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105 fasting blood sugar: Prediabetes – Diagnosis and treatment

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Prediabetes – Diagnosis and treatment

Diagnosis

The American Diabetes Association (ADA) recommends that diabetes screening for most adults begin at age 45. The ADA advises diabetes screening before age 45 if you’re overweight and have additional risk factors for prediabetes or type 2 diabetes.

There are several blood tests for prediabetes.

Glycated hemoglobin (A1C) test

This test shows your average blood sugar level for the past three months. The test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells called hemoglobin. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached.

In general:

  • An A1C level below 5.7% is considered normal
  • An A1C level between 5.7% and 6.4% is considered prediabetes
  • An A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes

Certain conditions can make the A1C test inaccurate — such as if you’re pregnant or have an uncommon form of hemoglobin.

Fasting blood sugar test

A blood sample is taken after you fast for at least eight hours or overnight.

In general:

  • A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal.
  • A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose.
  • A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes.

Oral glucose tolerance test

This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you’ll drink a sugary solution, and your blood sugar level will be measured again after two hours.

In general:

  • A blood sugar level less than 140 mg/dL (7.8 mmol/L) is considered normal.
  • A blood sugar level from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetes. This is sometimes referred to as impaired glucose tolerance.
  • A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher indicates type 2 diabetes.

If you have prediabetes, your doctor will typically check your blood sugar levels at least once a year.

Children and prediabetes testing

Type 2 diabetes is becoming more common in children and adolescents, likely due to the rise in childhood obesity. The ADA recommends prediabetes testing for children who are overweight or obese and who have one or more other risk factors for type 2 diabetes.

These other risk factors include:

  • Family history of type 2 diabetes.
  • Race. Children who are African American, Hispanic, Native American, Asian American and Pacific Islander are at higher risk.
  • Low birth weight.
  • Being born to a mother who had gestational diabetes.

The ranges of blood sugar level considered normal, prediabetic and diabetic are the same for children and adults.

Children who have prediabetes should be tested annually for type 2 diabetes — or more often if the child experiences a change in weight or develops signs or symptoms of diabetes, such as increased thirst, increased urination, fatigue or blurred vision.

Treatment

Healthy lifestyle choices can help you bring your blood sugar level back to normal, or at least keep it from rising toward the levels seen in type 2 diabetes.

To prevent prediabetes from progressing to type 2 diabetes, try to:

  • Eat healthy foods. Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Eat a variety of foods to help you achieve your goals without compromising taste or nutrition.
  • Be more active. Aim for at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity a week.
  • Lose excess weight. If you’re overweight, losing just 5% to 7% of your body weight — about 14 pounds (6.4 kilograms) if you weigh 200 pounds (91 kilograms) — can reduce the risk of type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits.
  • Stop smoking. Smoking may up your risk of developing type 2 diabetes.
  • Take medications as needed. If you’re at high risk of diabetes, your doctor might recommend metformin (Glumetza, others). Medications to control cholesterol and high blood pressure might also be prescribed.

Children and prediabetes treatment

Children with prediabetes should undertake the lifestyle changes recommended for adults with type 2 diabetes, including:

  • Losing weight
  • Eating fewer refined carbohydrates and fats, and more fiber
  • Reducing portion sizes
  • Eating out less often
  • Spending at least one hour every day in physical activity

Medication generally isn’t recommended for children with prediabetes unless lifestyle changes aren’t improving blood sugar levels. If medication is needed, metformin (Glumetza, others) is usually the recommended drug.

Clinical trials


Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Alternative medicine

Many alternative therapies have been touted as possible ways to treat or prevent type 2 diabetes. But, there’s no definitive evidence that any alternative treatments are effective. Therapies that have been said to be helpful in type 2 diabetes and are also likely to be safe, include:

  • Cassia cinnamon
  • Flaxseed
  • Ginseng
  • Magnesium
  • Oats
  • Soy
  • Xanthan gum

Talk to your doctor if you’re considering dietary supplements or other alternative therapies to treat or prevent prediabetes. Some supplements or alternative therapies might be harmful if combined with certain prescription medications. Your doctor can help you weigh the pros and cons of specific alternative therapies.

Preparing for your appointment

You’re likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in diabetes treatment (endocrinologist), a dietitian or a certified diabetes educator.

Here’s some information to help you get ready for your appointment.

What you can do

Before your appointment, take these steps:

  • Ask about any pre-appointment restrictions. You’ll probably need to fast for at least eight hours before your appointment so that your doctor can measure your fasting blood sugar level.
  • List symptoms you’ve been having and for how long.
  • List all medications, vitamins and supplements you take, including the doses.
  • List key personal and medical information, including other conditions, recent life changes and stressors.
  • Prepare questions to ask your doctor.

For prediabetes, some basic questions to ask your doctor include:

  • How can I prevent prediabetes from turning into type 2 diabetes?
  • Do I need to take medication? If so, what side effects can I expect?
  • I have other health conditions. How can I best manage them together?
  • How much do I need to exercise each week?
  • Should I avoid any foods? Can I still eat sugar?
  • Do I need to see a dietitian?
  • Can you recommend any local programs for preventing diabetes?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • Has your weight changed recently?
  • Do you exercise regularly? If so, for how long and how often?
  • Do you have a family history of diabetes?


Sept. 22, 2020

Borderline diabetes (prediabetes): Symptoms, causes, and treatments

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.

Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.

Doctors may also refer to borderline diabetes as:

This article looks at how to recognize risk factors for prediabetes, how to manage the condition, and how to prevent type 2 diabetes from developing.

Share on PinterestPrediabetes does not produce clear symptoms, so regular checks are important for people who are at risk.

Prediabetes does not have clear symptoms. Some people may not be aware that they have it until:

  • a doctor tests blood glucose and blood pressure levels
  • prediabetes has progressed to type 2 diabetes
  • a complication occurs, such as a heart attack

If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.

Most people will not know they have prediabetes until they receive testing.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:

Other risk factors include:

  • not getting enough exercise
  • having a family history of type 2 diabetes.

According to the American Heart Association, the following lifestyle factors may also be a risk for prediabetes in some people:

  • raised stress levels
  • smoking
  • drinking too much alcohol

Regularly consuming high-sugar drinks may also increase the risk.

One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.

These metabolic conditions can lead to prediabetes and diabetes.

People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.

Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.

Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.

A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.

Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.

The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.

According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:

  • fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
  • glucose tolerance levels of 140–199 mg/dl
  • an A1C test result of 5.7–6.4 percent

A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.

Blood glucose monitors for home use are available for purchase online.

Who should seek screening?

The NIDDK recommend that people with the following risk factors should undergo a prediabetes screening:

  • an age of 45 years or over
  • obesity or overweight, or a body mass index (BMI) over 25
  • a waist circumference larger than 40 inches in males or over 35 inches in females
  • a close relative with diabetes
  • a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
  • an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
  • a history of gestational diabetes, or diabetes as a result of pregnancy
  • having given birth to an infant weighing over 9 pounds
  • having a disease that harden the arteries
  • recent treatment with glucocorticoids or atypical antipsychotic medications

If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.

Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.

The NIDDK has an official resource to check diabetes risk. Click here to take the test.

However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.

Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.

A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.

According to the American Diabetes Association, diet and nutrition changes should include the following:

  • improving intake of unprocessed high-fiber carbohydrates
  • increasing fruit and vegetable consumption
  • reducing saturated fat and processed meat intake.

Click here to find out more about what to eat with prediabetes.

Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.

Current guidelines for Americans recommend that adults should:

  • have at least 150–300 minutes of moderate-intensity aerobic activity each week
  • do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups

Examples of moderate exercise are fast dancing and brisk walking.

Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.

The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:

  • a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
  • a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years

All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.

Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.

Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.

Monitoring borderline diabetes

In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.

Medical management may include treating related conditions, such as obesity and heart disease.

Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.

A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.

Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.

Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.

It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.

Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.

Borderline diabetes (prediabetes): Symptoms, causes, and treatments

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.

Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.

Doctors may also refer to borderline diabetes as:

This article looks at how to recognize risk factors for prediabetes, how to manage the condition, and how to prevent type 2 diabetes from developing.

