting your diabetes management plan. A1C level. This is a blood test, typically given at doctor's appointments, that measures your average blood sugar levels over a longer period. “It gives you a picture of what’s been going on over the past two to three months,” says Dawn Sherr, RD, a certified diabetes educator and spokesperson for the American Association of Diabetes Educators. Essentially, your A1C result shows how well your diabetes treatment plan is working. Depending on your results, you may need to have the test from two to four times a year. For most pe Continue reading >>
Know Your Blood Sugar Numbers: Use Them To Manage Your Diabetes
Checking your blood sugar, also called blood glucose, is an important part of diabetes care. This tip sheet tells you: why it helps you to know your blood sugar numbers how to check your blood sugar levels what are target blood sugar levels what to do if your levels are too low or too high how to pay for these tests Why do I need to know my blood sugar numbers? Your blood sugar numbers show how well your diabetes is managed. And managing your diabetes means that you have less chance of having serious health problems, such as kidney disease and vision loss. As you check your blood sugar, you can see what makes your numbers go up and down. For example, you may see that when you are stressed or eat certain foods, your numbers go up. And, you may see that when you take your medicine and are active, your numbers go down. This information lets you know what is working for you and what needs to change. How is blood sugar measured? There are two ways to measure blood sugar. Blood sugar checks that you do yourself. These tell you what your blood sugar level is at the time you test. The A1C (A-one-C) is a test done in a lab or at your provider’s office. This test tells you your average blood sugar level over the past 2 to 3 months. How do I check my blood sugar? You use a blood glucose meter to check your blood sugar. This device uses a small drop of blood from your finger to measure your blood sugar level. You can get the meter and supplies in a drug store or by mail. Read the directions that come with your meter to learn how to check your blood sugar. Your health care team also can show you how to use your meter. Write the date, time, and result of the test in your blood sugar record. Take your blood sugar record and meter to each visit and talk about your results with your h Continue reading >>
Understand Your Blood Glucose Test Results
Get the most out of your blood glucose test results – know what they mean, when to test, and how to respond. Daily glucose tests, routine A1C lab tests – that’s a lot of numbers to make sense of, which can be intimidating. Try to see them as your body talking to you. It’s telling you if there are things that throw your blood glucose levels off, when this is happening, and if you need to do something about it. Knowing what your numbers mean can help you take control of your diabetes and have more days feeling at your best. What Is A Normal Glucose Level The Canadian Diabetes Association (CDA) recommends an A1C of less than 7 per cent.1 For blood glucose, the recommended target ranges are 4-7 mmol/L before meals and 5-10 mmol/L two hours after a meal. It’s a good idea to sit down with your healthcare professional and discuss what target ranges are right for you. Things like your age, medications and time of day can impact your levels. If you start the day with a fasting test A fasting blood glucose test sets a “benchmark” for the day. It tells you how you did through the night, and also reveals how well your liver is working – which is responsible for releasing glucose as you sleep. If you test 2 hours after meals This is an immediate way to know how your meal plan might be affecting your blood glucose levels. The CDA recommends an after-meal target of 5-10 mmol/L.1 Your results will tell you if you need to adjust what you eat or by how much. If your glucose is low, take action right away It’s normal for glucose levels to go up and down over the course of a day. But know when they’re too low. Hypoglycemia happens when your blood glucose (measured with your meter) goes below 4 mmol/L. Learn how to recognize the symptoms of hypoglycemia and ways to manag Continue reading >>
Goals For Blood Glucose Control
People who have diabetes should be testing their blood glucose regularly at home. Regular blood glucose testing helps you determine how well your diabetes management program of meal planning, exercising and medication (if necessary) is doing to keep your blood glucose as close to normal as possible. The results of the nationwide Diabetes Control and Complications Trial (DCCT) show that the closer you keep your blood glucose to normal, the more likely you are to prevent diabetes complications such as eye disease, nerve damage, and other problems. For some people, other medical conditions, age, or other issues may cause your physician to establish somewhat higher blood glucose targets for you. The following chart outlines the usual blood glucose ranges for a person who does and does not have diabetes. Use this as a guide to work with your physician and your healthcare team to determine what your target goals should be, and to develop a program of regular blood glucose monitoring to manage your condition. Time of Check Goal plasma blood glucose ranges for people without diabetes Goal plasma blood glucose ranges for people with diabetes Before breakfast (fasting) < 100 70 - 130 Before lunch, supper and snack < 110 70 - 130 Two hours after meals < 140 < 180 Bedtime < 120 90- 150 A1C (also called glycosylated hemoglobin A1c, HbA1c or glycohemoglobin A1c) < 6% < 7% < = less than > = greater than > = greater than or equal to < = less than or equal to Information obtained from Joslin Diabetes Center's Guidelines for Pharmacological Management of Type 2 Diabetes. Continue reading >>
Your A1c Levels – What Goal To Shoot For?
