What are the diagnostic criteria for type 2 diabetes. How is type 2 diabetes diagnosed and treated. What lifestyle changes can help manage type 2 diabetes. What are the target blood sugar levels for people with type 2 diabetes. How often should A1C levels be tested in diabetics.

Diagnosing Type 2 Diabetes: Tests and Criteria

Type 2 diabetes is a chronic condition characterized by high blood sugar levels. Accurate diagnosis is crucial for proper management and prevention of complications. Let’s explore the primary diagnostic tests and criteria used by healthcare professionals.

Glycated Hemoglobin (A1C) Test

The A1C test is the most common method for diagnosing type 2 diabetes. This blood test provides insight into average blood sugar levels over the past 2-3 months. The results are interpreted as follows:

• Below 5.7%: Normal
• 5.7% to 6.4%: Prediabetes
• 6.5% or higher on two separate tests: Diabetes

Why is the A1C test preferred for diagnosis? It doesn’t require fasting and provides a broader view of blood sugar control over time, making it a convenient and reliable option for both patients and healthcare providers.

Alternative Diagnostic Tests

In cases where the A1C test is unavailable or unsuitable due to certain medical conditions, doctors may use other tests to diagnose diabetes:

1. Random Blood Sugar Test: A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher, regardless of when you last ate, suggests diabetes.
2. Fasting Blood Sugar Test: After an overnight fast, results are interpreted as:
   • Less than 100 mg/dL (5.6 mmol/L): Normal
   • 100 to 125 mg/dL (5.6 to 6.9 mmol/L): Prediabetes
   • 126 mg/dL (7 mmol/L) or higher on two separate tests: Diabetes
3. Oral Glucose Tolerance Test: Less commonly used except during pregnancy, this test involves drinking a sugary liquid after fasting overnight. Blood sugar levels are then tested periodically over the next two hours.

How do these tests complement each other? While the A1C test provides a long-term view, random and fasting blood sugar tests offer snapshots of current glucose levels, and the oral glucose tolerance test assesses how effectively your body processes sugar.

Screening Recommendations for Type 2 Diabetes

Early detection of type 2 diabetes is vital for preventing complications. The American Diabetes Association recommends routine screening for specific groups:

• All adults aged 45 or older
• Overweight or obese individuals under 45 with one or more diabetes risk factors
• Women with a history of gestational diabetes
• Individuals diagnosed with prediabetes
• Children who are overweight or obese and have a family history of type 2 diabetes or other risk factors

Why is targeted screening important? By focusing on high-risk groups, healthcare providers can identify and treat diabetes early, potentially preventing or delaying serious health complications.

Post-Diagnosis Steps and Ongoing Monitoring

After a type 2 diabetes diagnosis, your healthcare provider will implement a comprehensive management plan:

• Differentiation between type 1 and type 2 diabetes, as treatments may differ
• Regular A1C testing, at least twice a year or more frequently if treatment changes
• Setting target A1C levels, typically below 7% for most people
• Screening for diabetes-related complications and comorbid conditions

How often should A1C levels be tested? For most people with well-controlled diabetes, testing every six months is sufficient. However, those with unstable blood sugar or recent treatment changes may need more frequent testing.

Comprehensive Treatment Approach for Type 2 Diabetes

Managing type 2 diabetes involves a multifaceted approach aimed at maintaining blood sugar levels within a target range. The primary components of diabetes management include:

• Healthy eating habits
• Regular physical activity
• Weight management
• Medication or insulin therapy (if necessary)
• Blood sugar monitoring

Why is a comprehensive approach crucial? Each component plays a vital role in blood sugar control, and combining these strategies can lead to better overall health outcomes and delay or prevent diabetes-related complications.

Nutritional Strategies for Type 2 Diabetes Management

While there’s no one-size-fits-all “diabetes diet,” adopting healthy eating habits is crucial for managing type 2 diabetes. Key dietary recommendations include:

• Establishing a regular meal and snack schedule
• Controlling portion sizes
• Increasing intake of high-fiber foods (fruits, non-starchy vegetables, whole grains)
• Reducing consumption of refined grains, starchy vegetables, and sweets
• Choosing lean proteins and low-fat dairy
• Using healthy cooking oils like olive or canola oil
• Managing overall calorie intake

How can a registered dietitian help? These nutrition professionals can provide personalized guidance, helping you make healthy food choices, plan balanced meals, develop new habits, and monitor carbohydrate intake for better blood sugar control.

The Role of Physical Activity in Diabetes Management

Regular exercise is a cornerstone of type 2 diabetes management, offering numerous benefits:

• Improved insulin sensitivity
• Better blood sugar control
• Weight management
• Reduced risk of cardiovascular complications

What types of exercise are recommended for people with type 2 diabetes?

Aerobic Exercise

Adults should aim for at least 150 minutes of moderate aerobic activity per week. This can include activities like:

• Brisk walking
• Swimming
• Cycling
• Running

Resistance Exercise

Strength training is also important for diabetes management. It helps:

• Increase muscle mass
• Improve insulin sensitivity
• Enhance overall strength and balance

Examples of resistance exercises include weightlifting, yoga, and bodyweight exercises.

How much exercise is recommended for children with type 2 diabetes? Children should engage in at least 60 minutes of moderate to vigorous aerobic activity daily, along with activities that strengthen muscles and bones.

Medication and Insulin Therapy in Type 2 Diabetes Treatment

While lifestyle modifications are the foundation of type 2 diabetes management, many individuals also require medication or insulin therapy to achieve optimal blood sugar control. The choice of medication depends on various factors, including:

• Blood sugar levels
• Overall health status
• Presence of other medical conditions
• Potential side effects
• Cost and insurance coverage

Common Medications for Type 2 Diabetes

Several classes of medications are used to treat type 2 diabetes:

1. Metformin: Often the first-line medication, it reduces glucose production in the liver.
2. Sulfonylureas: These drugs stimulate the pancreas to produce more insulin.
3. DPP-4 inhibitors: They help the body continue to make insulin and reduce glucose production.
4. GLP-1 receptor agonists: These slow digestion and help lower blood glucose levels.
5. SGLT2 inhibitors: They work by helping the kidneys remove glucose from the body through urine.
6. Thiazolidinediones: These drugs help insulin work better in the muscle and fat cells.

When is insulin therapy necessary for type 2 diabetes? Insulin may be prescribed if oral medications are not effectively controlling blood sugar levels, or if the pancreas is no longer producing sufficient insulin. Some people may need insulin temporarily, while others may require it long-term.

Blood Sugar Monitoring: A Crucial Aspect of Diabetes Management

Regular blood sugar monitoring is essential for effective diabetes management. It helps individuals with type 2 diabetes:

• Understand how food, physical activity, and medications affect blood sugar levels
• Detect patterns and make necessary adjustments to their management plan
• Prevent or identify hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar)
• Track progress towards treatment goals

Blood Sugar Monitoring Methods

There are several ways to monitor blood sugar levels:

1. Traditional glucose meters: These devices require a small blood sample, usually obtained by pricking a fingertip.
2. Continuous glucose monitoring (CGM) systems: These devices use a small sensor inserted under the skin to measure glucose levels in interstitial fluid continuously.
3. Flash glucose monitoring: Similar to CGM, but requires the user to scan the sensor to obtain a reading.

How often should blood sugar be checked? The frequency of blood sugar monitoring varies depending on individual factors such as medication regimen, overall health, and glucose control. Your healthcare provider will recommend an appropriate testing schedule.

Preventing Complications of Type 2 Diabetes

Proper management of type 2 diabetes is crucial for preventing or delaying serious complications. Long-term complications of poorly controlled diabetes can affect various body systems:

• Cardiovascular system: Increased risk of heart disease, stroke, and high blood pressure
• Nervous system: Peripheral neuropathy, leading to numbness or tingling in extremities
• Kidneys: Diabetic nephropathy, potentially leading to kidney failure
• Eyes: Diabetic retinopathy, which can cause vision loss
• Skin: Increased susceptibility to infections and slow wound healing
• Feet: Poor circulation and nerve damage, increasing the risk of foot ulcers

Strategies for Complication Prevention

To minimize the risk of diabetes-related complications:

1. Maintain blood sugar levels within target ranges
2. Control blood pressure and cholesterol levels
3. Quit smoking and limit alcohol consumption
4. Attend regular check-ups and screenings
5. Practice good foot care and hygiene
6. Manage stress effectively

Why is early intervention important? Detecting and addressing complications in their early stages can significantly improve outcomes and quality of life for individuals with type 2 diabetes.

The Importance of Mental Health in Diabetes Management

Living with type 2 diabetes can be challenging, and it’s crucial to address the psychological aspects of the condition. Mental health plays a significant role in diabetes management:

• Stress can affect blood sugar levels and make diabetes harder to control
• Depression and anxiety are more common in people with diabetes
• Mental health issues can impact adherence to treatment plans

Strategies for Maintaining Mental Well-being

To support mental health while managing type 2 diabetes:

1. Seek support from family, friends, or support groups
2. Practice stress-reduction techniques like meditation or deep breathing exercises
3. Engage in regular physical activity, which can improve mood and reduce stress
4. Consider counseling or therapy if needed
5. Communicate openly with your healthcare team about any mental health concerns

How does addressing mental health improve diabetes management? By managing stress and maintaining good mental health, individuals with type 2 diabetes are better equipped to adhere to their treatment plans and make healthy lifestyle choices.

Emerging Treatments and Research in Type 2 Diabetes

The field of diabetes research is constantly evolving, with new treatments and management strategies emerging. Some promising areas of research include:

• Artificial pancreas systems: Combining continuous glucose monitoring with insulin pumps for automated insulin delivery
• Gene therapy: Exploring ways to modify genes related to insulin production or glucose metabolism
• Stem cell therapy: Investigating the potential of stem cells to regenerate insulin-producing cells
• Gut microbiome research: Studying the role of gut bacteria in glucose regulation and diabetes development
• Smart insulin: Developing insulin that activates only when blood sugar levels are elevated

How might these advancements impact diabetes care? As research progresses, new treatments could offer more personalized and effective management options, potentially improving quality of life and long-term outcomes for people with type 2 diabetes.