Share on PinterestPrediabetes does not produce clear symptoms, so regular checks are important for people who are at risk.

Prediabetes does not have clear symptoms. Some people may not be aware that they have it until:

  • a doctor tests blood glucose and blood pressure levels
  • prediabetes has progressed to type 2 diabetes
  • a complication occurs, such as a heart attack

If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.

Most people will not know they have prediabetes until they receive testing.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:

Other risk factors include:

  • not getting enough exercise
  • having a family history of type 2 diabetes.

According to the American Heart Association, the following lifestyle factors may also be a risk for prediabetes in some people:

  • raised stress levels
  • smoking
  • drinking too much alcohol

Regularly consuming high-sugar drinks may also increase the risk.

One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.

These metabolic conditions can lead to prediabetes and diabetes.

People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.

Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.

Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.

A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.

Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.

The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.

According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:

  • fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
  • glucose tolerance levels of 140–199 mg/dl
  • an A1C test result of 5.7–6.4 percent

A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.

Blood glucose monitors for home use are available for purchase online.

Who should seek screening?

The NIDDK recommend that people with the following risk factors should undergo a prediabetes screening:

  • an age of 45 years or over
  • obesity or overweight, or a body mass index (BMI) over 25
  • a waist circumference larger than 40 inches in males or over 35 inches in females
  • a close relative with diabetes
  • a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
  • an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
  • a history of gestational diabetes, or diabetes as a result of pregnancy
  • having given birth to an infant weighing over 9 pounds
  • having a disease that harden the arteries
  • recent treatment with glucocorticoids or atypical antipsychotic medications

If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.

Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.

The NIDDK has an official resource to check diabetes risk. Click here to take the test.

However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.

Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.

A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.

According to the American Diabetes Association, diet and nutrition changes should include the following:

  • improving intake of unprocessed high-fiber carbohydrates
  • increasing fruit and vegetable consumption
  • reducing saturated fat and processed meat intake.

Click here to find out more about what to eat with prediabetes.

Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.

Current guidelines for Americans recommend that adults should:

  • have at least 150–300 minutes of moderate-intensity aerobic activity each week
  • do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups

Examples of moderate exercise are fast dancing and brisk walking.

Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.

The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:

  • a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
  • a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years

All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.

Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.

Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.

Monitoring borderline diabetes

In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.

Medical management may include treating related conditions, such as obesity and heart disease.

Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.

A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.

Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.

Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.

It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.

Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.

Borderline diabetes (prediabetes): Symptoms, causes, and treatments

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.

Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.

Doctors may also refer to borderline diabetes as:

This article looks at how to recognize risk factors for prediabetes, how to manage the condition, and how to prevent type 2 diabetes from developing.

Share on PinterestPrediabetes does not produce clear symptoms, so regular checks are important for people who are at risk.

Prediabetes does not have clear symptoms. Some people may not be aware that they have it until:

  • a doctor tests blood glucose and blood pressure levels
  • prediabetes has progressed to type 2 diabetes
  • a complication occurs, such as a heart attack

If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.

Most people will not know they have prediabetes until they receive testing.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:

Other risk factors include:

  • not getting enough exercise
  • having a family history of type 2 diabetes.

According to the American Heart Association, the following lifestyle factors may also be a risk for prediabetes in some people:

  • raised stress levels
  • smoking
  • drinking too much alcohol

Regularly consuming high-sugar drinks may also increase the risk.

One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.

These metabolic conditions can lead to prediabetes and diabetes.

People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.

Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.

Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.

A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.

Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.

The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.

According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:

  • fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
  • glucose tolerance levels of 140–199 mg/dl
  • an A1C test result of 5.7–6.4 percent

A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.

Blood glucose monitors for home use are available for purchase online.

Who should seek screening?

The NIDDK recommend that people with the following risk factors should undergo a prediabetes screening:

  • an age of 45 years or over
  • obesity or overweight, or a body mass index (BMI) over 25
  • a waist circumference larger than 40 inches in males or over 35 inches in females
  • a close relative with diabetes
  • a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
  • an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
  • a history of gestational diabetes, or diabetes as a result of pregnancy
  • having given birth to an infant weighing over 9 pounds
  • having a disease that harden the arteries
  • recent treatment with glucocorticoids or atypical antipsychotic medications

If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.

Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.

The NIDDK has an official resource to check diabetes risk. Click here to take the test.

However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.

Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.

A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.

According to the American Diabetes Association, diet and nutrition changes should include the following:

  • improving intake of unprocessed high-fiber carbohydrates
  • increasing fruit and vegetable consumption
  • reducing saturated fat and processed meat intake.

Click here to find out more about what to eat with prediabetes.

Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.

Current guidelines for Americans recommend that adults should:

  • have at least 150–300 minutes of moderate-intensity aerobic activity each week
  • do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups

Examples of moderate exercise are fast dancing and brisk walking.

Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.

The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:

  • a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
  • a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years

All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.

Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.

Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.

Monitoring borderline diabetes

In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.

Medical management may include treating related conditions, such as obesity and heart disease.

Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.

A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.

Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.

Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.

It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.

Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.

Borderline diabetes (prediabetes): Symptoms, causes, and treatments

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.

Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.

Doctors may also refer to borderline diabetes as:

This article looks at how to recognize risk factors for prediabetes, how to manage the condition, and how to prevent type 2 diabetes from developing.

Share on PinterestPrediabetes does not produce clear symptoms, so regular checks are important for people who are at risk.

Prediabetes does not have clear symptoms. Some people may not be aware that they have it until:

  • a doctor tests blood glucose and blood pressure levels
  • prediabetes has progressed to type 2 diabetes
  • a complication occurs, such as a heart attack

If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.

Most people will not know they have prediabetes until they receive testing.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:

Other risk factors include:

  • not getting enough exercise
  • having a family history of type 2 diabetes.

According to the American Heart Association, the following lifestyle factors may also be a risk for prediabetes in some people:

  • raised stress levels
  • smoking
  • drinking too much alcohol

Regularly consuming high-sugar drinks may also increase the risk.

One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.

These metabolic conditions can lead to prediabetes and diabetes.

People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.

Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.

Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.

A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.

Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.

The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.

According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:

  • fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
  • glucose tolerance levels of 140–199 mg/dl
  • an A1C test result of 5.7–6.4 percent

A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.

Blood glucose monitors for home use are available for purchase online.

Who should seek screening?

The NIDDK recommend that people with the following risk factors should undergo a prediabetes screening:

  • an age of 45 years or over
  • obesity or overweight, or a body mass index (BMI) over 25
  • a waist circumference larger than 40 inches in males or over 35 inches in females
  • a close relative with diabetes
  • a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
  • an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
  • a history of gestational diabetes, or diabetes as a result of pregnancy
  • having given birth to an infant weighing over 9 pounds
  • having a disease that harden the arteries
  • recent treatment with glucocorticoids or atypical antipsychotic medications

If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.

Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.

The NIDDK has an official resource to check diabetes risk. Click here to take the test.

However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.

Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.

A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.

According to the American Diabetes Association, diet and nutrition changes should include the following:

  • improving intake of unprocessed high-fiber carbohydrates
  • increasing fruit and vegetable consumption
  • reducing saturated fat and processed meat intake.

Click here to find out more about what to eat with prediabetes.

Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.

Current guidelines for Americans recommend that adults should:

  • have at least 150–300 minutes of moderate-intensity aerobic activity each week
  • do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups

Examples of moderate exercise are fast dancing and brisk walking.

Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.

The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:

  • a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
  • a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years

All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.

Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.

Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.

Monitoring borderline diabetes

In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.

Medical management may include treating related conditions, such as obesity and heart disease.

Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.

A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.

Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.

Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.

It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.

Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.

Borderline diabetes (prediabetes): Symptoms, causes, and treatments

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A person with borderline diabetes, or prediabetes, has blood sugar levels that are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.

Borderline diabetes is a condition that may lead to type 2 diabetes. According to the American Diabetes Association, an estimated 10 to 23 percent of people with borderline diabetes will go on to develop type 2 diabetes within 5 years.

Doctors may also refer to borderline diabetes as:

This article looks at how to recognize risk factors for prediabetes, how to manage the condition, and how to prevent type 2 diabetes from developing.

