Normal Blood Sugar Levels for Diabetics and Non-Diabetics

• It’s important to know what a normal blood sugar is if you have diabetes, or if you may be at risk. 
• For diabetics, normal blood sugar levels are considered between 80 to 130 mg/dL after fasting, and less than 180 mg/dL one to two hours after eating. 
• For those without diabetes, normal blood sugar levels are considered between 70 to 99 mg/dL after fasting, and less than 140 after eating. 
• This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine. 
• This story is part of Insider’s guide to Diabetes. 

If you have

diabetes

, daily management of your blood sugar levels is important to feeling your best and preventing long-term health complications. 

Blood sugar can also be an important measurement to determine your risk for diabetes. For example, those with prediabetes will have their blood sugar tested at least annually, as abnormal blood sugar levels can indicate you may be likely to develop

type 2 diabetes

. 

Here’s what you need to know about how blood sugar is measured, what’s considered normal, and how to regulate blood sugar if it’s too high or low. 

What is blood sugar? 

Blood sugar, or blood glucose, is a measurement of the amount of glucose in your blood. 

When you eat carbohydrates, your body breaks down those carbs into glucose. This becomes your body’s main source of energy, and fuels the vital functions in your brain, heart, liver, and muscles, says Nestoras Mathioudakis, MD, a diabetes expert at Johns Hopkins Medicine. 

For people without diabetes, the pancreas releases insulin to help your cells absorb glucose and fuel your body. But for people with diabetes, the body does not produce insulin or it doesn’t work properly, and as a result, blood sugar levels must be carefully regulated to prevent health complications. 

How to measure blood sugar levels

There are two main ways to check your blood sugar levels: 

1. Blood glucose test. There are many at-home devices — such as finger-prick monitoring kits or continuous glucose monitors — that you can use to measure blood sugar on your own. 
2. An A1C test. A1C is a blood test, conducted by your doctor, that describes your average blood sugar levels for the past three months. 

Related

The best glucometers for tracking blood sugar

Type 1 diabetics, along with some type 2 diabetics, who require insulin medication, must check their blood sugar at least four times per day, says Mathioudakis. Typically, this should be done before a meal, one to two hours after a meal, and at bedtime. 

The timing of these measurements can help determine how much insulin to use. For example, it can be important to use more insulin after a high-sugar meal, or to avoid falling into hypoglycemia while you’re sleeping. 

To check your blood sugar at home, you should use blood glucose tests, such as a glucose meter or continuous glucose monitor (CGM). Both devices measure blood sugar with the unit mg/dL, which means a milligram of sugar per deciliter of blood. 

If you don’t have diabetes, but you may be at risk, your doctor might have you take an A1C test during a yearly check-up. This test reports results as a percentage; the higher the percentage, the higher your blood sugar has been in the past three months. Those with diabetes should get an A1C test at least twice a year — and sometimes every three months. 

What’s normal? 

The following chart depicts normal blood sugar measurements, depending on which test you use and when you take it. 

Yuqing Liu/Insider

Overall, what is considered a normal blood sugar level can look different depending on someone’s age, weight, gender, and other factors. 

For example, a 2017 study published in the journal Physiology & Behavior suggests that women could have lower fasting blood glucose levels and be more insulin resistant due to lower muscle mass compared to men. However, the same study finds that pre-diabetic symptoms like impaired fasting glucose is more common among men. Normal blood sugar levels also increase as you age.

So, talk with your doctor about what normal blood sugar is for you in order to best manage your health. 

How to regulate your blood sugar levels 

Most of the time, you’ll be able to regulate your blood sugar on your own if it’s too high or low. 

If your levels are too high — over 140 mg/dL before a meal or 180 mg/dL after a meal — you may be experiencing hyperglycemia. Symptoms can include: 

• Headache 
• Irritability
• Fatigue 
• Frequent urination
• Excess thirst

To lower blood sugar, you’d want to use more insulin medication to help your cells absorb glucose. 

On the other hand, hypoglycemia is when your blood sugar is too low, typically under 70 mg/dL. Common signs may include: 

• Hunger
• Nausea
• Confusion
• Feeling shaky or sweaty
• Blurred vision

If you need to raise your blood sugar, you should eat a glucose tablet or drink something sugary, such as fruit juice. 

Mathioudakis says that those with a family history of diabetes — and who show high fasting glucose — should talk with their doctor about how to regulate blood sugar levels. And if your blood sugar spikes too high, such as 200 mg/dL or more, you should seek immediate medical attention. 

Your Insulin Therapy – American Family Physician

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 2004 Aug 1;70(3):511-512.

Your doctor has given you insulin to help control your diabetes. You need two kinds of insulin: basal and mealtime insulin. Sometimes insulin is premixed for you. Keep a record of your blood sugar and insulin shots every day so the amounts of insulin can be changed to fit your lifestyle.

Your basal insulin type and dose are (your doctor will fill in the blanks):

Low blood sugar (this is called hypoglycemia) can happen if you take too much insulin.

