Symptoms & Signs of Diabetes Mellitus & Insipidus

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Sources:

MedicineNet: Diabetes Mellitus
<https://www.medicinenet.com/diabetes_mellitus/article.htm>

WebMD: Symptoms of Type 2 Diabetes
<http://diabetes.webmd.com/guide/diabetes-warning-signs>

MedTerms: Insulin
<http://www.medterms.com/script/main/art.asp?articlekey=3989>

WebMD: Obesity Overview
<https://www.webmd.com/diet/tc/obesity-overview>

WebMD: Obesity – Health Risks of Obesity
<https://www.webmd.com/diet/tc/obesity-health-risks-of-obesity>

MedicineNet: Prediabetes – Could You Have It?
<https://www. medicinenet.com/script/main/art.asp?articlekey=57580>

MedicineNet: Type 2 Diabetes Pictures Slideshow
<https://www.medicinenet.com/type_2_diabetes_pictures_slideshow/article.htm>

WebMD: Diabetes Symptoms and Types
<http://diabetes.webmd.com/guide/diabetes_symptoms_types>

WebMD: Diabetes and Infection
<http://diabetes.webmd.com/guide/infections-linked-diabetes>

WebMD: Understanding Diabetes – The Basics
<http://diabetes.webmd.com/guide/understanding-diabetes-basics>

MedicineNet: Diabetes Insipidus
<https://www.medicinenet.com/diabetes_insipidus/article.htm>

NIH: Diabetes Insipidus
<http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001415/>

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What is Normal, Low or High, & More

When people are newly diagnosed with diabetes, one of the first questions they ask is what their blood sugar levels should be; what is normal, too high, or too low? Since everyone’s personal health history and the way their body functions is as unique as a fingerprint, it may affect how the body responds to food, medication, and other factors that influence blood sugar levels.

Health organizations provide guidelines for normal glucose levels in people without diabetes, which are slightly different from the normal or target levels recommended for people diagnosed with diabetes. If you have diabetes, your healthcare provider will work with you to personalize your target blood sugar levels to meet your individual health needs.

This article is intended to help you get started with understanding the basic aspects of blood sugar levels, including:

What is blood sugar?

When you eat, the carbohydrate in your food is broken down into a usable form of energy called glucose. Glucose — also known as sugar — enters the bloodstream and a hormone called insulin helps move it into our cells.

This process lowers the amount of glucose in the bloodstream. When this process works efficiently, your muscles and organs have the fuel they need without there being too much glucose remaining in the blood.

What are normal blood sugar levels?

Health organizations like the American Diabetes Association (ADA) and Centers for Disease Control and Prevention (CDC) provide the following guidelines on normal blood sugar levels for people without diabetes:

Fasting plasma glucose

This blood sugar measurement is taken while you’re fasting – at least 8 hours from when you last ate – such as first thing in the morning.

• ADA recommendation: Fasting plasma glucose level below 100 mg/dL.

After meal / 2 hour plasma glucose

This blood sugar measurement is taken 2 hours after the start of a meal, or 2 hours after ingesting a sugary liquid during an oral glucose tolerance test.

• ADA recommendation: Blood glucose level below 140 mg/dL.

A1C

This blood test is taken independent of when you have eaten. It measures the amount of glucose that is stuck to the hemoglobin (part of your red blood cells), which accumulates over approximately 3 months.

• CDC recommendation: Less than 5.7%.

Normal blood sugar levels chart

Target blood sugar levels for people with diabetes

People with diabetes have difficulty creating or using enough insulin, which is the hormone that helps convert glucose into energy. Although there is no universal blood sugar chart for everyone with diabetes, clinical organizations like the ADA and American Association of Clinical Endocrinologists (AACE) offer guidelines on target blood sugar levels as a starting point.

Healthcare providers typically tailor normal blood sugar target ranges to an individual diabetes care plan. This includes considering your:

• Age
• Lifestyle
• Years since diabetes diagnosis
• Other health conditions
• Risk for severe low blood sugars
• Mental state
• Economic resources available to reach blood sugar goals

If you do not have target guidelines from your healthcare provider yet, you can use the blood sugar level charts below. This will help you get started with testing at home with a blood glucose meter and will make it easier to understand target A1C levels.

Target blood sugar ranges for non-pregnant people with diabetes

	ADA	AACE
Before Meals	70-130mg/dL	Less than 110 mg/dL
2 Hours After a Meal	Less than 180 mg/dL	Less than 140 mg/dL
A1C (HbA1c)	Less than 7. 0%	Less than 6.5%

Target blood sugar ranges for pregnant people with diabetes

Blood sugar targets during pregnancy are lower due to hormonal influences. The ADA, AACE, and Joslin Diabetes Center have slightly different guidelines for target blood sugar levels during pregnancy. In general, pregnant women with diabetes will want to follow individual guidelines provided by their endocrinologist.

The ADA recommends maintaining blood sugar levels of 95-140 mg/dL for pregnant women. However, some providers recommend an even tighter goal of blood glucose levels below 89 mg/dL before a meal and below 120 mg/dL after a meal.