Share on PinterestPrediabetes does not produce clear symptoms, so regular checks are important for people who are at risk.

Prediabetes does not have clear symptoms. Some people may not be aware that they have it until:

  • a doctor tests blood glucose and blood pressure levels
  • prediabetes has progressed to type 2 diabetes
  • a complication occurs, such as a heart attack

If a person’s blood sugar level remains high, they may begin to develop some symptoms of type 2 diabetes. Symptoms include frequent urination and increased thirst.

Most people will not know they have prediabetes until they receive testing.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a range of other conditions can increase the risk of prediabetes, including:

Other risk factors include:

  • not getting enough exercise
  • having a family history of type 2 diabetes.

According to the American Heart Association, the following lifestyle factors may also be a risk for prediabetes in some people:

  • raised stress levels
  • smoking
  • drinking too much alcohol

Regularly consuming high-sugar drinks may also increase the risk.

One 2017 review found that people who regularly drink sugary beverages face an increased risk of metabolic diseases, such as high blood pressure and high levels of blood glucose and fats.

These metabolic conditions can lead to prediabetes and diabetes.

People who lead an inactive lifestyle are at higher risk of taking in too many calories without burning them through exercise.

Other people who may be at risk of developing prediabetes include those with polycystic ovary syndrome (PCOS) and those who have experienced instances of high blood sugar levels in the past.

Anyone with any of these risk factors may benefit from a prediabetes screening to identify whether they have the condition.

A doctor typically diagnoses prediabetes with a blood test, particularly a glucose tolerance test. A glucose tolerance test measures how quickly the body can process the sugar in the blood in a 2-hour period.

Other tests include measuring blood sugar levels after a person has not eaten for a specific period. This is called a fasting blood test.

The doctor may also use an A1C test. This involves measuring the average blood sugar levels over 2–3 months. People do not need to fast or take any special liquids or medications for this test, and it gives reliable results.

According to the American Diabetes Association, a doctor will diagnose prediabetes when test results show the following measurements:

  • fasting blood sugar levels of 100–125 milligrams per deciliter (mg/dl)
  • glucose tolerance levels of 140–199 mg/dl
  • an A1C test result of 5.7–6.4 percent

A doctor will often re-test these levels to confirm that the readings are not due to one-off spikes in blood sugar.

Blood glucose monitors for home use are available for purchase online.

Who should seek screening?

The NIDDK recommend that people with the following risk factors should undergo a prediabetes screening:

  • an age of 45 years or over
  • obesity or overweight, or a body mass index (BMI) over 25
  • a waist circumference larger than 40 inches in males or over 35 inches in females
  • a close relative with diabetes
  • a condition that increases insulin resistance, including PCOS, acanthosis nigricans, and nonalcoholic steatohepatitis
  • an ethnic background that places an individual at high risk of diabetes, including people who are African-American, Asian-American, Latino, Native American, or a Pacific Islander
  • a history of gestational diabetes, or diabetes as a result of pregnancy
  • having given birth to an infant weighing over 9 pounds
  • having a disease that harden the arteries
  • recent treatment with glucocorticoids or atypical antipsychotic medications

If a doctor identifies any of these risk factors, they may recommend that the person has a screening for blood glucose levels.

Medical professionals advise repeating screening tests every 1 to 3 years if a person has these risk factors.

The NIDDK has an official resource to check diabetes risk. Click here to take the test.

However, anyone who is concerned that they may have borderline diabetes should visit the doctor for testing and a proper diagnosis.

Prediabetes is reversible, but it is often easier to prevent than treat. Lifestyle factors are the primary causes of prediabetes, and making changes in some aspects of life can significantly reduce risk factors.

A balanced, nutritious diet that moderates sugar intake and regular exercise can help reverse borderline diabetes.

According to the American Diabetes Association, diet and nutrition changes should include the following:

  • improving intake of unprocessed high-fiber carbohydrates
  • increasing fruit and vegetable consumption
  • reducing saturated fat and processed meat intake.

Click here to find out more about what to eat with prediabetes.

Exercise is also important. According to a report in Diabetes Care, exercise can help prevent or delay diabetes from developing.

Current guidelines for Americans recommend that adults should:

  • have at least 150–300 minutes of moderate-intensity aerobic activity each week
  • do muscle-strengthening exercises at least twice a week, such as lifting weights or doing push-ups

Examples of moderate exercise are fast dancing and brisk walking.

Regular exercise and a healthful diet not only help reduce the risk of developing diabetes but also protect the heart against future diseases.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a long-term study that aimed to identify practical steps for reducing diabetes risk and reversing prediabetes.

The people who took part in the DPP Lifestyle Change Program aimed to lose 7 percent of their body weight and maintain this loss through dietary changes and activity. After 3 years, the results of the program showed:

  • a 58-percent drop in the risk of developing diabetes regardless of sex or ethnicity, compared with those who took a placebo
  • a 71-percent drop in risk people of developing type 2 diabetes among people aged over 60 years

All the people in the program received motivational support on effective diet and exercise and attended “lifestyle change classes,” for the duration of the study.

Follow-ups took place regularly. After 15 years, people in the DPP Lifestyle Change Program continued to see a delay in the onset of diabetes compared to people who took a medication called metformin or a placebo.

Anyone who developed diabetes during the study received extra medical care. However, diet and exercise remained important in managing symptoms and reducing the risk of complications.

Monitoring borderline diabetes

In addition to lifestyle changes, doctors may recommend other steps for managing the risk of diabetes.

Medical management may include treating related conditions, such as obesity and heart disease.

Managing prediabetes also involves continued monitoring of the risk factors and regular testing of blood sugar levels.

A person can reverse borderline diabetes if they can make and maintain the necessary lifestyle changes.

Borderline diabetes is the stage before type 2 diabetes develops. By this stage, blood sugar, blood pressure, and insulin resistance may start reaching harmful levels.

Prediabetes does not usually cause active symptoms, and most people will not be aware they have the condition until it becomes diabetes and starts causing severe health problems.

It is therefore essential for anyone who is at risk of developing diabetes to receive regular screening. Risk factors include high BMI and waist circumference, an age of more than 45 years, or other cardiovascular diseases.

Prediabetes is often reversible with a sustained exercise program and a balanced, low-sugar diet.

When “Normal” Blood Sugar Isn’t Normal (Part 2)

In the last article I explained the three primary markers we use to track blood sugar: fasting blood glucose (FBG), oral glucose tolerance test (OGTT) and hemoglobin A1c (A1c). We also looked at what the medical establishment considers as normal for these markers. The table below summarizes those values. In this article, we’re going to look at just how “normal” those normal levels are—according to the scientific literature. We’ll also consider which of these three markers is most important in preventing diabetes and cardiovascular disease.

 Marker  Normal  Pre-diabetes  Diabetes
 Fasting blood glucose (mg/dL)  <99  100-125  >126
 OGGT / post-meal (mg/dL after 2 hours)  <140  140-199  >200
 Hemoglobin A1c (%)  <6  6-6.4  >6.4

But before we do that, I’d like to make an important point: context is everything.

In my work with patients, I never use any single marker alone to determine whether someone has a blood sugar issue. I run a full blood panel that includes fasting glucose, A1c, fructosamine, uric acid and triglycerides (along with other lipids), and I also have them do post-meal testing at home over a period of 3 days with a range of foods.

If they have a few post-meal spikes and all other markers or normal, I’m not concerned. If their fasting BG, A1c and fructosamine are all elevated, and they’re having spikes, then I’m concerned and I will investigate further.

On a similar note, I’ve written that A1c is not a reliable marker for individuals because of context: there are many non-blood sugar-related conditions that can make A1c appear high or low. So if someone is normal on all of the other blood sugar markers, but has high A1c, I’m usually not concerned.

With all of that said, let’s take a look at some of the research.

Fasting blood sugar

According to continuous glucose monitoring studies of healthy people, a normal fasting blood sugar is 83 mg/dL or less. Many normal people have fasting blood sugar in the mid-to-high 70s.

While most doctors will tell you that anything under 100 mg/dL is normal, it may not be. In this study, people with FBG levels above 95 had more than 3x the risk of developing future diabetes than people with FBG levels below 90. This study showed progressively increasing risk of heart disease in men with FBG levels above 85 mg/dL, as compared to those with FBG levels of 81 mg/dL or lower.