In conclusion, managing type 2 diabetes requires a comprehensive approach that combines medical treatment with lifestyle modifications. By understanding the diagnosis process, treatment options, and the importance of ongoing monitoring, individuals with type 2 diabetes can take an active role in their health and minimize the risk of complications. As research continues to advance, new treatments and management strategies may offer even more effective ways to control blood sugar levels and improve overall health outcomes.

Type 2 diabetes – Diagnosis and treatment

Diagnosis

Type 2 diabetes is usually diagnosed using the glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. Results are interpreted as follows:

• Below 5.7% is normal.
• 5.7% to 6.4% is diagnosed as prediabetes.
• 6.5% or higher on two separate tests indicates diabetes.

If the A1C test isn’t available, or if you have certain conditions that interfere with an A1C test, your doctor may use the following tests to diagnose diabetes:

Random blood sugar test. Blood sugar values are expressed in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L) of blood. Regardless of when you last ate, a level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially if you also have signs and symptoms of diabetes, such as frequent urination and extreme thirst.

Fasting blood sugar test. A blood sample is taken after an overnight fast. Results are interpreted as follows:

• Less than 100 mg/dL (5.6 mmol/L) is normal.
• 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is diagnosed as prediabetes.
• 126 mg/dL (7 mmol/L) or higher on two separate tests is diagnosed as diabetes.

Oral glucose tolerance test. This test is less commonly used than the others, except during pregnancy. You’ll need to fast overnight and then drink a sugary liquid at the doctor’s office. Blood sugar levels are tested periodically for the next two hours. Results are interpreted as follows:

• Less than 140 mg/dL (7.8 mmol/L) is normal.
• 140 to 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) is diagnosed as prediabetes.
• 200 mg/dL (11.1 mmol/L) or higher after two hours suggests diabetes.

Screening. The American Diabetes Association recommends routine screening with diagnostic tests for type 2 diabetes in all adults age 45 or older and in the following groups:

• People younger than 45 who are overweight or obese and have one or more risk factors associated with diabetes
• Women who have had gestational diabetes
• People who have been diagnosed with prediabetes
• Children who are overweight or obese and who have a family history of type 2 diabetes or other risk factors

After a diagnosis

If you’re diagnosed with diabetes, your doctor or health care provider may do other tests to distinguish between type 1 and type 2 diabetes — since the two conditions often require different treatments.

Your health care provider will repeat the test A1C levels at least two times a year and when there are any changes in treatment. Target A1C goals vary depending on your age and other factors. For most people, the American Diabetes Association recommends an A1C level below 7%.

You will also receive regular diagnostic tests to screen for complications of diabetes or comorbid conditions.

Treatment

Management of type 2 diabetes includes:

• Healthy eating
• Regular exercise
• Weight loss
• Possibly, diabetes medication or insulin therapy
• Blood sugar monitoring

These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications.

Healthy eating

Contrary to popular perception, there’s no specific diabetes diet. However, it’s important to center your diet around:

• A regular schedule for meals and healthy snacks
• Smaller portion sizes
• More high-fiber foods, such as fruits, nonstarchy vegetables and whole grains
• Fewer refined grains, starchy vegetables and sweets
• Modest servings of low-fat dairy, low-fat meats and fish
• Healthy cooking oils, such as olive oil or canola oil
• Fewer calories

Your health care provider may recommend seeing a registered dietitian, who can help you:

• Identify healthy choices among your food preferences
• Plan well-balanced, nutritional meals
• Develop new habits and address barriers to changing habits
• Monitor carbohydrate intake to keep your blood sugar levels more stable

Physical activity

Exercise is important for losing weight or maintaining a healthy weight. It also helps with regulating blood sugar levels. Talk to your primary health care provider before starting or changing your exercise program to ensure that activities are safe for you.

Aerobic exercise. Choose an aerobic exercise that you enjoy, such as walking, swimming, biking or running. Adults should aim for 30 minutes or more of moderate aerobic exercise on most days of the week, or at least 150 minutes a week. Children should have 60 minutes of moderate to vigorous aerobic exercise daily.

Resistance exercise. Resistance exercise increases your strength, balance and ability to perform activities of daily living more easily. Resistance training includes weightlifting, yoga and calisthenics.

Adults living with type 2 diabetes should aim for two to three sessions of resistance exercise each week. Children should engage in activities that build strength and flexibility at least three days a week. This can include resistance exercises, sports and climbing on playground equipment.

Limit inactivity. Breaking up long bouts of inactivity, such as sitting at the computer, can help control blood sugar levels. Take a few minutes to stand, walk around or do some light activity every 30 minutes.

Weight loss

Weight loss results in better control of blood sugar levels, cholesterol, triglycerides and blood pressure. If you’re overweight, you may begin to see improvements in these factors after losing as little as 5% of your body weight. However, the more weight you lose, the greater the benefit to your health and disease management.

Your health care provider or dietitian can help you set appropriate weight-loss goals and encourage lifestyle changes to help you achieve them.

Monitoring your blood sugar

Your health care provider will advise you on how often to check your blood sugar level to make sure you remain within your target range. You may, for example, need to check it once a day and before or after exercise. If you take insulin, you may need to do this multiple times a day.

Monitoring is usually done with a small, at-home device called a blood glucose meter, which measures the amount of sugar in a drop of your blood. You should keep a record of your measurements to share with your health care team.

Continuous glucose monitoring is an electronic system that records glucose levels every few minutes from a sensor placed under your skin. Information can be transmitted to a mobile device such as your phone, and the system can send alerts when levels are too high or too low.

Diabetes medications

If you can’t maintain your target blood sugar level with diet and exercise, your doctor may prescribe diabetes medications that help lower insulin levels or insulin therapy. Drug treatments for type 2 diabetes include the following.

Metformin (Fortamet, Glumetza, others) is generally the first medication prescribed for type 2 diabetes. It works primarily by lowering glucose production in the liver and improving your body’s sensitivity to insulin so that your body uses insulin more effectively.

Some people experience B-12 deficiency and may need to take supplements. Other possible side effects, which may improve over time, include:

• Nausea
• Abdominal pain
• Bloating
• Diarrhea

Sulfonylureas help your body secrete more insulin. Examples include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include:

• Low blood sugar
• Weight gain

Glinides stimulate the pancreas to secrete more insulin. They’re faster acting than sulfonylureas, and the duration of their effect in the body is shorter. Examples include repaglinide and nateglinide. Possible side effects include:

• Low blood sugar
• Weight gain

Thiazolidinediones make the body’s tissues more sensitive to insulin. Examples include rosiglitazone (Avandia) and pioglitazone (Actos). Possible side effects include:

• Risk of congestive heart failure
• Risk of bladder cancer (pioglitazone)
• Risk of bone fractures
• High cholesterol (rosiglitazone)
• Weight gain

DPP-4 inhibitors help reduce blood sugar levels but tend to have a very modest effect. Examples include sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta). Possible side effects include:

• Risk of pancreatitis
• Joint pain

GLP-1 receptor agonists are injectable medications that slow digestion and help lower blood sugar levels. Their use is often associated with weight loss, and some may reduce the risk of heart attack and stroke. Examples include exenatide (Byetta, Bydureon), liraglutide (Saxenda, Victoza) and semaglutide (Rybelsus, Ozempic). Possible side effects include:

• Risk of pancreatitis
• Nausea
• Vomiting
• Diarrhea

SGLT2 inhibitors affect the blood-filtering functions in your kidneys by inhibiting the return of glucose to the bloodstream. As a result, glucose is excreted in the urine. These drugs may reduce the risk of heart attack and stroke in people with a high risk of those conditions. Examples include canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance). Possible side effects include:

• Risk of amputation (canagliflozin)
• Risk of bone fractures (canagliflozin)
• Risk of gangrene
• Vaginal yeast infections
• Urinary tract infections
• Low blood pressure
• High cholesterol

Other medications your doctor might prescribe in addition to diabetes medications include blood pressure and cholesterol-lowering medications, as well as low-dose aspirin, to help prevent heart and blood vessel disease.

Insulin therapy

Some people who have type 2 diabetes need insulin therapy. In the past, insulin therapy was used as a last resort, but today it may be prescribed sooner if blood sugar targets aren’t met with lifestyle changes and other medications.

Different types of insulin vary on how quickly they begin to work and how long they have an effect. Long-acting insulin, for example, is designed to work overnight or throughout the day to keep blood sugar levels stable. Short-acting insulin might be used at mealtime.

Your doctor will determine what type of insulin is appropriate for you and when you should take it. Your insulin type, dosage and schedule may change depending on how stable your blood sugar levels are. Most types of insulin are taken by injection.

Side effects of insulin include the risk of low blood sugar (hypoglycemia), diabetic ketoacidosis and high triglycerides.

Weight-loss surgery

Weight-loss surgery changes the shape and function of your digestive system. This surgery may help you lose weight and manage type 2 diabetes and other conditions related to obesity. There are various surgical procedures, but all of them help you lose weight by limiting how much food you can eat. Some procedures also limit the amount of nutrients you can absorb.

Weight-loss surgery is only one part of an overall treatment plan. Your treatment will also include diet and nutritional supplement guidelines, exercise and mental health care.

Generally, weight-loss surgery may be an option for adults living with type 2 diabetes who have a body mass index (BMI) of 35 or higher. BMI is a formula that uses weight and height to estimate body fat. Depending on the severity of diabetes or comorbid conditions, surgery may be an option for someone with a BMI lower than 35.

Weight-loss surgery requires a lifelong commitment to lifestyle changes. Long-term side effects include nutritional deficiencies and osteoporosis.

Pregnancy

Women with type 2 diabetes will likely need to change their treatment plans and adhere to diets that carefully controls carbohydrate intake. Many women will need insulin therapy during pregnancy and may need to discontinue other treatments, such as blood pressure medications.

There is an increased risk during pregnancy of developing diabetic retinopathy or a worsening of the condition. If you are pregnant or planning a pregnancy, visit an ophthalmologist during each trimester of your pregnancy, one year postpartum or as advised.