Measuring Your A1C An A1C test gives you and your provider insight into all of your blood glucose ups and downs over the past two or three months. It’s like the 24/7 video of your blood sugar levels. Observing your A1C results and your blood glucose (also known as blood sugar) results together over time are two of the key tools you and your health care provider can use to monitor your progress and revise your therapy as needed over the years. Recent research is changing the way health professionals look at A1C levels. Instead of setting tight controls across the board, a healthy A1C level is now a moving target that depends on the patient. In the past, an A1C of 7 percent was considered a healthy goal for everyone. Yehuda Handelsman, M.D., medical director of the Metabolic Institute of America in Tarzana, California, says experts now recommend taking a patient-centered approach to managing A1C levels, which means evaluating goals based on individual diabetes management needs and personal and lifestyle preferences. Current ADA Goals The 2015 American Diabetes Association (ADA) Standards of Medical Care in Diabetes advise the following A1C levels: • 6.5 percent or less: This is a more stringent goal. Health care providers might suggest this for people who can achieve this goal without experiencing a lot of hypoglycemia episodes or other negative effects of having lower blood glucose levels. This may be people who have not had diabetes for many years (short duration); people with type 2 diabetes using lifestyle changes and/or a glucose-lowering medication that doesn’t cause hypoglycemia; younger adults with many years to live healthfully; and people with no significant heart and blood vessel disease. • 7 percent: This is a reasonable A1C goal for many adults with d Continue reading >>
Blood Sugar Level Ranges
Tweet Understanding blood glucose level ranges can be a key part of diabetes self-management. This page states 'normal' blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes. If a person with diabetes has a meter, test strips and is testing, it's important to know what the blood glucose level means. Recommended blood glucose levels have a degree of interpretation for every individual and you should discuss this with your healthcare team. In addition, women may be set target blood sugar levels during pregnancy. The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE) but each individual’s target range should be agreed by their doctor or diabetic consultant. Recommended target blood glucose level ranges The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes. In addition, the International Diabetes Federation's target ranges for people without diabetes is stated.    The table provides general guidance. An individual target set by your healthcare team is the one you should aim for. NICE recommended target blood glucose level ranges Target Levels by Type Upon waking Before meals (pre prandial) At least 90 minutes after meals (post prandial) Non-diabetic* 4.0 to 5.9 mmol/L under 7.8 mmol/L Type 2 diabetes 4 to 7 mmol/L under 8.5 mmol/L Type 1 diabetes 5 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L Children w/ type 1 diabetes 4 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L *The non-diabetic figures are provided for information but are not part of NICE guidelines. Normal and diabetic blood sugar ranges For the majority of healthy ind Continue reading >>
What Are The Ideal Levels Of Blood Sugar?
A blood sugar or blood glucose chart identifies ideal blood sugar levels throughout the day, including before and after meals. Doctors use blood sugar charts to set target goals and monitor diabetes treatment plans. Blood sugar charts also help those with diabetes assess and self-monitor blood sugar test results. What is a blood sugar chart? Blood sugar charts act as a reference guide for blood sugar test results. As such, blood sugar charts are important tools for diabetes management. Most diabetes treatment plans involve keeping blood sugar levels as close to normal or target goals as possible. This requires frequent at-home and doctor-ordered testing, along with an understanding of how results compare to target levels. To help interpret and assess blood sugar results, the charts outline normal and abnormal blood sugar levels for those with and without diabetes. In the United States, blood sugar charts typically report sugar levels in milligrams per deciliter (mg/dL). In the United Kingdom and many other countries, blood sugar is reported in millimoles per liter (mmol/L). A1C blood sugar recommendations are frequently included in blood sugar charts. A1C results are often described as both a percentage and an average blood sugar level in mg/dL. An A1C test measures the average sugar levels over a 3-month period, which gives a wider insight into a person's overall management of their blood sugar levels. Blood sugar chart guidelines Appropriate blood sugar levels vary throughout the day and from person to person. Blood sugars are often lowest before breakfast and in the lead up to meals. Blood sugars are often highest in the hours following meals. People with diabetes will often have higher blood sugar targets or acceptable ranges than those without the condition. These Continue reading >>
Is My Blood Sugar Normal?