What’s even more important to understand about FBG is that it’s the least sensitive marker for predicting future diabetes and heart disease. Several studies show that a “normal” FBG level in the mid-90s predicts diabetes diagnosed a decade later.

Far more important than a single fasting blood glucose reading is the number of hours a day our blood sugar spends elevated over the level known to cause complications, which is roughly 140 mg/dl (7.7 mmol/L). I’ll discuss this in more detail in the OGGT section.

One caveat here is that very low-carb diets will produce elevated fasting blood glucose levels. Why? Because low-carb diets induce insulin resistance. Restricting carbohydrates produces a natural drop in insulin levels, which in turn activates hormone sensitive lipase. Fat tissue is then broken down, and non-esterified fatty acids (a.k.a. “free fatty acids” or NEFA) are released into the bloodstream. These NEFA are taken up by the muscles, which use them as fuel. And since the muscle’s needs for fuel has been met, it decreases sensitivity to insulin. You can read more about this at Hyperlipid.

So, if you eat a low-carb diet and have borderline high FBG (i.e. 90-105), it may not be cause for concern. Your post-meal blood sugars and A1c levels are more important.

Hemoglobin A1c

In spite of what the American Diabetes Association (ADA) tells us, a truly normal A1c is between 4.6% and 5.3%.

But while A1c is a good way to measure blood sugar in large population studies, it’s not as accurate for individuals. An A1c of 5.1% maps to an average blood sugar of about 100 mg/dL. But some people’s A1c results are always a little higher than their FBG and OGTT numbers would predict, and other people’s are always a little lower.

This is probably due to the fact that several factors can influence red blood cells. Remember, A1c is a measure of how much hemoglobin in red blood cells is bonded (glycated) to glucose. Anything that affects red blood cells and hemoglobin – such as anemia, dehydration and genetic disorders – will skew A1c results.

A number of studies show that A1c levels below the diabetic range are associated with cardiovascular disease. This study showed that A1c levels lower than 5% had the lowest rates of cardiovascular disease (CVD) and that a 1% increase (to 6%) significantly increased CVD risk. Another study showed an even tighter correlation between A1c and CVD, indicating a linear increase in CVD as A1c rose above 4.6% – a level that corresponds to a fasting blood glucose of just 86 mg/dL. Finally, this study showed that the risk of heart disease in people without diabetes doubles for every percentage point increase above 4.6%.

Studies also consistently show that A1c levels considered “normal” by the ADA fail to predict future diabetes. This study found that using the ADA criteria of an A1c of 6% as normal missed 70% of individuals with diabetes, 71-84% with dysglycemia, and 82-94% with pre-diabetes. How’s that for accuracy?

What we’ve learned so far, then, is that the fasting blood glucose and A1c levels recommended by the ADA are not reliable cut-offs for predicting or preventing future diabetes and heart disease. This is problematic, to say the least, because the A1c and FBG are the only glucose tests the vast majority of people get from their doctors.

OGTT / post-meal blood sugars

If you recall, the oral glucose tolerance test (OGTT) measures how our blood sugar responds to drinking a challenge solution of 75 grams of glucose. I don’t recommend this test, because A) it’s not realistic (no one ever drinks 75 grams of pure glucose), and B) it can produce horrible side effects for people with poor glucose control.

However, there’s another more realistic and convenient way to achieve a similar measurement, and that is simply using a glucometer to test your blood sugar one and two hours after you eat a meal. This is called post-prandial (post-meal) blood sugar testing. As we go through this section, the numbers I use apply to both OGTT and post-meal testing.

As the table at the beginning of this article indicates, the ADA considers OGTT of between 140 – 199 two hours after the challenge to be pre-diabetic, and levels above 200 to be diabetic.

But once again, continuous glucose monitoring studies suggest that the ADA levels are far too high. Most people’s blood sugar drops below 120 mg/dL two hours after a meal, and many healthy people drop below 100 mg/dL or return to baseline.

A continuous glucose monitoring study showed that sensor glucose concentrations were between 71 – 120 mg/dL for 91% of the day. Sensor values were less than or equal to 60 or 140 mg/dL for only 0.2% and 0.4% of the day, respectively.

On the other hand, some studies suggest that even healthy people with no known blood sugar problems can experience post-meal spikes above 140 mg/dL at one hour. As I said in the beginning of the article, context is everything and all of the markers for blood sugar must be interpreted together.

If post-meal blood sugars do rise above 140 mg/dL and stay there for a significant period of time, the consequences are severe. Prolonged exposure to blood sugars above 140 mg/dL causes irreversible beta cell loss (the beta cells produce insulin) and nerve damage. Diabetic retinopathy is an extremely common (and serious) diabetic complication. Cancer rates increase as post-meal blood sugars rise above 160 mg/dL. This study showed stroke risk increased by 25% for every 18 mg/dL rise in post-meal blood sugars. Finally, 1-hour OGTT readings above 155 mg/dL correlate strongly with increased CVD risk.

What does it all mean?

Let’s take a look again at what the ADA thinks is “normal” blood sugar:

 Marker  Normal  Pre-diabetes  Diabetes
 Fasting blood glucose (mg/dL)  <99  100-125  >126
 OGGT / post-meal (mg/dL after 2 hours)  <140  140-199  >200
 Hemoglobin A1c (%)  <6  6-6.4  >6.4

But as we’ve seen in this article, these levels depend highly on context and whether all markers are elevated, or just a few of them.

If you’re interested in health and longevity – instead of just slowing the onset of serious disease by a few years – you might consider shooting for these targets. But remember to interpret the numbers together, and also remember that blood sugar is highly variable. If you wake up one morning and have a fasting blood sugar of 95, but your A1c and post-meal numbers are still normal, that’s usually no cause for concern. Likewise, if you see a one-hour post-meal spike of 145 mg/dL, but all of your other numbers are normal, that is also usually no cause for concern.

 Marker  Ideal
 Fasting blood glucose (mg/dL)  <86*
 OGGT / post-meal (mg/dL after 2 hours)  <120
 Hemoglobin A1c (%)  <5.3


*If you’re following a low-carb diet, fasting blood sugars in the 90s and even low 100s may not be a problem, provided your A1c and post-meal blood sugars are within the normal range.

Another key takeaway from this article is that fasting blood glucose and A1 are not often reliable for predicting diabetes or CVD risk. Post-meal blood sugars are a more accurate marker for this purpose. And the good news is that this can be done cheaply, safely and conveniently at home, without a doctor’s order and without subjecting yourself to the brutality of an OGTT.

Blood glucose level | Medtronic Diabetes Russia

Norms of blood glucose

Blood glucose is measured in millimoles (mmol / L) per liter. The measurement is carried out using a blood glucose meter and a test strip. The recommended range for blood sugar levels for patients with diabetes is shown in Table 1 below.

Fasting blood sugar Blood sugar after meals (after 90 minutes)
Diabetes free 4.0-5.9 mmol / L
(72-106 mg / dL)
Up to 7.8 mmol / L
(140 mg / dl)
Type 1 diabetes 5-7 mmol / L (90-126 mg / dL) About 5-9 mmol / L (90-162 mg / dL)
Type 2 diabetes 4-7 mmol / L (90-126 mg / dL) About 5-8.5 mmol / L (90-153 mg / dL)

Blood sugar levels generally fluctuate throughout the day.However, if a healthy body can handle the excess sugar on its own, diabetes requires outside help. To take the right and timely measures, you need to constantly monitor your blood sugar levels.

What factors affect blood sugar levels?

The blood sugar level changes under the influence of various factors. Among them:

  • Food consumption
  • Skipped meals
  • Physical activity
  • Stress
  • Disease
  • Alcohol consumption
  • Taking medicines
  • Changes in the usual way of life
  • Pregnancy

As you can see, many different elements of daily life can affect blood sugar levels.This is why blood sugar control should be done on a regular basis.

When should you measure your blood sugar?

  • Before meals
  • 2 hours after eating
  • Bedtime
  • Before exercise
  • Before drinking alcohol
  • In case of feeling unwell

Hypoglycemia and hyperglycemia: what to do?