Signs of trouble

Regularly monitoring your blood sugar levels is important to avoid severe complications. Also, be aware of signs and symptoms that may suggest irregular blood sugar levels and the need for immediate care:

High blood sugar (hyperglycemia). Eating certain foods or too much food, being sick, or not taking medications at the right time can cause high blood sugar. Signs and symptoms include:

• Frequent urination
• Increased thirst
• Dry mouth
• Blurred vision
• Fatigue
• Headache

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). This life-threatening condition includes a blood sugar reading higher than 600 mg/dL (33.3 mmol/L). HHNS may be more likely if you have an infection, are not taking medicines as prescribed, or take certain steroids or drugs that cause frequent urination. Signs and symptoms include:

• Dry mouth
• Extreme thirst
• Drowsiness
• Confusion
• Dark urine
• Seizures

Diabetic ketoacidosis. Diabetic ketoacidosis occurs when a lack of insulin results in the body breaking down fat for fuel rather than sugar. This results in a buildup of acids called ketones in the bloodstream. Triggers of diabetic ketoacidosis include certain illnesses, pregnancy, trauma and medications — including the diabetes medications called SGLT2 inhibitors.

Although diabetic ketoacidosis is usually less severe in type 2 diabetes, the toxicity of the acids can be life-threatening. In addition to the signs and symptoms of hypoglycemia, such as frequent urination and increased thirst, ketoacidosis may result in:

• Nausea
• Vomiting
• Abdominal pain
• Shortness of breath
• Fruity-smelling breath

Low blood sugar. If your blood sugar level drops below your target range, it’s known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, unintentionally taking more medication than usual or being more physical activity than usual. Signs and symptoms include:

• Sweating
• Shakiness
• Weakness
• Hunger
• Irritability
• Dizziness
• Headache
• Blurred vision
• Heart palpitations
• Slurred speech
• Drowsiness
• Confusion

If you have signs or symptoms of low blood sugar, drink or eat something that will quickly raise your blood sugar level — fruit juice, glucose tablets, hard candy or another source of sugar. Retest your blood in 15 minutes. If levels are not at your target, repeat the sugar intake. Eat a meal after levels return to normal.

If you lose consciousness, you will need to be given an emergency injection of glucagon, a hormone that stimulates the release of sugar into the blood.

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Lifestyle and home remedies

Careful management of type 2 diabetes can reduce your risk of serious — even life-threatening — complications. Consider these tips:

• Commit to managing your diabetes. Learn all you can about type 2 diabetes. Make healthy eating and physical activity part of your daily routine.
• Work with your team. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it.
• Identify yourself. Wear a necklace or bracelet that says you are living with diabetes, especially if you take insulin or other blood sugar-lowering medication.
• Schedule a yearly physical exam and regular eye exams. Your regular diabetes checkups aren’t meant to replace regular physicals or routine eye exams.
• Keep your vaccinations up to date. High blood sugar can weaken your immune system. Get a flu shot every year. Your health care provider may also recommend the pneumonia vaccine. The Centers for Disease Control and Prevention (CDC) also recommends the hepatitis B vaccination if you haven’t previously received this vaccine and you’re 19 to 59 years old.
• Take care of your teeth. Diabetes may leave you prone to more-serious gum infections. Brush and floss your teeth regularly and schedule recommended dental exams. Consult your dentist right away if your gums bleed or look red or swollen.
• Pay attention to your feet. Wash your feet daily in lukewarm water, dry them gently, especially between the toes, and moisturize them with lotion. Check your feet every day for blisters, cuts, sores, redness and swelling. Consult your health care provider if you have a sore or other foot problem that isn’t healing.
• Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Take medication as prescribed.
• If you smoke or use other types of tobacco, ask your health care provider to help you quit. Smoking increases your risk of various diabetes complications. Talk to your health care provider about ways to stop smoking tobacco.
• Use alcohol sparingly. Depending on the type of drink, alcohol may lower or raise blood sugar levels. If you choose to drink alcohol, only do so with a meal. The recommendation is no more than one drink daily for women and no more than two drinks daily for men. Check your blood sugar frequently after consuming alcohol.

Alternative medicine

Many alternative medicine treatments claim to help people living with diabetes. According to the National Center for Complementary and Integrative Health, studies haven’t provided enough evidence to recommend any alternative therapies for blood sugar management. Research has shown the following results about popular supplements for type 2 diabetes:

• Chromium supplements have been shown to have few or no benefits. Large doses can result in kidney damage, muscular problems and skin reactions.
• Magnesium supplements have shown benefits for blood sugar control in some but not all studies. Side effects include diarrhea and cramping. Very large doses — more than 5,000 mg a day — can be fatal.
• Cinnamon, in some studies, has lowered fasting glucose levels but not A1C levels. Therefore, there’s no evidence of overall improved glucose management. Most cinnamon contains a substance called coumarin that may cause or worsen liver disease.

Talk to your doctor before starting a dietary supplement or natural remedy. Do not replace your prescribed diabetes medication with alternative medicines.

Coping and support

Type 2 diabetes is a serious disease, and following your diabetes treatment plan takes round-the-clock commitment. To meet the demands of diabetes management, you may need a good support network.

Anxiety and depression are common in people living with diabetes. Talking to a counselor or therapist may help you cope with the lifestyle changes or stressors that come with a type 2 diabetes diagnosis.

Support groups can be good sources of diabetes education, emotional support, and helpful information, such as how to find local resources or where to find carbohydrate counts for a favorite restaurant. If you’re interested, your health care provider may be able to recommend a group in your area.

You can visit the American Diabetes Association website to check out local activities and support groups for people living with type 2 diabetes. The American Diabetes Association also offers online information and online forums where you can chat with others who are living with diabetes. You can also call the organization at 800-DIABETES (800-342-2383).

Preparing for your appointment

Keeping your annual wellness visits enables your health care provider to screen for diabetes and to monitor and treat conditions that increase your risk of diabetes — such as high blood pressure, high cholesterol or a high BMI.

If you are seeing your health care provider because of symptoms that may be related to diabetes, you can prepare for your appointment by being ready to answer the following questions:

• When did your symptoms begin?
• Does anything improve the symptoms or worsen the symptoms?
• What medicines do you take regularly, including dietary supplements and herbal remedies?
• What are your typical daily meals? Do you eat between meals or before bedtime?
• How much alcohol do you drink?
• How much daily exercise do you get?
• Is there a history of diabetes in your family?

If you are diagnosed with diabetes, your health care provider will begin a treatment plan. You may be referred to a doctor who specializes in hormonal disorders (endocrinologist). Your care team may also include the following specialists:

• Dietitian
• Certified diabetes educator
• Foot doctor (podiatrist)
• Doctor who specializes in eye care (ophthalmologist)

Talk to your health care provider about referrals to other specialists who will be providing care.

Questions for ongoing appointments

Before any appointment with a member of your treatment team, make sure you know whether there are any restrictions, such as fasting before taking a test. Questions that you should regularly review with your doctor or other members of the team include:

• How often do I need to monitor my blood sugar, and what is my target range?
• What changes in my diet would help me better manage my blood sugar?
• What is the right dosage for prescribed medications?
• When do I take the medications? Do I take them with food?
• How is management of diabetes affecting treatment for other conditions? How can I better coordinate treatments or care?
• When do I need to make a follow-up appointment?
• Under what conditions should I call you or seek emergency care?
• Are there brochures or online sources you recommend?
• Are there resources available if I’m having trouble paying for diabetes supplies?

What to expect from your doctor

Your provider is likely to ask you a number of questions at regularly scheduled appointments, including:

• Do you understand your treatment plan and feel confident you can follow it?
• How are you coping with diabetes?
• Have you experienced any low blood sugar?
• Do you know what to do if your blood sugar is too low or too high?
• What’s a typical day’s diet like?
• Are you exercising? If so, what type of exercise? How often?
• Do you sit for long periods of time?
• What challenges are you experiencing in managing your diabetes?

Jan. 20, 2021

Manage Blood Sugar | Diabetes

It’s important to keep your blood sugar levels in your target range as much as possible to help prevent or delay long-term, serious health problems, such as heart disease, vision loss, and kidney disease. Staying in your target range can also help improve your energy and mood. Find answers below to common questions about blood sugar for people with diabetes.

How can I check my blood sugar?

Use a blood sugar meter (also called a glucometer) or a continuous glucose monitor (CGM) to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, you’ll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.

When should I check my blood sugar?

How often you check your blood sugar depends on the type of diabetes you have and if you take any diabetes medicines.

Typical times to check your blood sugar include:

• When you first wake up, before you eat or drink anything.
• Before a meal.
• Two hours after a meal.
• At bedtime.

If you have type 1 diabetes, have type 2 diabetes and take insulin, or often have low blood sugar, your doctor may want you to check your blood sugar more often, such as before and after you’re physically active.

What are blood sugar targets?

A blood sugar target is the range you try to reach as much as possible. These are typical targets:

• Before a meal: 80 to 130 mg/dL.
• Two hours after the start of a meal: Less than 180 mg/dL.

Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.

What causes low blood sugar?

Low blood sugar (also called hypoglycemia) has many causes, including missing a meal, taking too much insulin, taking other diabetes medicines, exercising more than normal, and drinking alcohol. Blood sugar below 70 mg/dL is considered low.

Signs of low blood sugar are different for everyone. Common symptoms include:

• Shaking.
• Sweating.
• Nervousness or anxiety.
• Irritability or confusion.
• Dizziness.
• Hunger.

Know what your individual symptoms are so you can catch low blood sugar early and treat it. If you think you may have low blood sugar, check it even if you don’t have symptoms. Low blood sugar can be dangerous and should be treated as soon as possible.

How can I treat low blood sugar?

If you’ve had low blood sugar without feeling or noticing symptoms (hypoglycemia unawareness), you may need to check your blood sugar more often to see if it’s low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.

Carry supplies for treating low blood sugar with you. If you feel shaky, sweaty, or very hungry or have other symptoms, check your blood sugar. Even if you don’t have symptoms but think you may have low blood sugar, check it. If your blood sugar is lower than 70 mg/dL, do one of the following immediately:

• Take four glucose tablets.
• Drink four ounces of fruit juice.
• Drink four ounces of regular soda, not diet soda.
• Eat four pieces of hard candy.

Wait for 15 minutes and then check your blood sugar again. Do one of the above treatments again until your blood sugar is 70 mg/dL or above and eat a snack if your next meal is an hour or more away. If you have problems with low blood sugar, ask your doctor if your treatment plan needs to be changed.