• Symptoms of low blood sugar include shakiness, weakness, dizziness, confusion, and headache. Some people may not have symptoms.

• Check your blood sugar level if you have any of these symptoms. You also should check your blood sugar level during your insulin’s peak of activity (talk to your doctor about this).

• If your blood sugar level is below 70 mg per dL, follow the Rule of 15:

  1. Eat or drink 15 grams of carbohydrates (e.g., one half glass of orange juice or one slice of bread).

  2. Wait 15 minutes, and test your blood sugar level again.

  3. If your blood sugar level is still below 70 mg per dL, do steps 1 and 2 again. If your blood sugar level now is above 70 mg per dL, go back to your usual testing schedule.

• Your risk of low blood sugar depends on the kind of insulin you use and how long it works. Aspart and lispro last 4 hours, regular insulin lasts 6 hours, NPH lasts 10 to 16 hours, and glargine and ultralente last 24 hours.

• If you have trouble getting your blood sugar level back above 70 mg per dL, call your doctor or local emergency room for help.

Your mealtime insulin type and dose are (your doctor will fill in the blanks):

How much insulin you use before meals changes from meal to meal. Spell the word “SAFE” to figure out how much insulin you will need at mealtime:

Supplemental insulin—supplemental, or corrective, insulin will get your blood sugar level back into the range of 90 to 130 mg per dL before meals. Test your blood sugar level before the meal (if your blood sugar level is below 70 mg per dL between meals, follow the Rule of 15). Use the table below to find how much you need to change your insulin dose. One unit of insulin should cause your blood sugar level to drop 30 to 50 mg per dL, but you may need more insulin to get the same effect.

View/Print Table

Activity—take _______ units less insulin if you plan to exercise after the meal.

Food—carbohydrates; take 1 unit of insulin for every 10 grams of carbohydrate in your meal. A typical meal has 45 to 60 grams of carbohydrates, so you will need to take about 4 to 6 units of insulin per meal. People with insulin resistance may need to take more insulin to get the same effect.

Experience—You will learn how much insulin you need at different times. Keep a record of your blood sugar levels and the amount of insulin you take every time. This will help you remember what has worked for you in the past. Bring this record with you every time you see your doctor.

SAFE total: _____ This is the amount of mealtime insulin you should inject.

High blood sugar with type 1 diabetes

Long-term problems from high blood sugar

High blood sugar over a long period of time, such as months or years, causes damage to body organs. This damage is not usually seen for 10 years or longer.

High blood sugar, over time, leads to:

• Kidney damage and kidney failure
• Blood vessel damage that can cause heart attacks and strokes
• Eye disease that can cause poor vision or blindness
• Nerve damage that can cause pain like pins and needles in the feet
• Sores on the feet or legs that do not heal and could lead to removal of a toe, foot, or leg
• Sexual problems, such as not being able to get an erection

Taking care of your diabetes and keeping most of your blood sugars near the normal range throughout your life lowers your chance for these long-term problems.

What should I do when my blood sugar is high?

If your blood sugar is 240 or higher:

1. Check ketones. If you do not check for ketones, you will not know if you have them.
2. If you have small, moderate, or large ketones, take extra rapid-acting insulin right away.
3. Drink a lot of carbohydrate-free drinks right away.

Follow the instructions for taking extra insulin.

High blood sugar and checking ketones

There are many reasons your blood sugar can go too high. It is important to know what causes high blood sugar and why high blood sugar is dangerous.

Causes of high blood sugar

• Eating too much carbohydrate or too much quick-acting carbohydrate
• Not enough activity
• Stress
• Not taking enough insulin
• Forgetting to take insulin
• Illness or infections
• Injury or surgery

Signs of high blood sugar

• Urinating (going pee) a lot
• Thirsty and drinking a lot
• Dry mouth and dry skin
• Blurry vision
• Yeast infections in the groin area

It is normal to have high blood sugar once in a while.

Call your diabetes nurses if:

• You have high blood sugar a lot of the time
• You have high blood sugar that keeps happening about the same time each day

The nurses can help figure out the reason for the high blood sugar and suggest changes in insulin, exercise, or eating to help the high blood sugar come down.

What are ketones?

Ketones are an acid that can build up in the body when your body uses fat instead of sugar for energy. Ketones are caused from the breakdown of fat. Ketones harm the body.

Body fat is used for energy when:

• There is not enough insulin in the body to use sugar for energy
• You do not eat carbohydrate for long periods of time, such as skipping meals

Step 2

When should I check for ketones?

• When your blood sugar is 240 or higher
• Check ketones even if your blood sugar is not high if you are:
  • Sick, have an infection, or trauma
  • Vomiting (throwing up)
• If you forgot an insulin shot.

How do I check for ketones?