The two most common short-term complications of diabetes are a drop in blood sugar below the recommended target range, or, conversely, an increase in it.If your blood sugar is too high, the condition is called hyperglycemia. The condition of low blood sugar is called hypoglycemia (or simply “hypo”).

Both hyper- and hypoglycemia can ultimately lead to the development of short-term and long-term complications. For example, persistently high blood sugar can lead to serious complications in the long term. This is why it is critical to monitor blood sugar levels and take timely measures necessary to keep blood sugar levels within the recommended range.The system of continuous glucose monitoring can become a faithful assistant in this, the main purpose of which is to make everyday life with diabetes easier.

What is the blood sugar rate and what to do if it is high or low

Why do you need blood sugar

In fact, we are not talking about sugar, but about glucose. Sugar, like any other carbohydrate, is not directly absorbed by the body: it is broken down in the intestine to simple sugars (monosaccharides) and enters the bloodstream as glucose.

In the blood of a healthy person weighing 70 kg, there is always approximately 1 teaspoon (4 grams) of glucose.

This substance is the main source of energy for all cells in the body. It is thanks to him that we have the strength to breathe, move, learn and think.

How blood sugar is measured and what is considered the norm

In international practice, blood sugar (glycemia) is measured in the so-called molar concentration – millimoles per liter (mmol / L).In the USA, Germany and some other countries is also common mass concentration – in milligrams per deciliter (mg / dl). To convert one concentration to another, it is enough to remember the following equation: 1 mmol / L = 18 mg / dL.

A blood sugar test is done on an empty stomach – usually in the morning. This is important because any food you eat can raise your glucose levels.

You can take the analysis from a finger or from a vein. Venous blood tests give a more accurate result.

The norm of glucose in blood taken on an empty stomach from a vein is from 3.9 to 5.6 mmol / l (70-100 mg / dl).

If the test result is abnormal, this means the following:

  • From 5.6 to 6.9 mmol / L – the so-called prediabetes. This is a mild rise in blood sugar, which means that there are processes in your body that increase your risk of developing diabetes.
  • 7 mmol / L and above – hyperglycemia (increased blood glucose).Most often, the violation speaks of diabetes mellitus.
  • Below 3.9 mmol / L – hypoglycemia (decreased blood glucose). This is also an unhealthy condition that can be a sign of a number of disorders in the body.

Note: when analyzing blood from a finger, the normal values ​​shift – up to the range of 3.3–5.5 mmol / l.

Why does blood sugar change

The body regulates the amount of glucose in the blood with the help of:

  • enzymes that help break down carbohydrates in the intestine and thus affect the rate at which glucose enters the bloodstream;
  • Hormones that determine how quickly the cells in the body will consume sugar from the blood.

The necessary enzymes are produced by the pancreas. It also produces insulin, a key hormone that allows cells to metabolize glucose. If there is too little insulin or, for example, the cells for some reason stop responding to it (this is called insulin resistance), the blood sugar level rises. In the first situation, they speak of type 1 diabetes, in the second, type 2 diabetes.

The work of the following also affects glycemia:

  • liver and kidneys, which cleanse the blood from excess glucose and remove the substance from the body;
  • Thyroid: The hormones secreted by it determine the rate at which cells consume sugar from the blood;
  • adrenal glands.This paired endocrine gland also produces hormones (such as adrenaline) that affect metabolic rate.

Why is the deviation of the sugar level from the norm dangerous?

Both hypo- and hyperglycemia affect well-being. First of all, the brain suffers, since its cells consume about half (up to 60% – if we are talking about a hungry or sedentary person) of all the energy supplied by glucose.

Dizziness, loss of concentration, weakness, darkening of the eyes, trembling hands are common symptoms for both low and high blood sugar.But in addition to feeling unwell, abnormal glycemia has other, more serious consequences.

With constant hyperglycemia, glucose accumulates in organs and tissues and becomes toxic – begins to destroy the liver, kidneys, retina, blood vessels, heart, nervous system. With a lack of sugar, the cells of the body are chronically lacking in nutrition, and this also leads to damage to vital organs.

Why is the level of sugar in the blood elevated?

Most often this indicates a pre-diabetic state or already onset diabetes mellitus.However, other medical problems can also increase blood glucose .

  • Hyperthyroidism. This is a condition in which the thyroid gland produces too many hormones.
  • Pancreatitis is an inflammation of the pancreas.
  • Severe stress.
  • Trauma or surgery.
  • Liver diseases.
  • Stroke.
  • Pancreatic cancer, as well as other, more rare, tumors.

Why is blood sugar low

Hypoglycemia is also a common companion of diabetes.It occurs when a person with the condition mistakenly takes too much insulin. But there are other possible reasons for the drop in blood glucose levels.

  • Insufficient power supply. Your blood sugar drops if you are on a too strict diet or have an eating disorder such as anorexia or bulimia.
  • Exercising too hard and too long. Let’s say you’ve just run a marathon, ridden a few tens of kilometers on a bicycle, or just dug a vegetable garden, forgetting about lunch.
  • Hypothyroidism. This is a condition in which the thyroid gland produces too few hormones.
  • Diseases of the adrenal glands, pituitary gland, liver or kidneys.

How to find out if your blood sugar level has deviated from the norm

It is almost impossible to do this without a blood test. The fact is that the characteristic symptoms of a decrease or increase in glucose levels can be easily confused with ordinary fatigue or, for example, a reaction to changes in the weather.

In order not to miss the developing hypo- or hyperglycemia and the diseases that caused it, doctors – both Western and Russian – recommend regular blood sugar tests.

It is necessary to donate blood for sugar at least once every three years. This is especially important for people over 45.

In addition, the analysis is recommended as soon as possible if you have signs of diabetes:

  • increased urination;
  • you put on a lot of weight;
  • Your vision deteriorates;
  • Weakness comes on regularly, up to darkening in the eyes.

What to do if your blood sugar level is low or high

This situation must be discussed with a physician.The doctor will establish the causes of hypo- or hyperglycemia, make an accurate diagnosis and give instructions on how to return glucose levels to normal.

Depending on the diagnosis, the physician can prescribe medications. Some of them may have to be taken for a lifetime.

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School of Diabetes – Self-monitoring of blood glucose

The main goal of treatment is to achieve normal or close to that level of glycated hemoglobin (reflects the “average” blood glucose level for 2-3 months), so as not to prevent the development of complications of diabetes.

The individual goal of treatment (glycated hemoglobin and fasting glucose) you choose together with your doctor, it will depend on several conditions: the duration of the disease and the presence of complications, age and concomitant diseases, etc.

In most cases, the optimal target is a glycated hemoglobin level <7%. In order to achieve this goal, it is necessary that the blood glucose level during self-monitoring does not exceed the corresponding values ​​(see.(see table below).

Individual treatment goals for fasting / pre-meal plasma glucose and 2 hours post-meal based on selected target glycated hemoglobin (HbA1c) level.

HbA1c,% Plasma glucose on an empty stomach / before meals, mmol / l Plasma glucose 2 hours after meals, mmol / l
<6.5 <6.5 <8.0
<7.0 <7.0 <9.0
<7.5 <7.5 <10.0
<8.0 <8.0 <11.0

For self-monitoring of blood glucose, use:

Test strips for portable devices – glucometers.The use of the meter does not require special training, it is only necessary, as before using any household appliance or equipment, to carefully read the instructions. Glucometers differ from each other primarily by the method of the test (electro- and photochemical), as well as the speed of determination (from 5 to 45 seconds), the presence or absence of a special code, the memory size of the results and other functions. The technique is very simple: you need to turn on the device, enter the code of the test strips (if necessary), insert the test strip and apply on it a small drop of blood obtained from the finger (the test strip with a capillary device will suck blood from the drop by itself).

See more Technique for taking a drop of blood.

Modern glucometers allow you to quickly get an accurate result (permissible error of 10-20%) anywhere (you can carry them with you), and also have a number of useful additional functions, the number of which is constantly increasing (memory, sound signal for visually impaired patients, the ability download results to a computer, etc.)