What causes blood sugar to be high?

Many things can cause high blood sugar (hyperglycemia), including being sick, being stressed, eating more than planned, and not giving yourself enough insulin. Over time, high blood sugar can lead to long-term, serious health problems. Symptoms of high blood sugar include:

• Feeling very tired.
• Feeing thirsty.
• Having blurry vision.
• Needing to urinate (pee) more often.

If you get sick, your blood sugar can be hard to manage. You may not be able to eat or drink as much as usual, which can affect blood sugar levels. If you’re ill and your blood sugar is 240 mg/dL or above, use an over-the-counter ketone test kit to check your urine for ketones and call your doctor if your ketones are high. High ketones can be an early sign of diabetic ketoacidosis, which is a medical emergency and needs to be treated immediately.

What are ketones?

Ketones are a kind of fuel produced when fat is broken down for energy. Your liver starts breaking down fat when there’s not enough insulin in your bloodstream to let blood sugar into your cells.

What is diabetic ketoacidosis?

If you think you may have low blood sugar, check it even if you don’t have symptoms.

When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:

• Fast, deep breathing.
• Dry skin and mouth.
• Flushed face.
• Frequent urination or thirst that lasts for a day or more.
• Fruity-smelling breath.
• Headache.
• Muscle stiffness or aches.
• Nausea and vomiting.
• Stomach pain.

If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, call your health care provider right away. DKA requires treatment in a hospital.

DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who haven’t yet been diagnosed. People with type 2 diabetes can also develop DKA, but it’s less common.

How can I treat high blood sugar?

Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:

• Be more active. Regular exercise can help keep your blood sugar levels on track. Important: don’t exercise if ketones are present in your urine. This can make your blood sugar go even higher.
• Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
• Follow your diabetes meal plan. Ask your doctor or dietitian for help if you’re having trouble sticking to it.
• Check your blood sugar as directed by your doctor. Check more often if you’re sick or if you’re concerned about high or low blood sugar.
• Talk to your doctor about adjusting how much insulin you take and what types of insulin (such as short-acting) to use.

How do carbs affect blood sugar?

Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.

What is the A1C test?

The A1C test  is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctor’s office in addition to—not instead of—regular blood sugar testing you do yourself.

A1C testing is part of the ABCs of diabetes—important steps you can take to prevent or delay health complications down the road:

• A: Get a regular A1C test.
• B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
• C: Manage your cholesterol levels.
• s: Stop smoking or don’t start.

The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines you’re taking, and other factors. Work with your doctor to establish a personal A1C goal for you.

What else can I do to help manage my blood sugar levels?

Eating a healthy diet with plenty of fruit and vegetables, maintaining a healthy weight, and getting regular physical activity can all help. Other tips include:

• Keep track of your blood sugar levels to see what makes them go up or down.
• Eat at regular times, and don’t skip meals.
• Choose foods lower in calories, saturated fat, trans fat, sugar, and salt.
• Track your food, drink, and physical activity.
• Drink water instead of juice or soda.
• Limit alcoholic drinks.
• For a sweet treat, choose fruit.
• Control your food portions (for example, use the plate method: fill half your plate with non-starchy vegetables, a quarter with lean protein, and a quarter with a grain or starchy food).

How can I pay for tests and diabetes supplies?

Medicareexternal icon, Medicaid, and most private insurance plans pay for the A1C test and fasting blood sugar test as well as some diabetes supplies. Check your plan or ask your health care team for help finding low-cost or free supplies, and see How to Save Money on Diabetes Care for more resources.

Normal and Diabetic Blood Sugar Level Ranges

Understanding blood glucose level ranges can be a key part of diabetes self-management.

This page states ‘normal’ blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes.

If a person with diabetes has a meter, test strips and is testing, it’s important to know what the blood glucose level means.

Recommended blood glucose levels have a degree of interpretation for every individual and you should discuss this with your healthcare team.

In addition, women may be set target blood sugar levels during pregnancy

The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE) but each individual’s target range should be agreed by their doctor or diabetic consultant.

Recommended target blood glucose level ranges

The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes.

In addition, the International Diabetes Federation’s target ranges for people without diabetes is stated. ^{[19] [89] [90]}

The table provides general guidance. An individual target set by your healthcare team is the one you should aim for.

NICE recommended target blood glucose level ranges

Target Levels by Type	Upon waking	Before meals (pre prandial)	At least 90 minutes after meals (post prandial)
Non-diabetic*		4. 0 to 5.9 mmol/L	under 7.8 mmol/L
Type 2 diabetes		4 to 7 mmol/L	under 8.5 mmol/L
Type 1 diabetes	5 to 7 mmol/L	4 to 7 mmol/L	5 to 9 mmol/L
Children w/ type 1 diabetes	4 to 7 mmol/L	4 to 7 mmol/L	5 to 9 mmol/L

*The non-diabetic figures are provided for information but are not part of NICE guidelines.

Normal and diabetic blood sugar ranges

For the majority of healthy individuals, normal blood sugar levels are as follows:

• Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting ^[361]
• Up to 7. 8 mmol/L (140 mg/dL) 2 hours after eating

For people with diabetes, blood sugar level targets are as follows:

• Before meals : 4 to 7 mmol/L for people with type 1 or type 2 diabetes
• After meals : under 9 mmol/L for people with type 1 diabetes and under 8.5mmol/L for people with type 2 diabetes

Blood sugar levels in diagnosing diabetes

The following table lays out criteria for diagnoses of diabetes and prediabetes.

Blood sugar levels in diagnosing diabetes

Plasma glucose test	Normal	Prediabetes	Diabetes
Random	Below 11.1 mmol/l Below 200 mg/dl	N/A	11. 1 mmol/l or more 200 mg/dl or more
Fasting	Below 5.5 mmol/l Below 100 mg/dl	5.5 to 6.9 mmol/l 100 to 125 mg/dl	7.0 mmol/l or more 126 mg/dl or more
2 hour post-prandial	Below 7.8 mmol/l Below 140 mg/dl	7.8 to 11.0 mmol/l 140 to 199 mg/dl	11.1 mmol/l or more 200 mg/dl or more

Random plasma glucose test

A blood sample for a random plasma glucose test can be taken at any time. This doesn’t require as much planning and is therefore used in the diagnosis of type 1 diabetes when time is of the essence.

Fasting plasma glucose test

A fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning.

The NICE guidelines regard a fasting plasma glucose result of 5.5 to 6.9 mmol/l as putting someone at higher risk of developing type 2 diabetes, particularly when accompanied by other risk factors for type 2 diabetes.

Oral Glucose Tolerance Test (OGTT)

An oral glucose tolerance test involves first taking a fasting sample of blood and then taking a very sweet drink containing 75g of glucose.

After having this drink you need to stay at rest until a further blood sample is taken after 2 hours.

HbA1c test for diabetes diagnosis

An HbA1c test does not directly measure the level of blood glucose, however, the result of the test is influenced by how high or low your blood glucose levels have tended to be over a period of 2 to 3 months.

Indications of diabetes or prediabetes are given under the following conditions:

• Normal: Below 42 mmol/mol (6.0%)
• Prediabetes: 42 to 47 mmol/mol (6. 0 to 6.4%)
• Diabetes: 48 mmol/mol (6.5% or over)

Transcript

There are two types of blood sugar levels that may be measured. The first is the blood glucose level we get from doing finger prick blood glucose tests. These give us a reading of how high our levels are at that very point in time.

The second is the HbA1c reading, which gives a good idea of our average control over a period of 2 to 3 months. The target blood glucose levels vary a little bit depending on your type of diabetes and between adults and children.

Where possible, try to achieve levels of between 4 and 7 mmol/L before meals and under 8.5 mmol/L after meals. The target level for HbA1c is under 48 mmol/mol (or 6.5% in the old units).

Research has shown that high blood glucose levels over time can lead to organ and circulation damage.

By monitoring blood glucose levels, we can spot when sugar levels are running high and can then take appropriate action to reduce them.

Keeping blood glucose above 4 mmol/l for people on insulin or certain medications for type 2 diabetes is important to prevent hypos occurring, which can be dangerous.

Your doctor may give you different targets. Children, older people and those at particular risk of hypoglycemia may be given wider targets.

Download a FREE blood glucose level chart for your phone, desktop or as a printout.

Why are good blood sugar levels important?

It is important that you control your blood glucose levels as well as you can as too high sugar levels for long periods of time increases the risk of diabetes complications developing.

Diabetes complications are health problems which include:

This list of problems may look scary but the main point to note is that the risk of these problems can be minimised through good blood glucose level control. Small improvements can make a big difference if you stay dedicated and maintain those improvements over most days.

Diagnosis | ADA

There are several ways to diagnose diabetes. Each way usually needs to be repeated on a second day to diagnose diabetes.

Testing should be carried out in a health care setting (such as your doctor’s office or a lab). If your doctor determines that your blood sugar level is very high, or if you have classic symptoms of high blood sugar in addition to one positive test, your doctor may not require a second test to diagnose diabetes.

A1C

The A1C test measures your average blood sugar for the past two to three months. The advantages of being diagnosed this way are that you don’t have to fast or drink anything.

• Diabetes is diagnosed at an A1C of greater than or equal to 6.5%
   

Result	A1C
Normal	less than 5.7%
Prediabetes	5. 7% to 6.4%
Diabetes	6.5% or higher

Fasting Plasma Glucose (FPG)

This test checks your fasting blood sugar levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast.

• Diabetes is diagnosed at fasting blood sugar of greater than or equal to 126 mg/dl
   

Oral Glucose Tolerance Test (OGTT)

The OGTT is a two-hour test that checks your blood sugar levels before and two hours after you drink a special sweet drink. It tells the doctor how your body processes sugar.

• Diabetes is diagnosed at 2 hour blood sugar of greater than or equal to 200 mg/dl
   

Random (also called Casual) Plasma Glucose Test

This test is a blood check at any time of the day when you have severe diabetes symptoms.

• Diabetes is diagnosed at blood sugar of greater than or equal to 200 mg/dl

What is prediabetes?

Before people develop type 2 diabetes, they almost always have “prediabetes”—blood sugar levels that are higher than normal but not yet high enough to be diagnosed as diabetes.