There are two ways to check for ketones:

• Step 7
  Urine ketones
• Blood ketones

Steps to check for urine ketones:

1. Gather the supplies
   • Urine ketone strips (check expiration date)
   • Small paper cup to pee in
   • Timer or watch with a second hand
2. Unscrew the lid and take 1 strip out of the bottle.
3. Screw the lid back on right away to keep them fresh.
4. Step 8
   Do not touch the test end of the strip.
5. Dip the test end of the strip into the cup of fresh urine.
6. Take it out right away.
7. Remove extra urine by drawing it along the rim of the cup.
8. Exactly 15 seconds after dipping it in the urine, compare the ketone strip with the color chart on the bottle of ketone strips.
9. If you have ketones, follow these instructions.

Ketone strip storage

• Keep ketone strips at room temperature between 59° and 86° F. Keep them out of direct sunlight.
• Step 8
  After opening the first time, write the date on the bottle.
• Always put the lid back on right away after opening.
• Do not keep them in the bathroom because the moisture could ruin the strips.
• Throw the ketone strips away 6 months after first opening if they are not gone.
• Do not use them after the expiration date. Call your pharmacy for a refill.

Steps to check for blood ketones:

1. Gather the supplies:
   • Blood ketone meter
   • Blood ketone test strips
   • Lancet device with lancets
2. Wash and dry your hands.
3. Take the blood ketone strip out of the foil wrapper.
4. Put a test strip into meter and it will turn on.
5. Use a small needle, called a lancet, to poke your finger. Get a drop of blood on your fingertip.
6. Touch the window of the test strip to the drop of blood on your finger. The test strip “sucks” the drop of blood into the strip.
7. In a few seconds, your blood ketone reading will show on the screen of the meter.

• Readings below 0.6 mmol/L are in the normal range.
• Readings between 0.6 and 1.5 mmol/L may indicate the development of a problem that may need medical help. Contact your health care provider for instructions.
• Readings above 1.5 mmol/L indicate the patient may be at risk for developing diabetic ketoacidosis (DKA). Contact your health care provider immediately.

What should I do if I have ketones?

If you have small, moderate, or large ketones, take extra rapid-acting insulin and drink lots of carbohydrate-free drinks right away.

Follow the instructions for taking extra insulin.

Call your diabetes doctor or nurse right away if you do not know what to do.

Diabetic ketoacidosis (DKA)

When ketones are large and stay large 4 or more hours, the amount of acid in your body is very high. Very high ketones are dangerous. It can turn into DKA if it is not treated with extra insulin and carbohydrate-free drinks right away.

DKA is an emergency and can lead to coma or death.

DKA can be prevented by knowing:

• When to check for ketones
• How to check for ketones
• What to do for ketones

If you do not check for ketones, you will not know if you have them.

Warning signs of DKA are:

• Ketones in the blood and/or urine
• Vomiting (throwing up) or stomach pain
• Fruity odor to your breath
• Drowsiness or trouble staying awake
• Fast and deep breathing

Go to an emergency room right away if you have any of the signs of ketoacidosis.

Most People With Prediabetes Aren’t Aware They Have It — Here’s What to Know

Posted OnMay 6, 2020

byRebeca.gordenstein

Prediabetes is when your blood sugar levels are high, but not high enough to be considered type 2 diabetes.

“It’s sort of an in-between condition,” says Sue Kirkman, MD, professor of medicine in the division of endocrinology and metabolism at UNC Health. “It’s considered a precursor to type 2 diabetes.”

Breaking Down Prediabetes

Blood sugar levels that are between 100 and 127 mg/dL are considered prediabetes, according to the American College of Cardiology. Normal is between 70 and 100 mg/dL, and anything above 127 is considered type 2 diabetes.

About one-third of Americans have prediabetes, according to the Centers for Disease Control and Prevention (CDC), although the majority don’t know it.

People who have been diagnosed with the condition have a 50 percent chance of moving on to full-blown type 2 diabetes within the next five to 10 years, according to the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK).

“If changes aren’t made in eating habits and activity, many people with prediabetes will move into the diabetes category,” Julie Stefanski, RDN, a dietitian, certified diabetes instructor and spokesperson for the Academy of Nutrition & Dietetics, tells LIVESTRONG.com.

Even if you don’t develop diabetes, though, having prediabetes can up your risk of heart and kidney disease, per the Mayo Clinic.

If you know you have prediabetes, you have the opportunity to take measures to get your blood sugar levels down to a healthy range and prevent the condition from progressing.

Causes of Prediabetes

The biological causes of prediabetes (and diabetes) have to do with insulin resistance.

Insulin is the hormone that guides blood sugar molecules (broken down from the food you eat) out of the bloodstream and into cells, where they’re used as fuel. In prediabetes and diabetes, your body either loses the ability to respond properly to insulin or doesn’t make enough insulin, which means the sugar levels in your blood build up.

“As prediabetes develops, the body struggles more and more to process certain foods,” Stefanski explains. “The pancreas must make higher levels of insulin to take sugar out of the blood and put it into the cells of the body. Eventually the body won’t be able to keep up with insulin needs and blood sugar levels will rise.”