At the same time, it is necessary to take into account your possibilities: choose a device that you can afford to “maintain”, since the main expenses are not the cost of the device, but the cost of consumables – test strips.Sometimes the costs of purchasing test strips can be partially covered by relatives, for example, as a gift for a holiday, you can ask for a gift of test strips.

Remember that you need to calibrate your meters on a regular basis (check their accuracy with a known concentration of glucose solution supplied with the meter, or at laboratories / firms that offer such services), and change the batteries in time.

Remember not to use

test strips

  • Exposed to high or low temperatures
  • Expired

  • Stored in an open box

How often should self-monitoring of blood glucose levels be performed?

General rules for self-testing are approximately as follows.

In ordinary life, for patients on insulin, self-monitoring of blood glucose levels should be performed daily at least 4 times a day – before meals and before bedtime, sometimes 2 hours after meals, and several times a month at 2-4 am.

The frequency of self-monitoring of blood glucose depends on the type of antihyperglycemic therapy:

Type of antihyperglycemic therapy Frequency of examination
On intensive insulin therapy At least 4 times daily
On oral glucose-lowering therapy and / or GLP-1 receptor agonists and / or basal insulin At least 1 time per day at different times + 1 glycemic profile (at least 4 times a day) per week
On ready-mixed insulin At least 2 times a day at different times + 1 glycemic profile (at least 4 times a day) per week
On diet therapy Once a week at different times of the day

Additional measurements are required in the following situations:

  • sports
  • travel
  • symptoms of hypoglycemia
  • before driving.

Regular blood glucose measurement allows the trained patient to independently adjust their insulin doses and / or adjust their diet and physical activity to achieve target blood glucose values ​​to prevent future complications. However, sometimes self-monitoring blood glucose data are insufficient to understand the causes of poor glycemic control. Installing a continuous blood glucose monitoring system (CGMS) can help in this situation.

Self-control in type 2 diabetes mellitus

What does “self-control” mean and why is it needed?

Self-control is understood as the analysis of some parameters at home: self-determination of sugar levels in blood and urine, ketone bodies (acetone) in urine, measurement of weight and blood pressure.

Self-sufficient
determination of sugar level
in blood and urine

Ketone bodies (acetone)
in urine

Weight measurement
and blood pressure

The value of the results obtained with self-monitoring at home is much higher, since they reflect your condition in real life.The results of blood glucose measurements taken in a clinic or hospital, as well as blood pressure measurements under these conditions, may not correspond to reality. Firstly, you are in completely different, unusual conditions, and secondly, these measurements are single and have only diagnostic value. It is not possible to adjust insulin dosages for better diabetes management based on a single result in the past.

Self-testing will allow you

  • Determine if you have met your diabetes treatment goals.
  • Evaluate the effectiveness of selected treatment
  • Independently or with the help of a doctor, make timely adjustments in insulin doses, make changes in diet and physical activity.
  • Assess how the changes made affect diabetes management.
  • Become an active participant in the treatment process, understand what is happening to you and manage the situation.

Self-check diary

All self-monitoring scores, as well as information regarding your diet, physical activity and therapy received, must be recorded in the Self-Monitoring Diary and shown to the doctor at each visit.There are programs that allow you to read the readings from your blood glucose meter to a computer or smartphone, add other information there, and thus keep an electronic diary.

The diary serves as the basis for correcting the treatment, both independently and after discussion with the doctor. Remember that it is important for the doctor to know what is happening to you at home, in real life. Therefore, be sure to bring your Self-Monitoring Diary with you to every visit so that you can make informed decisions with your doctor and effectively manage your diabetes!

A handy self-check diary can be found here.

Self-monitoring of blood glucose

The main goal of diabetes management is to achieve target levels of blood glucose and glycated hemoglobin (reflects the “average” blood glucose level over 2-3 months) in order to prevent the development of complications of diabetes.

The individual goal of treatment (glycated hemoglobin and glucose levels on an empty stomach and after meals) you choose together with your doctor, it will depend on several conditions: the duration of the disease and the presence of complications, age and concomitant diseases, etc.e. In most cases, the optimal target is a glycated hemoglobin level <7%. In order to achieve this goal, it is necessary that the blood glucose level during self-monitoring does not exceed the corresponding values ​​(see table below).

HbA1c,% Plasma glucose on an empty stomach / before meals, mmol / l Plasma glucose 2 hours after meals, mmol / l
<6.5 <6.5 <8.0
<7.0 <7.0 <9.0
<7.5 <7.5 <10.0
<8.0 <8.0 <11.0

For self-monitoring of blood glucose you can use:

Test strips inserted into portable devices – glucometers.No special training is required to use the meter. You must carefully read the instructions.

Meters may differ from each other:

  • by test method (electro- and photochemical),
  • glucose test rate (5 to 45 seconds),
  • the presence or absence of a special code that must be entered to use the test strips,
  • memory capacity of the obtained results,
  • additional functions.

You must turn on the meter, enter the test strip code (if necessary), insert the test strip and apply a small drop of blood from your finger to it (the test strip with a capillary device will draw the blood from the drop by itself).

Advantages:

  • speed of obtaining results,
  • high accuracy (permissible error, 10-20%, does not significantly affect the assessment of the result),
  • carryable,
  • convenient additional functions (memory, sound signal for visually impaired patients, the ability to download results to a computer or smartphone, etc.)etc.).

Disadvantages:
– the higher cost of test strips and the cost of purchasing the device itself.

Choose a device that you can afford to “maintain”, since the main expense is not the cost of the device, but the purchase of test strips.

Remember that you need to calibrate your meters regularly (check their accuracy with a known concentration of glucose solution supplied with the meter, or in laboratories / companies that offer such services), and change the batteries in time.

Remember not to use test strips:

  • exposed to high or low temperatures,
  • Expired

  • ,
  • stored in open packaging.

Technique for taking a drop of blood

For blood sampling, it is most convenient to use special devices (supplied with the device or purchased separately), into which needles (lancets) are inserted, allowing to make a skin puncture less painful.Lancets should be changed to prevent blunt needle injury and infection.

Before piercing a finger, wash your hands with warm water (except for hygiene, this will ensure blood flow) and wipe them dry. It is not necessary to treat the skin with alcohol or other solutions – this can distort the result.

The puncture should be done on the lateral surface of the terminal phalanx of the finger. Blood vessels pass in the lateral surfaces, and nerve fibers in the pads.Punctures in the pads produce less blood, are more painful, and heal less well. It is better not to pierce thumbs and forefingers, as they are more often used for various activities (writing, etc.)

After the puncture, you must bring your finger with a drop of blood to the test strip and drop it on it or allow the capillary strip to suck in blood. If, for some reason, it was not possible to wash your hands, then wipe the first drop of blood and use the second one for analysis.Now you have to wait a few seconds – and the result is ready. After that, enter the result in the Self-Control Diary.

How often should the self-test be carried out

blood glucose levels?

The frequency of self-monitoring depends on many factors: therapy regimen, lifestyle, etc. This is an absolutely individual scheme that is developed in conjunction with a doctor.

General rules for the conduct of self-control

If you are on insulin therapy in a multiple injection mode, then self-monitoring of blood glucose should be performed daily at least 4 times a day – before main meals and before bedtime, and also periodically 2 hours after meals, and several times a month at 2 -4 a.m.

Additional measurements will be required in the following situations:

  • Sports,
  • travel,
  • comorbidities,
  • symptoms of hypoglycemia,
  • before driving.

Regular measurement of blood glucose allows the trained patient to independently (based on the doctor’s recommendations) change insulin doses and / or adjust their diet and physical activity, achieving target blood glucose values ​​that will prevent future complications.

However, sometimes self-monitoring blood glucose data are insufficient to understand the causes of poor glycemic control. Installing a continuous blood glucose monitoring system (CGMS) can help in this situation.

Self-monitoring of glucose in urine

Do i need to measure urine glucose? There is a clear relationship between urine glucose and blood glucose.Glucose in urine appears when its blood level exceeds 8-10 mmol / L (this level is called the “renal threshold”). It is impossible to find insulin based on the level of glucose in the urine. In the case of regular self-monitoring of blood glucose, urinary glucose does not provide any additional information and does not need to be determined.