Doctors sometimes refer to prediabetes as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on what test was used when it was detected. This condition puts you at a higher risk for developing type 2 diabetes and cardiovascular disease.

Symptoms

There are no clear symptoms of prediabetes, so you may have it and not know it.

Some people with prediabetes may have some of the symptoms of diabetes or even problems from diabetes already. You usually find out that you have prediabetes when being tested for diabetes. 

If you have prediabetes, you should be checked for type 2 diabetes every one to two years.

Results indicating prediabetes are:

• An A1C of 5.7%–6.4%
• Fasting blood sugar of 100–125 mg/dl
• An OGTT 2 hour blood sugar of 140 mg/dl–199 mg/dl

Preventing type 2 diabetes

You will not develop type 2 diabetes automatically if you have prediabetes. For some people with prediabetes, early treatment can actually return blood sugar levels to the normal range.

Research shows that you can lower your risk for type 2 diabetes by 58% by:

Don’t worry if you can’t get to your ideal body weight. Losing even 10 to 15 pounds can make a huge difference. 

Diabetes Blood Sugar Chart | Blood Glucose Chart

Blood sugar chart: Normal and diabetic blood sugar ranges

This blood sugar chart shows normal blood glucose levels before and after meals and recommended HbA1c levels for people with and without diabetes.

Source: American Diabetes Association

Fasting blood sugar

A fasting blood sugar (sometimes called fasting plasma glucose or FPG) is a blood sugar that is measured after fasting (not eating or drinking anything, except water) for at least eight hours. The purpose of doing a fasting blood sugar test is to determine how much glucose (sugar) is in the blood, and this test is commonly used to check for diabetes or prediabetes. The blood test is usually measured at a lab, at the doctor’s office or at a hospital. A blood sample may be drawn from a vein in your arm and collected in a tube which will then be analyzed by a lab. Or, a blood sample may be obtained by doing a finger-stick with a lancet.

Normal fasting blood sugar for person without diabetes

A normal fasting blood glucose for someone who does not have diabetes ranges from 70 to 99 mg/dl. The American Diabetes Association recommends a routine screening for type 2 diabetes starting at age 45. If the results are normal, the screening should be repeated every 3 years.

If have diabetes risk factors, which include being overweight or obese, having a family history of type 2 diabetes, having a history of gestational diabetes, or being of a certain race/ethnicity (African American, Latino, Asian American, Pacific Islander, or Native American), you should be screened for diabetes sooner than age 45.

Children and adolescents who have diabetes symptoms or who are overweight and have a family history of type 2 diabetes, are of African American, Latino, Asian American, Native American or Pacific Islander descent, who have signs of prediabetes (acanthosis nigricans, high blood pressure, high cholesterol) or a mother who had gestational diabetes should be tested beginning at age 10 and then every 3 years thereafter.

A fasting blood sugar of 100 to 125 mg/dl is indicative of prediabetes, which is a condition where blood sugar levels are above “normal” but not high enough to be considered diabetes. Prediabetes is a risk factor for type 2 diabetes, heart disease and stroke. It’s managed by lifestyle changes and, in some cases, medication.

Official fasting blood sugar ADA recommendation for someone with diabetes

The American Diabetes Association recommends a fasting blood sugar target of 80 to 130 mg/dl for most nonpregnant adults with diabetes. However, the fasting blood sugar target may need to be individualized for certain people based on such factors as duration of diabetes, age and life expectancy, cognitive status, other health conditions, cardiovascular complications, and hypoglycemia unawareness. It’s important that people with diabetes discuss their target blood sugar goals with their healthcare provider.

What’s a normal blood sugar after eating?

After-meal blood sugar for someone without diabetes

A normal blood sugar is lower than 140 mg/dl. A blood sugar between 140 and 199 mg/dl is considered to be prediabetes, and a blood sugar of 200 mg/dl or higher can indicate diabetes. Someone who does not have diabetes is unlikely to be checking their blood sugars. However, one of the screening tests for diabetes is called an oral glucose tolerance test, or OGTT. (A slightly different version of the OGTT is also used to diagnose gestational diabetes, which is diabetes that develops during pregnancy). For this test, the person needs to fast overnight and go to the doctor’s office or a lab in the morning. A blood sample will be used to measure the fasting blood sugar. The person then drinks a sugary drink that contains 75 grams of sugar. Two hours later, blood sugar is checked again. 

Normal blood sugar levels after eating for diabetics

The American Diabetes Association recommends that the blood sugar 1 to 2 hours after the beginning of a meal be less than 180 mg/dl for most nonpregnant adults with diabetes. This is typically the peak, or highest, blood sugar level in someone with diabetes. Again, this target may need to be individualized for certain people based on such factors as duration of diabetes, age and life expectancy, cognitive status, other health conditions, cardiovascular complications, and hypoglycemia unawareness. It’s important that people with diabetes discuss their target blood sugar goals with their healthcare provider.

HbA1c

The HbA1C test is a blood test that provides average levels of blood glucose over the past three months. Other names for this test are hemoglobin A1C, A1C, glycated hemoglobin, and glycosylated hemoglobin test. A person does not need to fast before having their HbA1C test measured; in other words, it’s OK to eat or drink something beforehand. The HbA1C test may not be accurate for some people, including those with anemias and for those receiving treatment for HIV, and for people of African, Mediterranean, or Southeast Asian descent. The HbA1C result is reported as a percentage; the higher the percentage, the higher the blood sugar level.

In addition to being a tool for diagnosing diabetes, the HbA1C test is used to help people who have diabetes manage their condition.

Normal HbA1c for person without diabetes

For someone who does not have diabetes, a normal HbA1C level is below 5.7%. An A1C between 5.7% to 6.4% is indicative of prediabetes.

It’s recommended that adults over the age of 45 — or adults under 45 who are overweight and have one or more risk factors for diabetes — have a baseline A1C checked. If the result is normal, the A1C should be checked every 3 years. If the result indicates prediabetes, the A1C should be checked every 1 to 2 years.

Official HbA1c ADA recommendation for someone with diabetes

The American Diabetes Association recommends an HbA1C of less than 7% for most nonpregnant adults with diabetes. A lower goal, such as less than 6.5%, may be appropriate for some people who have had diabetes for a shorter amount of time, for younger people, for those without heart disease, and/or for those with type 2 diabetes treated with lifestyle or metformin only. A higher HbA1C goal, such as less than 8%, may be appropriate for people with a history of severe hypoglycemia, a limited life expectancy, advanced diabetes complications, other illnesses, or for whom a lower HbA1C goal is difficult to achieve. It’s important that people with diabetes discuss their target blood sugar goals with their healthcare provider.

HbA1C levels should be checked between two to four times per year in people who have diabetes.

Blood sugar chart: summary

The fasting blood sugar, 2-hour post-meal blood sugar, and HbA1C tests are important ways to diagnose prediabetes and diabetes, as well as indicate how well a person’s diabetes is being managed. If you think you have diabetes, it’s important to not try and diagnose yourself by doing a finger-stick with a home blood glucose meter. There are strict standards and procedures that laboratories use for diagnosing diabetes; therefore, you should get tested at your doctor’s office or at a laboratory.

It’s also important to talk with your doctor to make sure you understand a) how often you should have certain tests, such as a fasting blood glucose or HbA1C test; b) what your results mean; and c) what your blood sugar and HbA1C targets are.

If you have not been previously diagnosed with prediabetes or diabetes but your results are above “normal,” your doctor may recommend other tests and should discuss a plan of treatment with you. Treatment may include lifestyle changes, such as weight loss, a healthy eating plan, and regular physical activity. You may need to start taking diabetes medications, including insulin. If you are diagnosed with diabetes, it’s recommended that you learn how to check your blood sugars with a meter so that you and your healthcare team can determine how your treatment plan is working for you.

En Español: Tabla del Nivel de Azúcar en la Sangre: ¿Cuál es el Rango Normal Para el Nivel de Azúcar en la Sangre?

Interested in learning more? Read about normal blood glucose numbers, getting tested for type 2 diabetes and using blood sugar monitoring to manage diabetes.

Originally Published June 11, 2019

Hyperglycemia and hypoglycemia in type 2 diabetes – InformedHealth.org

If someone has diabetes that isn’t treated properly, they have too much sugar in their blood (hyperglycemia). Too little sugar in the bloodstream (hypoglycemia) is usually a side effect of treatment with blood-sugar-lowering medication.

Diabetes is a metabolic disease in which there’s a problem with insulin (a hormone). It can affect your health in many ways. In type 2 diabetes, not enough insulin is released into the bloodstream, or the insulin can’t be used properly. In type 1 diabetes, the body only produces very little insulin, or none at all.

When is blood sugar considered to be too high or too low?

Slight fluctuations in blood sugar levels are completely normal, and also happen every day in people who don’t have diabetes, in response to the food they eat. Between around 60 and 140 milligrams of sugar per deciliter of blood (mg/dl) is considered to be healthy. This is equivalent to a blood sugar concentration of between 3.3 and 7.8 mmol/l. “Millimoles per liter” (mmol/l) is the unit that blood sugar is measured in. It describes the amount of a certain substance per liter.

If someone has readings over 7.8 mmol/l (140 mg/dl), they are considered to have hyperglycemia. These high blood sugar levels mainly occur if there isn’t enough insulin or the insulin doesn’t work properly. Without the effect of insulin, the organs can’t make good use of the sugar in the blood, so the sugar builds up. If type 1 diabetes is left untreated, blood sugar levels can increase to over 27.8 mmol/l (500 mg/dl). Such high levels tend to be uncommon in type 2 diabetes.

Blood sugar levels below 3.3 mmol/l (60 mg/dl) are considered to be too low. But, as you can see in the illustration below, there are no clear-cut borders between normal blood sugar levels and too high or too low blood sugar levels.

Blood sugar: Normal range between hyperglycemia and hypoglycemia

Signs of hyperglycemia

Hyperglycemia doesn’t always have immediately noticeable effects. Someone might have it for years without having any physical symptoms. But very high blood sugar can cause the following symptoms:

• Extreme thirst

• Frequent urination

• Tiredness

• Listlessness

• Nausea

• Dizziness

If someone has extremely high blood sugar levels, they may feel confused and drowsy or even lose consciousness (diabetic coma).