No one really knows what causes insulin resistance in the first place, though it seems to be a combination of factors.

“The risk factors for prediabetes are the same as risk factors for type 2 diabetes,” Dr. Kirkman says. According to the Mayo Clinic, those include:

1. Family history and genetics: If you have a parent or sibling with type 2 diabetes, you’re more likely to develop prediabetes (and type 2 diabetes).

2. Age: The risk of developing prediabetes rises after the age of 45.

3. Being overweight or obese: The risk is even greater if fat is concentrated around the abdomen.

4. Waist size: Men with waists larger than 40 inches around and women who have waist circumferences larger than 35 inches are at a higher risk for insulin resistance, even if their body mass index (BMI) is normal, according to the NIDDK.

5. Being inactive: Regular exercise is key to reaching and maintaining a healthy weight and helps your body better process sugar and use insulin.

6. Diet: Red and processed meat along with sugary beverages increase the risk of prediabetes. Eating more fruits, vegetables, whole grains, olive oil and nuts is linked to a lower risk.

7. Gestational diabetes: Women with a history of this pregnancy condition are at higher risk for prediabetes and type 2.

8. Race and ethnicity: African Americans, Hispanics, Native Americans, Asian Americans and Pacific Islanders have a higher risk than other groups.

9. Polycystic ovary syndrome: This hormonal disorder in women, commonly referred to as PCOS, is marked by small cysts on the ovaries, according to the Mayo Clinic.

10. Metabolic syndrome: This condition is marked by high blood pressure combined with abnormal cholesterol levels and a large waist size, per the NIDDK.

11. Other risk factors: Obstructive sleep apnea and smoking may increase insulin resistance. Certain medications and hormonal disorders can also put you at higher risk.

Symptoms of Prediabetes

Like the early stages of diabetes, prediabetes usually doesn’t have any symptoms at all. That’s why some 90 percent of people with the condition don’t even know they have it, Dr. Kirkman says.

Some people may have warning signs, which could include:

• Acanthosis nigricans, which are patches of dark, velvety skin. “These can appear on the neck, in the armpits or groin and indicate that the body is struggling to metabolize foods and beverages that raise blood sugar,” Stefanski says. Skin tags may appear in the same areas, according to the NIDDK.
• Feeling extra thirsty even though you’re drinking a lot of water, per the Mayo Clinic.
• Urinating frequently.
• Feeling hungry all the time, even though you’re eating a healthy amount.
• Fatigue.
• Blurred vision is also sometimes a sign, according to the CDC.

Diagnosing Prediabetes

Because prediabetes usually doesn’t have any symptoms, “it’s important to get screening tests if you have risk factors,” Dr. Kirkman says.

The American Diabetes Association (ADA) recommends testing be considered in adults who have no symptoms but have a BMI of 25 or higher (23 or higher in Asian Americans) and one or more other risk factors.

Testing should begin for all people starting at age 45. If your results are normal, you don’t have to be re-tested for three years, Dr. Kirkman says.

The same three tests that can diagnose diabetes are also used to diagnose prediabetes, according to the Endocrine Society. They are:

1. Fasting blood glucose test (FBG): This is a blood test that takes place after you’ve been fasting for eight hours (usually overnight) and drinking only water. Prediabetes is when your fasting blood sugar is between 100 and 125 mg/dL, says Dr. Kirkman.

2. Hemoglobin A1c test (HbA1C): This test measures your blood sugar levels over the past three months. Prediabetes is indicated when your numbers are between 5.75 and 6.4 percent, says Dr. Kirkman.

3. Oral glucose tolerance test (OGTT): This test is rarely used, says Dr. Kirkman. That’s partly because it’s difficult to do. You have to have blood drawn two hours before and after drinking a sugary beverage, all after eight hours of fasting. A result over 140 means you are prediabetic, while over 200 indicates diabetes, per the NIDDK.

Typically, doctors will repeat the tests before giving a diagnosis of diabetes or prediabetes, says Dr. Kirkman.

Treating Prediabetes

Treating prediabetes really means preventing type 2 diabetes, and the sooner you get started the better. The American Academy of Family Physicians (AAFP) notes that the longer you have either condition, the higher the likelihood you’ll end up with health complications.

“The main goal is to not advance to the point where you have type 2 diabetes,” Dr. Kirkman says. “The treatments are primarily losing weight and exercising or certain medication.”

If you’re overweight, losing just 5 to 7 percent of your body weight (or 10 to 14 pounds for a 200-pound person) can lower your risk for type 2 diabetes, according to the NIDDK. This will help push your blood pressure and cholesterol levels into healthy ranges, per the AAFP, and most importantly, adds Dr. Kirkman, “some people with weight loss will actually revert to having normal blood sugar.”

There’s debate about whether you can actually “reverse” prediabetes or even type 2 diabetes but, says Dr. Kirkman, with proper lifestyle changes, you can prevent or indefinitely delay progression.

The best way to lose weight is through diet and exercise, each of which bring their own benefits to the table.