Self-control of the level of ketone bodies

The appearance of ketone bodies may indicate the development of a serious complication – diabetic ketoacidosis.

Ketone bodies in urine are determined using test strips that may be similar to those commonly used for self-monitoring of blood sugar. The test strip is dipped into a container with urine and after a while it is compared with a color scale showing the level of ketone bodies.

Most endocrinologists believe that it is advisable to determine the level of ketone bodies:

  • with a blood sugar level above 13 mmol / l,
  • in the presence of symptoms of diabetic ketoacidosis (especially nausea, vomiting, abdominal pain),
  • if there is a concomitant illness (for example, influenza or SARS).

Be sure to talk to your doctor about how and when you should measure your ketone levels.

Self-monitoring of blood pressure

Type 2 diabetes mellitus is often associated with an increase in blood pressure, which leads to the development of cardiovascular disease and the development of kidney damage.

Self-monitoring of blood pressure will allow:

  • to evaluate the effectiveness of the prescribed therapy,
  • to make timely correction of therapy,
  • to evaluate the effectiveness of the changes in therapy.

Targets for the treatment of hypertension in type 2 diabetes mellitus:

Indicator Target values, mm Hg
Systolic blood pressure 120-130
Diastolic blood pressure 70-80

Take a blood pressure measurement while sitting at rest for at least 10 minutes.The arm should be bent at the elbow and lie horizontally.

A few practical tips:

  • Purchase a tonometer: it can be mechanical or electronic (semi- and automatic). If you plan to measure your blood pressure yourself, then it is more convenient to use an electronic tonometer.
  • Choose the “worst” hand. The blood pressure level may differ on the right and left hands by 10-15 mm Hg. Measure blood pressure on both hands, and then take measurements on the arm that obtained the higher blood pressure numbers.
  • The cuff should not be applied tightly, so that there is space for 1 finger between it and the hand. There are cuffs of 2 diameters – for patients with medium and large arm circumferences. Inflate the air into the cuff with the hand opposite to the one on which the cuff is applied.
  • Do not forget to regularly calibrate the tonometer in a service workshop (this should be done at least once a year), as well as change the batteries in the electronic tonometer.
  • Blood pressure should be measured daily at different times and recorded in the Self-Monitoring Diary. It should also contain information about the medications you receive to control your blood pressure.

Self-check weight

Most people with type 2 diabetes are overweight or obese. You can find out if you are overweight or obese by using the body mass index (BMI) formula.BMI = human weight divided by height in meters squared (BMI = kg / m2)

Body mass index, kg / m 2 Correspondence between the mass of a person and his height
16 or less Severe underweight
16-18.5 Insufficient (deficiency) body weight
18.5-25 Norm
25-29.9 Overweight (pre-obesity)
30-34.9 First degree obesity
35-39.9 Second degree obesity
40 and more Obesity of the third degree (morbid)

Obesity treatment goals: to reduce weight by 5-10% from the baseline and maintain the obtained result.

The most unfavorable distribution of fat is its deposition on internal organs (the so-called abdominal or visceral obesity, or obesity of the “apple” type), as evidenced by a waist circumference of more than 94 cm in men and more than 80 cm in women. Visceral obesity contributes to the development of type 2 diabetes, arterial hypertension and cardiovascular disease.

Weighing at home will allow you to assess the dynamics of weight and thus assess the effectiveness of lifestyle changes: diet and physical activity.

Weigh yourself once a week, it is best to do this at the same time (in the morning, on an empty stomach) in the same clothes. At the same time, you can measure your waist circumference with a tape measure. Be sure to record the results in the Self-Control Diary.

What other parameters need to be monitored?

Glycated hemoglobin (HbA1c).

This indicator reflects the “average” blood sugar level over the last 2-3 months (but is not equal to it in terms of the digital value!) And allows you to assess the effectiveness of the glucose-lowering therapy in combination with lifestyle changes.

The level of glycated hemoglobin should be determined in the laboratory every 3-4 months. This test can be performed at any time of the day (it is not required to take on an empty stomach. The individual target level of glycated hemoglobin you select together with your doctor. It will depend on several conditions: the duration of the disease and the presence of complications, age and concomitant diseases, etc. In most In some cases, the optimal target is a glycated hemoglobin level below 7%.

A glycated hemoglobin level higher than the target indicates that lifestyle changes and / or antihyperglycemic therapy is needed.

HbA1c,
%
SSGP,
mmol / l
HbA1c,
%
SSGP,
mmol / l
HbA1c,
%
SSGP,
mmol / l
HbA1c,
%
SSGP,
mmol / l
four 3.8 eight 10.2 12 16.5 sixteen 22.9
4.5 4.6 8.5 11.0 12.5 17.3 16.5 23,7
five 5.4 nine 11.8 13 18.1 17 24.5
5.5 6.2 9.5 12.6 13.5 18.9 17.5 25.3
6 7.0 10 13.4 fourteen 19.7 eighteen 26.1
6.5 7.8 10.5 14.2 14.5 20.5 18.5 26.9
7 8.6 eleven 14.9 fifteen 21.3 nineteen 27.7
7.5 9.4 11.5 15.7 15.5 22.1 19.5 28.5

SSGP – average daily blood plasma glucose

What other parameters need to be monitored?

Indicators of lipid metabolism (synonyms: lipid spectrum, lipid profile).

Includes several parameters: total cholesterol, low density lipoproteins, triglycerides, high density lipoproteins.
Cholesterol is necessary for the body to synthesize hormones, vitamins, and cell membranes. It is carried throughout the body in conjunction with proteins, forming particles called lipoproteins. Conditionally, lipoproteins are divided into “bad” (atherogenic) – these are low density lipoproteins (LDL), they give cholesterol to the walls of blood vessels, contributing to the development of atherosclerotic plaques, which clog the vessels and cause the development of myocardial infarction, stroke and gangrene.
Triglycerides (TGs) are also involved in the formation of plaques. The defense mechanism is represented by “good” high density lipoproteins (HDL) (antiatherogenic) – they take cholesterol from the vessel wall, preventing plaque formation.

The target LDL cholesterol level depends on the degree of cardiovascular risk.

Two levels of recommendation are possible:

  • with very high risk and progression of atherosclerosis <1.8 mmol / L
  • with high cardiovascular risk <2.5 mmol / L

Your doctor will help you set your target level.

It is necessary to determine the lipid spectrum in the laboratory at least once a year.

If your lipid spectrum is abnormal, your doctor will prescribe special medications in addition to changing your diet and increasing physical activity.

90,000 The risk of diabetes can be detected 20 years before the onset of the disease

Signs of type 2 diabetes may appear 20 years before the diagnosis is made – such a discovery was made by scientists from the Aizawa hospital in Matsumoto (Japan).

The study covered 27 392 people and lasted from 2005 to 2013. In the first phase, the authors collected data on the weight and blood sugar levels of the participants, according to the Daily Mail.

11 years later, 1,067 people were diagnosed with diabetes. It turned out that the patients had elevated body mass index (BMI), blood sugar and insulin resistance long before doctors confirmed the disease.

The norm is a sugar level less than 100 mg / dl on an empty stomach (milligrams per deciliter), indicators 100-125 mg / dl – pre-diabetic state, above 126 mg / dl – diabetes.

Japanese scientists found that people with a level of 101.5 mg / dL ten years later were diagnosed with the disease. Participants with 105 mg / dL levels became ill after five years, and those with 110 mg / dL within a year.

Among 15,778 volunteers who were in good health at the start of the study, 4,781 developed prediabetes over time. But blood sugar also started to rise early and gradually.

Japanese scientists have noted that type 2 diabetes does not develop in three days.In most cases, patients have the ability to prevent it. But you need to monitor your condition and change your lifestyle as soon as the blood sugar level begins to rise, and not wait for severe consequences.

Previously, scientists found that in the first two years after the onset of diabetes, beta cells that produce insulin can recover. But for this you have to go on a very strict diet. After three years, the opportunity to go into remission is likely to disappear.

90,000 High blood sugar in a child

21.04.2020


What to do? Where to run? Often the accidental “detection” of elevated blood glucose levels occurs while playing with the grandmother’s glucometer. Let’s measure the baby’s sugar? And there … oh horror! 5.8-6.0 mmol / L.