What can you do if your blood sugar levels are too high?

If you have the above symptoms over a long period of time or if they keep occurring, it’s important to see a doctor. They could be a sign of diabetes.

If these symptoms occur in people who have already been diagnosed with diabetes, they could be a sign that the treatment is no longer effective enough. Then medication can be prescribed or adjusted to make your blood sugar levels go back down. You may stay at the hospital while your blood sugar levels are being stabilized. If you are feeling drowsy, confused or lose consciousness, the emergency services should be called (112 in Germany and many other countries, 911 in the U.S.).

Signs of hypoglycemia

Low blood sugar is most common in people who use insulin or take certain tablets to reduce high blood sugar. This is because things like unexpected physical activity, eating too little food or drinking too much alcohol can mean that you need less insulin than you thought, causing your blood sugar to drop too low.

Signs that your blood sugar is too low may include:

• Racing pulse

• Cold sweats

• Pale face

• Headache

• Feeling incredibly hungry

• Shivering, feeling weak in the knees

• Feeling restless, nervous or anxious

• Difficulty concentrating, confusion

The severity of these symptoms depends on the blood sugar levels and can vary from person to person. The symptoms don’t occur all at once. If you aren’t sure whether your blood sugar is too low, you can measure it to make sure. 

Your blood sugar levels may also drop at night, making you feel tired and weak in the morning.

Mild hypoglycemia doesn’t usually have any serious health effects. But severe hypoglycemia can lead to a loss of consciousness and become life-threatening.

What can you do if your blood sugar levels are too low?

It is important to react quickly enough and eat or drink something, like dextrose sugar or a sugary drink (no “diet” or “zero” soft drinks with artificial sweeteners!).

If someone has severe hypoglycemia they may feel drowsy and confused, and might even become unconscious. People who have type 1 diabetes often carry a pre-filled syringe on them in case that happens, containing the hormone glucagon. Glucagon makes the liver release sugar into the bloodstream. Someone else can then inject the hormone if necessary. If this is not possible, it is important to call the emergency services immediately (in Germany and many other countries: 112, in the U.S.: 911) and ask for medical help.

If your blood sugar levels keep on dropping too low, you should see your doctor. It could then be a good idea to change your lifestyle or medication.

Sources

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Diabetes by the Numbers | Everyday Health

A1C level. This is a blood test, typically given at doctor’s appointments, that measures your average blood sugar levels over a longer period. “It gives you a picture of what’s been going on over the past two to three months,” says Dawn Sherr, RD, a certified diabetes educator and spokesperson for the American Association of Diabetes Educators. Essentially, your A1C result shows how well your diabetes treatment plan is working.

Depending on your results, you may need to have the test from two to four times a year. For most people, an A1C level of 7 percent or less is ideal. If your A1C level is higher, you and your doctor may discuss making changes to your diabetes treatment plan. Healthy lifestyle practices, like consistent blood sugar control and regular physical activity, can help keep your A1C levels low.

Blood pressure. Monitoring your blood pressure is another important way to maintain your health. “People with diabetes are more likely to develop heart disease, and blood pressure is a big factor in that,” Sherr says.

Your blood pressure should be checked several times a year — ideally, every time you see the doctor who is treating your diabetes, Sherr says. Most people with diabetes should aim for a blood pressure of less than 140/80. To prevent high blood pressure, cut back on salt in your diet, exercise regularly, and quit smoking. Some people with type 2 diabetes may need to take medications to lower their blood pressure.

Cholesterol. This is a substance in your body with two components. Low-density lipoprotein (LDL) is known as bad cholesterol; it can build up in your arteries and contribute to heart disease. High-density lipoprotein (HDL) is called the good cholesterol and has a protective effect on your arteries. Your doctor will perform a blood test once a year to check your cholesterol levels, though you may have it checked more often if your numbers are high, Sherr says.

A test result of less than 100 mg/dl of LDL cholesterol is ideal, while HDL cholesterol should be above 40 mg/dl for men and 50 mg/dl for women. Triglycerides, a type of blood fat that can increase your risk of heart disease, should be less than 150 mg/dl for both men and women. If your cholesterol levels are outside these ranges, you can improve them by losing excess weight, exercising, and eating a healthy diet that’s rich in fresh produce and low in fat.

BMI. Short for body mass index, this is a measure that uses your height and weight to estimate how much body fat you have. Since managing weight plays a role in controlling type 2 diabetes, a healthy BMI is important.

Your doctor will probably review your BMI annually, but you can also calculate it yourself by dividing your weight in pounds by your height in inches squared, and then multiplying that number by 703. Online calculators are also available to do the math for you. A healthy BMI ranges from 18.5 to 24.9 — anything over that is considered overweight, and a BMI over 30 is considered obese.

However, the measurement may not be accurate for some people, such as those with a large amount of muscle. “The BMI score can sometimes be deceiving and not the best way to look at the health effects of someone’s weight,” says Fernando Ovalle, MD, an endocrinologist and professor of medicine at University of Alabama at Birmingham College of Medicine. In these cases, other measurements may be used, such as waist-to-hip ratio and abdominal circumference.

Microalbumin. This test measures the amount of protein, or albumin, in your urine, which helps your doctor know how well your kidneys are working. Your doctor should administer this test at least once a year.

The test compares the level of albumin with the level of creatinine, a waste product. Your albumin-to-creatinine ratio should be less than 30, according to the National Institute of Diabetes and Digestive and Kidney Diseases. To keep your microalbumin results within a healthy range, it’s important to keep your kidneys healthy. High blood pressure and high blood sugar can both damage your kidneys, so controlling those factors will go a long way toward preventing kidney problems — and many other health problems — in the future.

90,000 type 2 diabetes sugar rate

type 2 diabetes sugar rate

After completing the course of treatment, many underwent routine laboratory blood tests, which are carried out every three months. Based on the results of the tests, it was possible to reduce the amount of cholesterol, increase the production of insulin and restore the production of hormones by various internal organs. In the reviews, patients say that a similar complex result has not been achieved after using synthetic drugs.The convenience of using one drug and the ability to save on price are especially noted.

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Diabetes mellitus type 2. RCHD (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan) Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan – 2019. ICD categories: Non-insulin dependent diabetes mellitus (E11).According to the Consensus of the ROO Association of Endocrinologists of Kazakhstan for the Diagnosis and Treatment of Type 2 Diabetes Mellitus in 2019, when choosing a starting and maintenance antihyperglycemic therapy for type 2 diabetes, the following Algorithm should be adhered to: List of additional drugs (less than 100% probability of use): no. Diabetes treatment. Blood sugar rate: table by age. When we talk about the norm of sugar, we mean a certain concentration of glucose in a person’s blood. The indicator is measured in millimoles per liter (abbreviated as mmol / L) and is determined during a blood test, which today can be performed both in the hospital and at home.The norm is presented as a range from 3.3 to 5.5 mmol / L, and not a specific value. Type 2 diabetes is a less severe form, occurs in 90% of cases. This is acquired non-insulin dependent diabetes. It is associated with the fact that cells perceive insulin worse, due to which glucose does not penetrate into them, remains in the blood, which leads to an increase in the level. In type 2 diabetes, the normal blood sugar after a meal (after 90 minutes) is determined to be up to 8.5 mmol / l (153 mg / dl). And the norm of glucose before meals is in the range of 4-7 mmol / l (72-126 mg / dl).Patients with a confirmed diagnosis ask questions about why glycemia is higher in the morning than in the evening and what to do if high glucose levels are observed in the morning on an empty stomach, which do not fit into the norm of sugar in type 2 diabetes? The thing is that the nature of metabolic processes in the body depends on the general state of health and on the time of day. In endocrinology, there is such a thing as the effect of the morning dawn. It turns out that type 2 diabetes implies that the rate of blood sugar before meals and after 60 years will be increased.During this period, the body can no longer cope with the function of the correct use of glucose, therefore, its indicators increase. This is especially true for those people who are overweight. Glucose readings versus time of day. As mentioned above, the eating process affects the sugar reading. It is not the same throughout the day. The change in its values ​​is different for sick and healthy people. Sugar norms. What is type 2 diabetes? We will analyze the causes of occurrence, diagnosis and treatment methods in the article by Dr. Khitaryan.G., a phlebologist with 31 years of experience. Above Dr. Khitaryan’s article. G. worked as a literary editor Margarita Tikhonova, scientific editor Sergei Fedosov. compensated – the normal blood sugar level achieved with the help of treatment, and the absence of sugar in the urine; subcompensated – the level of glucose in the blood (up to 13.9 mmol / l) and in the urine (up to 50 g / l) is moderate, while there is no acetone in urine. Diagnosis of type 2 diabetes mellitus. In order to diagnose type II diabetes, it is necessary to assess the symptoms of the disease and conduct the following studies After meals: up to 9 mmol / L for people with type 1 diabetes and up to 8.5 mmol / L for people with type 2 diabetes.Table 2. Blood sugar levels in the diagnosis of diabetes. Fasting plasma glucose measurement. This analysis is performed after a minimum of eight hours of fasting (usually in the morning). If, 2 hours after exercise, the blood sugar level does not exceed 7.8 mmol / L, this is normal. A decrease in tolerance is diagnosed if this indicator is between 7.8 and 11.1 mmol / l. Measurement of the level of HbA1c for the diagnosis of diabetes mellitus. Glycosylated hemoglobin is one of the most important laboratory parameters in diabetes mellitus.Type 2 diabetes usually develops in adults who consume a lot of sugar. Due to the constant spikes in blood glucose, cells become immune over time to fluctuating insulin levels. The disease is preceded by a condition of prediabetes, which can be corrected by changing your eating habits. The glucose norm in women is 3.3-5.5 mmol / l. Age-related changes in women, starting from 50 years old, form other indicators. Table – Blood sugar levels are normal in women.Sometimes blood sugar levels are also measured in the middle of the night, between 4 and 3 a.m., to detect the conditions of low blood sugar and hypoglycemia that are common in people with type 1 diabetes who are treated with insulin, and also to find out what the change in sugar levels is in these situations. More frequent sugar measurements should be taken. Sugar Ratio for Type 2 Diabetes. This is influenced by the fact that a person in the second stage of the disease cannot do without insulin, so he does not need additional medical intervention, so sugar practically does not change.For starters, it is best to lose a few pounds of excess weight, monitor your diet and try to do your meals at the same time. Type 2 diabetes is a disease that is becoming more common around the world. According to the latest data1, in the last 10 years alone, the number of patients has increased by 60%. Type 2 diabetes accounts for approximately 90% of all people with diabetes2. Nerve damage High blood sugar (glucose) levels over long periods of time can damage the capillaries that are responsible for nerve endings in the extremities, such as the legs.As a result, tingling or numbness may occur, which ultimately leads to loss of sensation in the affected areas.