When it comes to diet, there’s no one right way to eat if you have prediabetes. One place to start, though, is in the timing of your meals.

“Start by cutting back on the portions of foods you’re eating at one time,” Stefanski says. “Rather than eating the majority of your food during a few hours at night, spread those choices out more so that the body doesn’t have to process everything at the same time.”

You can also diminish portion sizes gradually, drink water rather than sweetened beverages and opt for whole fruit over fruit juice.

Green vegetables are a great way to feel full without raising your blood sugar, and the AAFP recommends eating more whole grains, lean proteins and low-fat dairy.

Foods to avoid include those that are processed, fried and sugary.

“No matter what your weight, it’s important to become more physically active,” Stefankski says. “We’ve worked regular activity out of our daily lives. As humans, we need to move and stay active to keep processes within the body working appropriately.”

The CDC recommends aiming for at least 150 minutes of moderate physical activity each week. Brisk walking is a good option, as are swimming and bike riding.

Research shows that people who get support are more likely to achieve their goals. Indeed, those with prediabetes who enacted changes encouraged by the National Diabetes Prevention Program (DPP), which includes a support component, lowered their risk of developing type 2 diabetes by as much as 58 percent.

There’s some controversy as to whether medications can or cannot help people with prediabetes. In one study, though, conducted as part of the DPP Outcomes Study, the medication metformin dropped the risk of developing type 2 diabetes by 31 percent. Ask your doctor if medication might be right for you.

Monitoring Blood Glucose and Ketones | Pediatric Diabetes Education | Children’s Hospital at Dartmouth-Hitchcock (CHaD)

Ketone monitoring

Ketones are an acid. They are present in the blood or urine when sugar is not available for energy and the body has used stored fat. This occurs when there is not enough insulin available to allow the sugar to be used as energy, or when you have not eaten enough.

Blood glucose monitoring

It is extremely important to keep track of your blood glucose information. Great organization of your diabetes can help control the risk of complications in the future, and keep you happy! Blood glucose meters come with a diary to write down your blood glucose values as well as your insulin doses. Computer programs can also download the information from your glucose meter. It is important to look at this information on a regular basis as you learn to adjust your insulin. Remember, the goal is to keep your glucose in the “target” range, and not to feel bad when your glucose is out of the target range. By keeping track of your information, you can make changes to meet your goals.

Use this Daily Record Sheet (PDF) to make organization quick and easy! (Courtesy of Understanding Diabetes by Dr. H. Peter Chase.)

You should follow the directions included with your meter when you monitor your blood. Remember, a machine is only as accurate as its user. It is important that the meter is coded properly and the procedure is done correctly. Use the following chart for your target areas, being mindful of your age for the target level.

You should discuss what your individual target ranges are with your health care provider.

Transcribed from Understanding Diabetes by Dr. H. Peter Chase.

Normal Sugar Glucose Levels in Men and Women

Regularly checking your glucose levels will ensure that you have a healthy blood sugar.

Image Credit: mthipsorn/iStock/GettyImages

The rate of new diabetes diagnoses has been steadily rising in the U.S. Currently, more than 100 million American adults are living with diabetes or prediabetes, according the Centers for Disease Control and Prevention (CDC).

Controlling blood sugar is key to managing the disease, but even if you haven’t been diagnosed with diabetes, your blood sugar levels might give you some insight into your health. Catching a high blood sugar reading earlier rather than later, for example, can help you better treat any potential or growing concerns.

Read more: What to Eat to Feel Better — Inside and Out

What Are Normal Blood Glucose Levels?

Your blood glucose, or blood sugar, is the main sugar found in your blood, according to the U.S. National Library of Medicine. Blood glucose comes from food and provides your body with energy. Your levels may rise and fall throughout the day, depending on what and when you eat.

Normal blood glucose levels, regardless of gender, are between 70 and 99 milligrams per deciliter (mg/dL) if the test is taken fasted, according to Virginia Mason Medical Center. Two hours after eating, a normal blood sugar level is anything below 140 mg/dL.

Testing Your Blood Glucose

The glycated hemoglobin or A1C test is a blood test that estimates your average blood glucose levels for the two- to three-month period prior to the lab draw, according to the Mayo Clinic. This test doesn’t require fasting and gives your physician an idea of how well you are managing your blood glucose. Ideally, for men and women, your A1C should be below 5.7 percent. Values between 5.7 and 6.4 percent indicate potential pre-diabetes.

Another common way to test your blood sugar levels is a fasting glucose test, taken at your doctor’s office, according to the Mayo Clinic. This test is done before you’ve had anything to eat in the previous eight to 12 hours. You may also take a random blood sugar test, which is a blood sample taken at a random time. Any random blood sugar level of 200 mg/dL or higher indicates potential diabetes.

What If Your Blood Sugar Levels Are Too High?

Blood sugar levels that stay very high can eventually lead to diabetes complications with the kidneys, feet and eyes, according to the National Library of Medicine. While there are some differences between type 1 and type 2 diabetes, both are characterized by high levels of glucose in the bloodstream, according to the Mayo Clinic.