Another “find”: improper preparation for the blood glucose test (for example: before the morning examination, the child ate chocolate at night; the test was taken after breakfast; or the child did not eat ANYTHING in the morning, but drank sweet tea).

In overweight children, glycemic figures can be up to 6.7 mmol / l – this is a reason to seek help from a pediatric endocrinologist and conduct a glucose tolerance test in order to exclude insulin resistance.

However, only the readings of the glucometer are not reliable and sufficient for the diagnosis of diabetes mellitus. The diagnosis is established by a doctor taking into account an objective examination, analysis of complaints (thirst, polyuria, fatigue, loss of appetite, weight loss, moodiness, skin disorders), interpretation of laboratory data – primarily, the level of glucose in the venous blood and the results of additional examinations.

The situation with an increase in blood glucose is not safe for the health of the child! Gradually, the toxic effect of high sugar levels leads to damage to nerve endings, blood vessels and other organs and systems of the child’s body. Over time, with diabetes mellitus, wounds and cuts do not heal well, vision deteriorates, weakness in the legs appears, and pains in the lower extremities join. The course of the disease also depends on other, so far poorly understood, factors, including genetic ones.

Research by scientists shows that complications of diabetes can be prevented or delayed by maintaining normal blood sugar levels, through adequate treatment of the underlying disease under the supervision of a specialist endocrinologist.

If you have any questions, please contact a pediatric endocrinologist.
An experienced children’s endocrinologist Danilycheva Lyubov Ivanovna works at the Children’s Diagnostic Center!

Be healthy!

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90,000 Gestational Diabetes – Bahçeci IVF Clinic

How is Gestational Diabetes Diagnosed?

Diabetes mellitus is an extremely important medical problem when the pancreas produces very little or no insulin.Diabetes, which is on the rise with obesity, has become a global health problem.

Diabetes is a metabolic disease associated with the metabolism of proteins, fats and especially carbohydrates. Without insulin, sugar and other nutrients cannot enter the cells that need them. Thus, when cells lack sugar, blood glucose levels rise above normal levels. There are two different forms of diabetes: type 1 and type 2. In type 1 diabetes, the pancreas cannot provide the body with enough insulin.The diagnosis is usually made at an early age. Type 1 diabetes is always treated with insulin. Type 2 diabetes is known as non-insulin dependent diabetes. In women, this is observed especially in combination with polycystic ovary syndrome. However, a woman who has never been diagnosed with diabetes can be diagnosed with diabetes during pregnancy. This condition, known as gestational diabetes, can go away on its own after pregnancy. The risk group for gestational diabetes includes women with a family history of diabetes mellitus, high blood pressure, high cholesterol, and overweight.Gestational diabetes occurs in about 3 percent of all pregnant women, but in about 10 percent of these cases, the condition becomes permanent.

How Does Gestational Diabetes Develop?

Women with gestational diabetes do not have diabetes before pregnancy. Although insulin levels in these women are sufficient, hormones produced by the placenta prevent insulin from acting and therefore blood sugar levels rise. This effect usually intensifies in the 20th and 24th weeks of pregnancy.However, in overweight women, blood glucose levels can be high from the first months of pregnancy. As the placenta leaves the mother’s body during childbirth, these hormones stop being produced and the disease goes away.

Who Is At Risk for Gestational Diabetes?

• Women with a family history of diabetes,
• Overweight women,
• Women with previously born babies weighing more than 4 kg,
• Women who have had a miscarriage,
• Pregnant women over 25,
• Women with a high blood glucose in previous pregnancies,
• Women whose urine contains sugar.

What Should People With Gestational Diabetes Do?

Women at risk of gestational diabetes should have an oral glucose tolerance test during the first months of pregnancy. Even if diabetes is not diagnosed at this stage, the test should be repeated at 20-24 weeks of gestation.

Since the condition is asymptomatic, all pregnant women should be tested for gestational diabetes. During the oral glucose tolerance test, a solution containing 50 g of glucose is given at any time of the day.An hour later, the blood glucose level is assessed. If the blood glucose level exceeds 140 mg / dl, another test with 100 g of glucose is done, as the situation is assessed as risky. If the results show glucose levels below 140 mg / dL, there is no risk of developing diabetes.

If a pregnant woman has a fasting glucose level of more than 126 g / dL, or if the glucose level measured at any time is more than 200 g / dL, this means that she had diabetes before pregnancy.

How Does Gestational Diabetes Affect My Baby?

In women with gestational diabetes, blood sugar usually rises around the 24th week.This does not lead to any deviations in the development of the baby. However, if the disease is diagnosed during the first trimester, the expectant mother should be careful. Women diagnosed with diabetes before pregnancy can also give birth to healthy babies. However, these women should have regular blood glucose tests.

Gestational diabetes is an important risk factor as it results in high birth weight in the baby. Because the mother has high blood sugar, the baby’s pancreas makes more insulin, which leads to weight gain.Hence, a caesarean section may be required. The baby may have low blood sugar at birth, so the baby’s blood sugar must be monitored. In addition, these children may suffer from low levels of calcium and magnesium, which must also be monitored.

What To Look For In Gestational Diabetes?

There are two ways to monitor gestational diabetes. The first is to control the mother’s blood sugar. The second way is to monitor the development of the child.The most important thing in gestational diabetes is to keep blood sugar under control. Blood sugar levels are maintained between 60 and 120 mg / dL with regular blood tests. It is necessary to measure blood sugar levels on an empty stomach and after meals. In addition, blood sugar should be measured before dinner and at 10:30 pm (sometimes at 3-4 am). Fasting blood sugar should be equal to or below 95 mg / dL; and postprandial blood sugar levels should be equal to or below 140 mg / dL (one hour after a meal) and 120 mg / dL (two hours after a meal).In addition, it is important to measure the level of ketone bodies in the urine from time to time. High urinary ketones are an important marker of diabetes.

Power & Physical

Acceptable weight gain during pregnancy is 9 to 12 kg. If a woman was overweight before pregnancy, then the corresponding weight gain is 7-8 kg; and if she was underweight, the corresponding weight gain should be 17-20 kg. Exercise and a healthy lifestyle are essential for diabetes.This is because exercise helps to lower blood sugar levels as well as keep it in check. Pregnant women are advised to go for walks 4-5 times a week. In addition to walking, they can do daily aerobic exercise for 45 minutes. While nutrition is very important for all pregnant women, it is even more important for women with gestational diabetes. Vegetables, whole grains, dried legumes, and meats should be preferred. Eat olive oil, whole grain bread, low fat yogurt, and skim milk.Margarine should not be consumed and carbohydrate intake should be limited. Carbohydrates should not exceed 40% of your total daily calorie intake. Another important point is blood pressure values. Blood pressure should be monitored regularly; in case the systolic blood pressure is over 140 and the diastolic blood pressure is over 90, you should see your doctor immediately.

When and How is Gestational Diabetes Treated with Insulin?

If fasting blood sugar exceeds 105 mg / dl despite diet, and blood sugar exceeds 120 mg / dl within 2 hours of a meal, insulin treatment is required.Pregnant women who begin insulin treatment should have their blood sugar levels monitored at home. Insulin can be taken several times a day, according to your doctor’s instructions. Oral antidiabetic drugs are not used during pregnancy as they pass through the placenta.

Childbirth and the Puerperium

Women diagnosed with gestational diabetes may have a vaginal delivery. However, the child’s condition is the main factor for making a decision.Childbirth usually occurs at 38 weeks gestation. If your blood sugar remains high during labor, insulin is given through an IV line. With regular follow-up, you can give birth to a healthy baby.

In the postpartum period, the mother’s nutrition should be the same as during pregnancy. When blood sugar levels return to normal, insulin treatment ends. For this reason, blood sugar should be measured regularly on the day of birth and on the following days. If postpartum blood sugar is within the normal range, it should still be measured 1-2 months after birth.

Women with gestational diabetes are at a higher risk (about 10%) of developing diabetes in the future. That is why they need to keep their weight under control, exercise regularly and eat healthy foods.