“Is my blood sugar normal?” seems like a simple question – but it’s not! The answer can vary dramatically based on your situation. Let’s look at some of the factors to consider. Please remember: you should figure out your personal goals in consultation with your doctor. Normal Blood Sugar in Diabetic vs. Non-Diabetic First, a quick note on how we measure blood sugar. In the USA, blood sugars are measured by weight in milligrams per deciliter, abbreviated as mg/dL. Most everyone else uses millimole per liter, abbreviated mmol. If you are in the USA, look at the big numbers, most everyone else look at the small numbers. In a person without diabetes, blood sugars tend to stay between 70 and 100 mg/dL (3.8 and 5.5 mmol). After a meal, blood sugars can rise up to 120 mg/dL or 6.7 mmol. It will typically fall back into the normal range within two hours. In a person with diabetes, the story is much more complex: Below 70 mg/dL Below 3.8 mmol Low Blood Sugars (Hypoglycemia). When blood sugars drop below this level, you may start feeling hunger, shakiness, or racing of the heart. Your body is starved for sugar (glucose). Read how to detect and treat low blood sugars. 70 mg/dL to 140 mg/dL 3.8 mmol to 7.7 mmol Normal Blood Sugar. In this range, the body is functioning normally. In someone without diabetes, the vast majority of the time is spent in the lower half of this range. 140 mg/dL to 180 mg/dL 7.7 mmol to 10 mmol Elevated Blood Sugars. In this range, the body can function relatively normally. However, extended periods of time in this zone put you at risk for long-term complications. Above 180 mg/dL Abovoe 10 mmol High Blood Sugars. At this range, the kidney is unable to reabsorb all of the glucose in your blood and you begin to spill glucose in your urine. Your bo Continue reading >>
Goals Of Treatment
Blood sugar control means knowing a few important numbers. The ADA recommends that your glucose levels be: Before Meal 70–130 mg/dl After Meal < 180 mg/dl Goals Of Diabetes Treatment To keep the blood sugar as normal as possible without serious high or low blood sugars Normal ranges for blood sugar People who don’t have diabetes keep their blood sugars between 60 – 100 mg/dl overnight and before meals, and less than 140 mg/dl after meals. Although the ultimate goal of diabetes management is to return the blood sugar to the natural or non-diabetic level, this may be difficult without excessive low blood sugars or hypoglycemia. What are the blood sugar (glucose) targets for diabetes? The ultimate treatment goal for Type 1 diabetes is to re-create normal (non-diabetic) or NEARLY normal blood sugar levels – without causing low blood sugars. Good blood sugar control requires that you know and understand a few general numbers. The numbers measure how much glucose is in your blood at certain times of the day and represent what the American Diabetic Association believes are the best ranges to prevent complications. American Diabetes Association Recommendations A1c* < 7.0% Before Meal Glucose Level 70-130 mg/dl After Meal Glucose Level < 180 mg/dl *Hemoglobin (A1c) is a measure of your average blood glucose control over the previous 3 months. Think of the A1c as a long-term blood glucose measure that changes very gradually. For example: When you have type 1 diabetes you are treated with insulin replacement therapy. The goal is to replace the insulin in the right amount and at the right time. Sometimes, more insulin than needed is taken and this will cause hypoglycemia. To minimize this risk, many providers will recommend that individuals treated with insulin target a pre Continue reading >>
Blood Glucose Monitoring
One of the main aims of diabetes treatment is to keep blood glucose levels within a specified target range. The key is balancing your food with your activity, lifestyle and diabetes medicines. Blood glucose monitoring can help you understand the link between blood glucose, food, exercise and insulin. Over time your readings will provide you and your health professionals with the information required to determine the best management strategy for your diabetes. Maintaining good blood glucose control is your best defence to reduce the chances of developing complications from diabetes. Self-blood glucose monitoring allows you to check your blood glucose levels as often as you need to or as recommended by your doctor or Credentialled