Patients diagnosed with diabetes are encouraged to practice healthy eating and get regular physical activity in order to maintain a healthy weight, according to the Mayo Clinic. Treatment for type 1 diabetes involves insulin injections and frequent blood-sugar checks. On the other hand, treatment of type 2 diabetes usually requires lifestyle change and diabetes medication or insulin, if prescribed by a doctor.

Read more: Is Your Doctor Missing What’s Wrong With You?

Steroids And Diabetes: The Effect On Your Glucose Levels

One of the most popular blogs of all time here at The LOOP is on steroid usage and diabetes, so we wanted to bring it back to you along with some new tips.  [Originally published August 27, 2015—Updated October 29^th, 2020.]

There are various reasons that people take steroid medications. Reasons include bone or muscle injury, pain, lung conditions such as asthma flare-ups, and influenza infections. COVID-19 can cause shortness of breath and breathing problems¹ and steroids might be used. If your medical provider prescribes a steroid medication, here are some things you should know.

 What are steroids?

The label “steroid” is a general term; glucocorticoid is the more specific medical term. Glucocorticoids are naturally made in the body (by the kidney’s adrenal glands) and they have anti-inflammatory properties. They also regulate metabolism (which includes glucose metabolism). In addition to steroids that the body naturally produces, there are also synthetic versions that are designed to act like hormones that reduce inflammation. Some common generic names of glucocorticoids that can affect the entire body system (called systemic) are prednisone, hydrocortisone and dexamethasone. There are inhaled glucocorticoids that affect the lungs directly and include beclomethasone, budesonide, fluticasone.² Inhaled glucocorticoids are used for asthma and long-term lung conditions such as Chronic Obstructive Pulmonary Disease (COPD). There are also topical glucocorticoids in the form of lotions or creams which include hydrocortisone and betamethasone. In this article, we will focus on systemic (i.e. oral, injected, or inhaled) glucocorticoids that we’ll call “steroids” since these are the most likely to affect glucose levels.

What if I’m prescribed steroids and have diabetes?

A known side effect of systemic steroids is elevated glucose levels (hyperglycemia). As you know, this can be especially challenging for people with diabetes. Insulin is the best way to counteract hyperglycemia caused by steroids. In a hospital setting, individuals can receive steroids by IV (intravenous) route. IV doses are often much higher than you would get from oral pills. In the hospital, the medical providers might prescribe different types of insulin to be given at different times of the day to help reduce hyperglycemia.³ If you’re taking steroid pills at home, you might not be starting any new insulin, but you can ask your provider for guidance on the dose to take of your current insulin.

Some steroids, such as prednisone, can raise the glucose level for part of the day. This will be most noticeable if the prednisone is only taken once per day, such as in the morning. Before you take the morning prednisone pill, your glucose level might be the same as it usually is. But later in the day, your glucose level could be a lot higher. This is because steroids increase insulin resistance causing your body’s own insulin or injected insulin to not work as well.⁴ Some people are especially worried about what they eat because they think the food is causing the unusually high glucose reading, but it is most likely from the steroid.

What should I keep in mind while taking steroids?

If you’re using an insulin pump, the basal rate can be increased slightly for part of the day, if needed.  You can do this using a temporary basal rate. If you are using the MiniMed 670G system, ask your provider if you should switch to Manual Mode during the time you are taking the steroid. One of the best ways to determine if you need a higher basal rate is by monitoring your glucose level using a continuous glucose monitor (CGM) such as the Guardian Connect system or MiniMed insulin pump systems.

Consider how many days you will be taking the steroid. If you only take the steroid for a few days, the long-term impact of hyperglycemia is unknown. But you do want to avoid short-term consequences of high glucose such as dehydration or diabetic ketoacidosis (DKA)⁵:

• Be sure to stay well hydrated with sugar-free beverages.
• Check your glucose several times per day and as directed by your healthcare team.
• According to the American Diabetes Association, experts advise checking for ketones every 4-6 hours when your glucose level is above 240 mg/dL. Let your healthcare provider know if you have ketones in your urine, especially if the level is moderate or higher.
• Talk with your provider about your insulin dose and always follow their advice. If you do increase your insulin dose while you are taking steroids, be sure to go back to your usual dose when you stop taking the steroids.
• Do not stop your steroid medication early, unless recommended by your healthcare provider.

We hope these tips are helpful for you!

References:

¹Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Your Health: Symptoms of Coronavirus. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html Accessed October 21, 2020.

²Egbuonu F, Antonio FA, Edavalath M. Effect of Inhaled Corticosteroids on Glycemic Status. The Open Respiratory Medicine Journal, 2014, 8, (Suppl 1: M7) 101-105.

³Grommesh B, Lausch MJ, Vannelli AJ et al. Hospital Insulin Protocol Aims for Glucose Control in Glucocorticoid-Induced Hyperglycemia. Endocr Pract 2016; 22:180-189.