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Where to buy the medicine is important, since the success of the treatment depends on it.Divorce has taken on serious proportions, and many diabetics have suffered from fraudsters, not only paying a high price for Diafast, but also putting their health at greater risk. Reviews about Diafast from those who purchased the original, allows you to get a real picture of the effectiveness and dynamics of treatment. They confirm that it was possible to normalize the blood glucose level and keep it without severe dietary restrictions (the diet is not canceled, it is just that the diet becomes more varied and rich).Although Diafast has recently appeared on the market, it has already caused a real stir and a wave of reviews and comments from real users and doctors. Not all of them are enthusiastic, and despite the results of clinical trials, clients say the remedy is nothing more than a divorce. What is worth believing and what is not, now let’s try to figure it out.

Monitoring of glucose (sugar) in the blood

As often as you measure your blood sugar, the data is often insufficient to understand the causes of poor glycemic control.

Continuous Blood Glucose Monitoring System (CGMS) is a sensor designed for continuous and automatic determination of glucose values ​​in subcutaneous adipose tissue fluid in the range of 2.2-22 mmol / L. This careful determination of glycemic fluctuations allows:

• Get a clear idea of ​​the nature of changes in blood sugar levels during the day;
• Identify issues on the path to successful diabetes management such as:
  • Chronic insulin overdose (Somoji syndrome)
  • High blood sugar after undiagnosed hypoglycemia, leading to increased insulin dose, recurrence of hypoglycemia, increased blood sugar, etc.etc .;
  • Dawn-Phenomenon – an increase in blood sugar in the early morning hours;
  • latent hypoglycemia;
  • unclear hyperglycemia, etc .;
• to adjust the antihyperglycemic therapy taking into account the individual characteristics obtained;
• Select the required insulin delivery program for insulin pump therapy.

You and the doctor get a complete picture of the fluctuations in blood glucose levels during the day, which is not possible when determining blood sugar using a glucometer.This is especially true during the night and early morning hours, when you are asleep and not exercising self-control.

Literary sources

• Algorithms for specialized medical care for patients with diabetes mellitus / Edited by I.I. Dedova, M.V. Shestakova, A. Yu. Mayorov. – 9th edition. – M .: UP PRINT; 2019. ISBN 978-5-91487-136-6 DOI: 10.14341 / DM221S1
• Standards of Medical Care in Diabetes – 2019.Diabetes Care. 2019 Jan; 42 (Suppl 1): S173-S181. doi: 10.2337 / dc19-S015
• Type 1 diabetes mellitus: a guide for patients / A. Yu. Mayorov, E. V. Surkova, O. G. Melnikova. – M.: Farm-Media, 2016 .– 120 p. : ill. ISBN 978-5-9907464-0-4
• Diabetes mellitus: variety of clinical forms / Dedov I.I., Shestakova M.V. – MIA, 2016 – 244 S. ISBN: 978-5-9986-0250-4
• Type 1 diabetes mellitus: realities and prospects / Dedov I.I., Shestakova M.V.- MIA, 2016 – 504 S. ISBN: 978-5-9986-0245-0
• Diabetes mellitus type 2: from theory to practice / Dedov I.I., Shestakova M.V. – MIA, 2016 – 576 S. ISBN: 978-5-9986-0248-1
• Diabetes overview [diabetes.org/diabetes] // American Diabetes Association [Official website]. Accessed on 04/10/19
• Diabetes [mayoclinic.org/diseases-conditions/diabetes] // Mayo Clinic [Official website]. Accessed on 04/10/19
• IDF Diabetes Atlas.Eighth edition, 2017. International Diabetes Federation. ISBN: 978-2-930229-87-4
• Global report on diabetes. Geneva: World Health Organization; 2018. License: CC BY-NC-SA 3.0 IGO
• Diabetes: the basics [https://www.diabetes.org.uk/diabetes-the-basics] // British Diabetic Association [Official website]. Accessed on 04/10/19
• LeRoith D, Biessels GJ, Braithwaite SS, et al. Treatment of Diabetes in Older Adults: An Endocrine Society Clinical Practice Guideline.J Clin Endocrinol Metab. 2019 May 1.104 (5): 1520-74
• DiMeglio LA, Acerini CL, Codner E, et al. ISPAD Clinical Practice Consensus Guidelines 2018: glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes. 2018 Oct. 19 Suppl 27: 105-14
• American Diabetes Association. 13. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018 Jan. 41 (Suppl 1): S137-43
• Diabetes Health Center [webmd.com / diabetes] // WebMD [Official website]. Accessed on 14/10/19
• Managing Diabetes [niddk.nih.gov/health-information/diabetes] // National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center [Official website]. Accessed on 04/10/19
• How to Prevent Diabetes [medlineplus.gov/howtopreventdiabetes.html] // U.S. National Library of Medicine [Official website]. Accessed on 04/10/19
• About diabetes [diabetesforecast.org / landing-pages / lp-about-diabetes.html] // American Diabetes Association [Official magazine website]. Accessed on 04/10/19

SARU. DIA. 11/19/2382

90,000 Blood Sugar Allowance – Targets and Recommendations

Understanding blood glucose is a key skill in diabetes self-management.In this article, we look at target ranges (norms) for blood sugar levels for people without diabetes and for adults and children with type 1 and 2 diabetes.

If you are performing self-control using a glucometer, you need to understand what the numbers say (readings of blood sugar measurements).

Recommended blood sugar levels are subject to individual interpretation and should therefore be discussed with your healthcare professional for your target blood sugar ranges.

The following ranges are guidelines provided by the National Institute of Clinical Excellence (NICE), but each person’s target range must be agreed upon by their physician or diabetic consultant.

Recommended blood glucose values ​​

Recommended NICE blood glucose levels are given below for adults with type 1 diabetes, type 2 diabetes, and children with type 1 diabetes.

In addition, the target group of the International Diabetes Federation for people without diabetes is indicated.

The table provides general guidelines. The individual goal set by your doctor is the one you should aim for.

Normal and Diabetic Blood Sugar Levels

For most healthy people, a normal blood sugar level looks like this:

• 4.0 to 5.4 mmol / L during fasting.
• to 7.8 mmol / L 2 hours after eating.

For people with diabetes, the blood sugar levels are as follows:

• Before meals : 4 to 7 mmol / L for people with T1DM or T2DM.
• After meals : up to 9 mmol / L for people with T1DM and less than 8.5 mmol / L for people with T2DM.

Blood sugar level in the diagnosis of diabetes

The following table summarizes the criteria for the diagnosis of diabetes and prediabetes.

A blood sample for the random plasma glucose test can be taken at any time. It does not require such planning and is therefore used in the diagnosis of type 1 diabetes when timing is of the essence.

Fasting Plasma Glucose Test

The fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning.NICE guidelines consider a fasting plasma glucose result of 5.5 to 6.9 mmol / L, because someone has a higher risk of developing type 2 diabetes, especially when it is accompanied by other risk factors for developing type 2 diabetes.

Glucose Tolerance Test (OGTT)

An oral glucose tolerance test involves taking the first fasting blood sample and then taking a very sweet drink containing 75 g of glucose.

After you drink this drink, you need to stay still until another blood sample is taken 2 hours later.

HbA1c Test for Diabetic Diagnosis

The HbA1c test does not directly measure blood glucose, but the test result depends on how high or low your blood glucose is, typically lasting 2 to 3 months.

Indications for diabetes or prediabetes are given under the following conditions:

• Normal: below 42 mmol / mol (6.0%)
• Prediabetes: 42 to 47 mmol / mol (6.0 to 6.4%)
• Diabetes: 48 mmol / mol (6.5% or more)

Causes of the disease, symptoms and treatment

People get diabetes so often that doctors from all over the world are no longer talking about “morbidity”, but about an epidemic.Indeed, over 10 million people suffer from diabetes in Russia alone. So what is diabetes and why is it dangerous?

Diabetes: what is happening and who is to blame

Diabetes mellitus is a chronic disease in which the blood sugar is constantly high. It would seem – so what’s wrong with that?

“Supersweetened” blood leads to the appearance of free radicals that damage the cells of the body. Also, insidious glucose combines with proteins and DNA, turning them into substances that make the walls of arteries thicken.The blood vessels narrow and this leads to heart disease.

If the excess sugar is not removed from the blood in time, the person will gradually cease to navigate in space, will start delirious and will lose consciousness. Without medical assistance, a diabetic with “jumped” sugar can die.

Since the system responsible for the transfer of sugar from the blood to the cells can break down in several different ways, diabetes is also different and needs to be treated in different ways.

In this article we will tell you about the three types of diabetes mellitus, explain where the disease comes from, and what to do with it.

Type 1 diabetes mellitus

A person gets sick if the cells of the pancreas cannot produce insulin, the hormone responsible for the transfer of nutrient glucose from the blood to the cells. Insulin-dependent diabetes mellitus usually occurs in childhood or adolescence.

Type 1 diabetes occurs due to a malfunction in the immune system, in which the immune system begins to attack the β-cells of the pancreas. Less commonly, the disease develops due to viral diseases and stress.

Signs of the disease manifest themselves sharply, so it is impossible not to notice them. A person experiences excitement and a terrible thirst, and at the same time constantly “runs” to the toilet. His mouth smells like acetone, his skin itches and his head hurts. If a person is not helped, he may fall into a coma and die.

Treat type 1 diabetes mellitus with regular injections of insulin. Unfortunately, there is no other way to help such people: after all, there is still no way to support and “revive” the dead β-cells of the pancreas.