Diabetes Educator. To test blood glucose levels, you need: A blood glucose meter A lancet device with lancets Test strips. Blood glucose meters are usually sold as kits giving you all the equipment you need to start. There are many different types, offering different features and at different prices to meet individual needs. Most of these are available from Diabetes Australia in your state or territory, pharmacies and some diabetes centres. Your doctor or Credentialled Diabetes Educator can help you choose the meter that’s best for you, and your Credentialled Diabetes Educator or pharmacist can show you how to use your meter to get accurate results. To test your blood glucose levels, you prick your finger with the lancet and add a small drop of blood onto a testing strip. This strip is then inserted into the meter, which reads the strip and displays a number – your blood glucose level. When and how often you should test your blood glucose levels varies depending on each individual, the type of diabetes and the tablets and/or insulin being us Continue reading >>
Type 2 Diabetes Glucose Management Goals
Optimal management of type 2 diabetes requires treatment of the “ABCs” of diabetes: A1C, blood pressure, and cholesterol (ie, dyslipidemia). This web page provides the rationale and targets for glucose management; AACE guidelines for blood pressure and lipid control are summarized in Management of Common Comorbidities of Diabetes. Glucose Targets Glucose goals should be established on an individual basis for each patient, based on consideration of both clinical characteristics and the patient's psycho-socioeconomic circumstances.1-3 Accordingly, AACE recommends individualized glucose targets (Table 1) that take into account the following factors1,2: Life expectancy Duration of diabetes Presence or absence of microvascular and macrovascular complications Comorbid conditions including CVD risk factors Risk for development of or consequences from severe hypoglycemia Patient's social, psychological, and economic status Table 1. AACE-Recommended Glycemic Targets for Nonpregnant Adults1,2 Parameter Treatment Goal Hemoglobin A1C Individualize on the basis of age, comorbidities, and duration of disease ≤6.5 for most Closer to normal for healthy Less stringent for “less healthy” Fasting plasma glucose (FPG) <110 mg/dL 2-hour postprandial glucose (PPG) <140 mg/dL The American Diabetes Association (ADA) also recommends individualizing glycemic targets (Table 2) based on patient-specific characteristics3: Patient attitude and expected treatment efforts Risks potentially associated with hypoglycemia as well as other adverse events Disease duration Life expectancy Important comorbidities Established vascular complications Resources and support system Table 2. ADA-Recommended Glycemic Targets for Nonpregnant Adults3 Parameter Treatment Goal Hemoglobin A1C <6.5% for patients Continue reading >>
What Should My Glucose Be?
The NICE recommended target blood glucose levels are stated below alongside the International Diabetes Federation’s target ranges for people with diabetes. ••••• Recommended target blood glucose level ranges1 The NICE recommended target blood glucose levels are stated below alongside the International Diabetes Federation’s target ranges for people with diabetes. 2 Nice recommended target blood glucose level ranges Target Levels Before Meals (pre prandial) 2 hours after meals (post prandial) No diabetes or in health 4.0 to 5.9 mmol/L Under 8 mmol/L Adult with Type 1 diabetes 4 to 7 mmol/L Under 9 mmol/L Adult with Type 2 diabetes 4 to 7 mmol/L Under 8.5 mmol/L Children with Type 1 diabetes 4 to 8 mmol/L Under 10 mmol/L Keeping to these targets could reduce your risk of developing the complications of diabetes. Some people may find their target levels difficult to reach immediately. Is a trend emerging? Look carefully at your glucose results, are there any trends emerging? Is it always the same time of day? Are you high after certain meals? Understanding blood glucose level ranges is key to managing your diabetes effectively. 1 The ideal blood glucose level range should be individualised and your own needs should be discussed with your healthcare professional. 2 Type 2 diabetes: The management of Type 2 diabetes – NICE Clinical Guideline 66 , 2008 Continue reading >>
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