⁴Bevier WC, Zisser PHC, Jovanovič L et al. Use of Continuous Glucose Monitoring to Estimate Insulin Requirements in Patients with Type 1 Diabetes Mellitus During a Short Course of Prednisone. J Diabetes Sci Technol 2008;2(4):578-583.

⁵American Diabetes Association. Diabetes Complications: DKA (Ketoacidosis) & Ketones. https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones Accessed October 21, 2020.

IMPORTANT SAFETY INFORMATION

– Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.

– Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.

Medtronic Diabetes Insulin Infusion Pumps

– Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.

– Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.

Medtronic Diabetes Continuous Glucose Monitoring (CGM) Systems

– The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to treatment.

– Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected.

Important Safety Information

MINIMED 670G™ SYSTEM

The Medtronic MiniMed™ 670G system is intended for continuous delivery of basal insulin (at user selectable rates) and administration of insulin boluses (in user selectable amounts) for the management of type 1 diabetes mellitus in persons, seven years of age and older, requiring insulin as well as for the continuous monitoring and trending of glucose levels in the fluid under the skin. The MiniMed™ 670G system includes SmartGuard™ technology, which can be programmed to automatically adjust delivery of basal insulin based on Continuous Glucose Monitor sensor glucose values and can suspend delivery of insulin when the sensor glucose value falls below or is predicted to fall below predefined threshold values. The system requires a prescription. The Guardian™ Sensor (3) glucose values are not intended to be used directly for making therapy adjustments, but rather to provide an indication of when a fingerstick may be required. A confirmatory finger stick test via the CONTOUR®NEXT LINK 2.4 blood glucose meter is required prior to making adjustments to diabetes therapy. All therapy adjustments should be based on measurements obtained using the CONTOUR®NEXT LINK 2.4 blood glucose meter and not on values provided by the Guardian™ Sensor (3). Always check the pump display to ensure the glucose result shown agrees with the glucose results shown on the CONTOUR®NEXT LINK 2.4 blood glucose meter. Do not calibrate your CGM device or calculate a bolus using a blood glucose meter result taken from an Alternative Site (palm) or from a control solution test. It is not recommended to calibrate your CGM device when sensor or blood glucose values are changing rapidly, e.g., following a meal or physical exercise. If a control solution test is out of range, please note that the result may be transmitted to your pump when in the “Always” send mode.

Pump therapy is not recommended for people whose vision or hearing does not allow recognition of pump signals and alarms. Pump therapy is not recommended for people who are unwilling or unable to maintain contact with their healthcare professional. The safety of the MiniMed™ 670G system has not been studied in pregnant women. For complete details of the system, including product and important safety information such as indications, contraindications, warnings and precautions associated with system and its components, please consult http://www.medtronicdiabetes.com/important-safety-information#minimed-670g  and the appropriate user guide at http://www.medtronicdiabetes.com/download-library

For more information, please visit: MedtronicDiabetes.com/ISI.

Tags: blood glucose, cold/flu, diabetes management, illness, sick, steroids
90,000 Type 2 diabetes ⋆ Prof Dr Alper Celik

What is type 2 diabetes?

Diabetes is a disease caused by a sedentary lifestyle, unbalanced diet and genetic factors. Diabetes is divided into type 1 and type 2. The two main factors in the onset and progression of type 2 diabetes are the body’s resistance to insulin secretion in the body. It is commonly seen in overweight people. Genetic factor, obesity and physical activity are some of the factors that contribute to the onset of type 2 diabetes.Insulin resistance and decreased insulin secretion initiates the onset of this disease. The risk of developing type 2 diabetes is greater if there are cases of diabetes in the family’s medical history. In addition, there are risks for obese people, people over 45 years old, with hypertension and have problems with the thyroid gland.

What are the symptoms of type 2 diabetes?

A large amount of urination, drinking a lot of water or food, anorexia, dry mouth, weakness, fatigue, urination at night, blurred vision, itching are some of the symptoms.In type 1 diabetes, there is no production of insulin in the body; in type 2 diabetes, there is production of insulin in the body, but for some reason, the body cannot use it. This is why blood sugar levels are always high. A person who has high blood sugar, the veins are damaged first, and then the organs. Type 2 diabetes tends to occur in obese people. Accordingly, obesity is the first cause of diabetes. People who have this problem genetically need to monitor their weight especially carefully, because the likelihood of developing type 2 diabetes is high.Type 2 diabetes is a slow and insidious disease. For years without showing any symptoms, blood sugar levels can be high. This contributes to the delay in diagnosis.

How is type 2 diabetes diagnosed?

If the blood sugar is more than 200 mg, the increase in glucose is more than 200 mg, if the fasting sugar is more than 120 mg, then type 2 diabetes is diagnosed.
A diabetic patient is actually a healthy person if diabetes is diagnosed and treated early before organ damage occurs.Because the difficulties that the patient experienced at the beginning of treatment will decrease and this will improve the quality of life. With newly diagnosed diabetes, it would be wrong to talk about organ damage. However, if it is diagnosed late, or if the patient’s high blood sugar is ignored, organ damage can occur. The onset of organ damage can be the eyes, kidneys, and cardiovascular disease. Kidney tests, ECGs, cardiac stress tests, and eye lumps are checked.