Type 2 diabetes mellitus

The disease occurs when the body ceases to have enough of the produced insulin, or the sensitivity to it decreases. At the same time, everything is in order with the β-cells of the pancreas. “Non-insulin dependent” diabetes mellitus, as a rule, affects people over 40 years of age.

Type 2 diabetes occurs in people who have poor insulin sensitivity from their parents. In addition to them, those at risk are those who like to eat more and move less.To cope with the continuous flow of glucose, cells of the pancreas release more and more insulin into the blood every day, “break down” and no longer cope with the production of the hormone, which is why diabetes develops over time.

Signs of illness appear late, so people with diabetes often find out about their illness by accidentally donating blood. Because of this, type 2 diabetes is often detected only when an excess of glucose in the blood has done its “dirty work”: provoked hypertension, atherosclerosis or coronary heart disease.

Therefore, if an adult suddenly begins to experience itching and unusual thirst, if he regularly tends to sleep, he quickly gets tired at work, often gets sick or experiences tingling in his legs, you need to see a doctor as soon as possible. The sooner diabetes is detected, the easier it is to control it later.

They treat diabetes mellitus in a complex way: they drink drugs that lower blood sugar, try to eat as little fatty and sweet as possible, and try to move more.You cannot completely cure type 2 diabetes, but you can change your life so that diabetes does not interfere with her joy.

Type 3 diabetes mellitus

A person develops type 3 diabetes mellitus due to serious problems with the pancreas. The disease develops due to inflammation, swelling, or if the pancreas is removed during surgery.

Type 3 diabetes is similar to both type 1 and type 2 diabetes. If you have ever had a problem with the pancreas, do not keep it a secret from your doctor to avoid misdiagnosis.

Most Important Things to Know About Diabetes

The likelihood of developing type 1 diabetes mellitus is very low. If this did not happen in childhood, then most likely it will not happen.

However, the pancreas must be protected. To do this, you should give up fast food and smoking, and try to eat more vegetables. Type 2 and 3 diabetes is not only heredity, but also a way of life. Even people whose both parents had diabetes may not get sick if they move actively, eat a lot of plant foods and few unhealthy desserts.The best diabetes prevention is a healthy lifestyle!

Moreover, this rule applies to those people who are still “unlucky” to get diabetes. It has been proven that if you regularly measure your glucose levels and take prescribed medications, the amount of sugar in your blood can be successfully controlled and you can live a full life.

How to determine whether the sugar level is normal or not?

It is often asked what is the normal blood sugar level? Answering this question, you can say on an empty stomach less than 6.1 mmol / l, and after meals less than 7.8 mmol / l.
But for patients with diabetes mellitus it is impossible by definition to speak of “normal sugar”. There is a term – target range. In other words, the blood glucose level should not exceed the maximum value and not fall below the minimum. This range should be discussed with your doctor. it may differ from patient to patient.
The challenge for the person with diabetes is to keep the blood sugar within the target range.
There is a well-known myth that blood glucose levels can be sensed. Therefore, you do not need to use the meter. Unfortunately, this is more of a misconception. The body gradually gets used to high sugar. Of course, we are not talking about extreme values ​​above 20 mmol / L. Even at a value of 11-12 mmol / l, it can develop irreversible negative consequences and complications of diabetes. Therefore, blood glucose measurements should be carried out regularly, at least once a day. These are the official guidelines from diabetes treatment algorithms.

How can you make sure your blood sugar is in the right range and not kid yourself?

Simple, color-coded OneTouch Select Plus Flex® and OneTouch Verio Reflect® meters help you understand the results at a glance. Within 5 seconds, a number will appear on the screen and indicate what it means: too high, low sugar, or within the target range. And the OneTouch Select Plus Flex® and OneTouch Verio Reflect® meters can even set different pre- and post-meal ranges.

But it is very important to remember that regular self-monitoring does not effectively manage diabetes. It is imperative to take the right action with low and high sugar. To find out what to do, you just need to consult a doctor or search on the Internet. Only trust trusted sources of information.

Why is sugar testing not useful for early diagnosis of type 2 diabetes?

Sugar testing is useless for early diagnosis of type 2 diabetes!

If you understand that the body is quickly and easily able to stabilize blood sugar through urinary excretion, even in the case of profound insulin resistance, then you will also understand why a fasting blood sugar or glycated hemoglobin blood test (reflects the average blood sugar concentration over the last 90 days) is useless and confusing.This fasting blood sugar test can give you a false sense of security if your fasting blood sugar is normal.

Not only fasting sugar testing, but also glycated hemoglobin and Glucose Tolerance Test are useless for early detection of type 2 diabetes. they will show the presence of a problem ONLY when everything will be worse than ever and even a blind person will already know that you are deeply sick.

In all other cases, they will give you a false sense of security.

Provide a scale of insulin resistance from zero to ten, where zero is ideal insulin receptor sensitivity and 10 is type 2 diabetes. As you progress from 0 to 10, you are already not functioning optimally as a biological machine and your energy level will already be lower than evolution intended. But at this stage, you will not even suspect about it. Even when you have insulin resistance of 4-7 points, you will still consider yourself healthy.When insulin resistance increases to 8 points, you will understand that something is clearly wrong with you, but fasting sugar and glycated hemoglobin will still be normal! And these sugar tests will be normal even when you get close to 9! Only at the 10 mark will they expose the problem with which you have actually lived in an embrace for more than a decade !!

Do not even think of assuming that if your fasting sugar and glycated hemoglobin are normal, then you “have no problems with insulin resistance.”

You need to know that

TYPE 2 DIABETES DEVELOPS FROM EXCESS INSULIN!

As long as the pancreas has enough capacity to produce more insulin, only glucose tolerance changes. Those. when you do the simplest fasting blood sugar test, your blood glucose is normal. Those. this shows that your body coped with blood sugar levels overnight. But if you do a blood sugar test with a glucose load (glucose tolerance test), the blood glucose level will decrease much more slowly.Which actually reflects the propensity to develop type 2 diabetes. But in fact, there is no type 2 diabetes mellitus yet.

Usually, the endocrinologist at this stage makes a helpless gesture and advises you to control the consumption of sugars. This creates a psychological problem for you, but does not prevent, but only postpones the development of the disease. And your doctor advises you to come in periodically to control your blood sugar. In fact, if you get sick, then we will begin to treat. In the meantime, you are not our client.

But when you are diagnosed with type 2 diabetes, it is indicated as follows: “We screwed up as doctors and healthcare, because your problem and symptoms slowly developed for decades until today and we did not have enough brains to measure your insulin 10-20 years ago and explain in which direction reusable meals are moving you due to diets such as table number 9.Why don’t doctors check blood insulin levels?

More or less healthy insulin on an empty stomach is 34 IU / ml, where 5 IU / ml and above are different degrees of the problem. Almost everyone says that when a blood test for insulin shows from 3 to 25 IU / ml on an empty stomach, then a person is healthy. This range (3 – 25) has nothing to do with health and you may think that your fasting insulin 6 IU / ml or even 10 IU / ml is “good”.

If people with diabetes don’t take insulin, they waste their time and money when they measure their blood sugar.

According to a scientific study review from the Cochrane Collaboration, among people who have type 2 diabetes for more than one year and are not using insulin, the effect of blood sugar testing is very small. And when they get more diabetes, it makes even less of a difference. Worse, there is no evidence that sugar testing “affects patient satisfaction, overall well-being, or overall health-related quality of life.”

However, everyone with diabetes should have their blood sugar checked regularly.

90,000 What is the ideal blood sugar level to prevent another stroke or heart attack?

When it comes to preventing stroke, blood sugar control has always been important for people with diabetes . New research shows that stroke survivors with diabetes have an ideal blood sugar target to lower their risk of various types of vascular disease, such as stroke or heart attack, later on.The study was published September 29, 2021 in the American Academy of Neurology’s medical journal Neurulogy.

“We know diabetes is associated with an increased risk of a first stroke,” said study author Moon-Ku Han, MD, from Seoul National University College of Medicine in Korea. “But our results show that there is an optimal blood sugar level that can minimize the risk of recurrent stroke, heart attack or other vascular problems, and it ranges from 6.8% to 7.0% of total hemoglobin .

The study involved 18 567 people with diabetes, whose average age was 70 years. All participants were hospitalized with ischemic stroke caused by a blood clot. The researchers did a glycated hemoglobin (HbAlc) test to determine the average blood sugar level over the past two to three months. A level below 5.7% is considered normal; 6.5% or more usually indicates diabetes. Participants had an average glycated hemoglobin level of 7.5%.

Then a year later, the researchers conducted an observation to find out if there was a connection between the level of glycated hemoglobin with the risk of recurrent stroke, heart attack, or death from certain vascular causes.

Of all participants: 1437 (8%) had a heart attack or died of vascular disease within a year of starting the study, and 954 (5%) had another stroke.

A study found that people admitted to the hospital with glycated hemoglobin (HbAlc) levels above 6.8–7.0% had an increased risk of cardiovascular disease and recurrent stroke.

After adjusting for factors such as age and gender, the researchers found that the risk of heart attack or similar vascular disease in humans was 27% higher if they were hospitalized with glycated hemoglobin (HbAlc) levels above 7.0%. compared with those who enrolled with an HbAlc level below 6.5%.

The risk of recurrent stroke in humans was 28% higher when admitted to hospital with glycated hemoglobin levels above 7.0% compared with patients below 6.5%.

“Our results highlight the importance of closely monitoring your blood sugar levels if you are diabetic and have had a stroke,” said Khan.

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Irina Zaitseva

Nutritionist, Endocrinologist, Diabetologist, Doctor of the highest category, Candidate of Medical Sciences
| + posts

In 2009 she received a diploma from the Russian Medical University under the Federal Agency for Social Development and Health.She studied at the Faculty of General Medicine. Then she underwent residency in the specialty “Endocrinology”, having received the qualification “Endocrinologist-cardiologist”. In 2018, she attended the course “Dietology in the practice of an endocrinologist.” Certified in Endocrinology, Dietetics and GCP.

Irina Zaitseva is the author of more than 20 published works, and not only in Russia. He is also a co-author of textbooks on diabetology and endocrinology.

Member of the European Society of Endocrinology (ESE).

Member of the European Association for Obesity (EASO).