What is type 2 diabetes treatment?

The priority in treatment is a diet suitable for diabetes. The patient must undergo an exercise program. Insulin secretion is increased with appropriate tablets. Thus, the effect of insulin is increased and digestion is regulated.
In cases where no treatment is given or the treatment is not followed, the patient may fall into a coma. Vital organs begin to be affected. Eyes, kidneys and cardiovascular system are affected.There is bleeding in the eye or even blindness. With the onset of problems in kidney function, dialysis is required. Persistent high blood sugar levels lead to the risk of clogged veins and heart attacks in the veins. This can lead to cerebral hemorrhage, paralysis, gangrene, even deprivation of the legs. To prevent type 2 diabetes, lifestyle changes must be made, excess weight must be lost, exercise must be exercised, and medication or insulin treatment must be followed carefully.

Difference between type 1 and type 2 diabetes

In type 1 diabetes there is no production of insulin in principle, but in type 2 diabetes there is production but cannot be used or not produced enough. Insulin treatment for type 1 diabetes is started from the very onset of the disease, insulin resistance in type 2 diabetes is tried to be regulated with pills. Patients with type 2 diabetes are usually middle-aged and overweight. In type 1 diabetes, it doesn’t matter, child, young, old.
When treating type 2 diabetes, the patient must be eligible for the treatment. Doctor’s advice such as lifestyle changes, diet, exercise should be followed regularly.

Scientists talked about the danger of high blood sugar

https://ria.ru/20190724/1556841863.html

Scientists talked about the danger of high blood sugar

blood sugar – RIA Novosti, 24.07.2019

Scientists told about the danger of high blood sugar

The likelihood of getting pancreatic cancer increases dramatically even with a slight increase in blood sugar, which is typical for diabetics, as well as RIA Novosti, 24.07.2019

2019-07-24T16: 54

2019-07-24T16: 54

2019-07-24T16: 54

Science

Medicine

South Korea

WHO

Discoveries – RIA Science

Health – society

health

diabetes

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MOSCOW, July 24 – RIA Novosti. The likelihood of getting pancreatic cancer increases dramatically even with a slight increase in blood sugar levels, which is typical for both diabetics and quite healthy people. This conclusion was reached by Korean doctors who published an article in the Journal of Clinical Endocrinology & amp; Metabolism: According to current WHO data, there has been a global obesity epidemic in the world since the 1980s. Every third inhabitant of the globe suffers from extra pounds, and about 15% more from severe obesity.About 47% of diseases, for example, atherosclerosis, strokes, heart attacks, diabetes and cancer, are associated with similar metabolic disorders. As many doctors and scientists today believe, sugar and sugary drinks, which have become widely popular, are claiming the role of the main “distributor” of this epidemic. around the world in the past two decades, and the consequences of their spread are visible today. Two years ago, researchers in the United States found that excessive consumption of sugary carbonated drinks leads to the death of approximately 184 thousand people every year.Most of these deaths occur in Latin America and the United States itself. Park and his colleagues discovered another negative impact of sugar abuse by studying data collected by all South Korean hospitals during routine medical examinations from 2009 to 2013. In total, about 25 million people passed through doctors, which actually makes up the entire population of the country. Analyzing these data, scientists tried to test the hypothesis popular today that sugar not only indirectly contributes to the development of cancer, provoking excess weight gain and accompanying chronic inflammation but also directly accelerates the appearance of tumor cells in the human body.To do this, scientists compared how much sugar was present in the blood of patients with how often they became victims of pancreatic cancer, separately taking into account healthy people and diabetics. Comparing these indicators, the scientists tried to understand whether sugar influenced their health by itself, or its “carcinogenic” properties were manifested only in combination with diabetes. This analysis unexpectedly showed that the proportion of glucose in the blood influenced the likelihood of developing cancer not only when it prohibitively high concentrations, and in fact always.In fact, the chances of acquiring such a tumor gradually increased, from the lowest to the highest abnormalities in the proportion of sugar. the condition increased these chances by 50%, and diabetes actually doubled them. Importantly, having diabetes did not affect this relationship in any way, and its absence or taking insulin did not reduce the likelihood of developing cancer if the concentration of carbohydrates in the body remained high.This suggests that sugar itself contributed to the formation and growth of tumors, rather than accelerating their appearance in indirect ways. Given the growing number of diabetics and the level of sugar consumption in the world, this discovery and the associated diagnostic procedures, according to Pak and his team, may To dramatically reduce the prevalence of pancreatic cancer, it is necessary for the authorities and medical services around the world to begin to actively monitor the glucose levels in the body of all patients, not just diabetics, the scientists conclude.

https://ria.ru/201