To keep close tabs on levels, most diabetes specialists recommend that women with diabetes during pregnancy check their blood sugar:

• First thing in the morning (fasting)
• Before all meals
• 1 hour after all meals
• At bedtime
• Occasionally at 3 a.m.

Track your own personal ranges with our free weekly and monthly blood sugar charts >

Factors that can affect blood sugar levels

If you have prediabetes or diabetes, you may have insulin resistance or an inability to produce insulin. This means your body has difficulty regulating blood sugar levels on its own.

It’s a delicate balance to maintain, so the following list can help you familiarize yourself with factors that can cause your blood glucose levels to go up or down.

Why your blood sugar level may be high

Based on the ADA guidelines above, if your blood sugar is above 180 mg/dL two hours after a meal, it is considered above the normal range. What might cause your glucose or blood sugar to rise? Consider the following factors:

• Consuming more carbohydrates or a larger meal than usual
• Not taking enough insulin or oral diabetes medication based on carbohydrates or activity levels
• Reduced physical activity
• Illness, stress, and pain (both short-term and long-term)
• Menstrual periods
• Dehydration
• Side effects from medications like steroids or antipsychotics

Why your blood sugar level may be low

If blood sugar drops below 70 mg/dL, it is below normal levels. This can be caused by a variety of factors, such as:

• Not eating enough or missing a meal or snack
• Reducing the amount of carbohydrates you normally eat
• Alcohol consumption — especially if you’re drinking on an empty stomach
• Taking too much insulin or oral diabetes medication based on carbohydrates or activity levels
• Increased physical activity
• Side effects from medications (other than steroids or antipsychotics)

If you have diabetes, keep your blood glucose meter and sources of fast-acting glucose (like glucose tabs or fruit juice) close by in case your blood sugar drops. This is especially important for people with hypoglycemia unawareness, which is a condition that causes symptoms of low blood sugar to go unnoticed.

Eating balanced meals and snacks at regular times throughout the day is a big part of maintaining normal blood glucose levels. Check out our article on meal planning for diabetes to better understand the three macronutrients where calories come from and which have the biggest effect on blood sugar.

Meal Planning for Diabetes: How to Optimize Your Diet [Free Meal Plan Chart] >

Everyone will respond differently to certain factors, which is why it’s important to have individualized target glucose levels. To help you reach your target blood glucose goals, work with your healthcare provider to discuss modifications to your diet, physical activity, or medications, and alert them of other factors like a recent illness or stressful event.

High blood sugar: hidden dangers

In the short term, high blood sugar levels can zap your energy, cause excessive thirst and urination, and blur your vision. High blood sugar levels can also lead to dehydration, dry and itchy skin, and infections. Minimizing the time spent above your target blood sugar range can help you feel your best and will help prevent complications and injury to your body.

Over time, high blood sugar affects many parts of the body. Chronic high blood sugar can start to cause noticeable changes, including:

• Memory problems
• Vision problems like blurriness, diabetic retinopathy, and blindness
• Gum disease that leads to tooth loss, which can make eating healthy foods difficult due to problems chewing
• Heart attack and stroke due to increased plaque build-up in the vessels and other vascular issues
• Kidney disease, which can lead to the need for dialysis or a kidney transplant
• Nerve damage that can cause decreased sensation in the feet and legs which increases the risk for wounds to turn into serious infections and even amputation

Nerve damage from high blood sugar can also cause a variety of symptoms including:

• Pain and tingling in the feet and hands
• Difficulty emptying your bladder
• Problems during the digestion process after eating, which can cause food to sit in the stomach too long and lead to nausea, vomiting, and erratic blood sugar levels

People with diabetes are often reluctant to talk about it, but nerve damage from high blood sugar can also affect sexual response and function for men and women. Don’t be embarrassed to reach out to your doctor for help in any of these areas.

Checking your blood sugar frequently and taking immediate action when it is above range can reduce your risk of complications.

High blood sugar chart and action plan

High blood sugar is also referred to as hyperglycemia. This happens when the body does not have enough insulin or can’t use insulin properly due to insulin resistance.

The numbers below represent values in the hyperglycemic range and require action to bring levels down to a normal range.

Low blood sugar: what to watch out for

Hypoglycemia (low blood sugar) can occur in people with diabetes who:

• Take too much medication or insulin
• Are late eating a meal or snack
• Have increased physical activity
• Drink too much alcohol

Symptoms of low blood sugar include feeling weak, sweaty or clammy, confused, hungry and/or irritable. Sometimes people experience a fast heartbeat and some symptoms may make a person appear to be drunk. A severely low blood sugar can result in unconsciousness, seizures, coma or death — especially when a low occurs during the night.

Low blood sugar affects many parts of the body, but the most frustrating part can be that hypoglycemia can happen anytime and anywhere — even when you think you are closely following the plan for your diabetes care. If low blood sugar is severe, people may need to go to the hospital to help raise their glucose level or miss work due to the side effects.

It can happen during a date, during a business meeting, or even while driving, which is the most dangerous scenario if there is confusion or loss of consciousness while behind the wheel. It’s important to use your blood glucose meter to check your blood sugar before you drive to keep yourself and others safe. Frequent testing with your blood sugar meter and taking action when blood sugar is trending low can prevent a severe low and keep your life on track.

Low blood sugar chart and action plan

Low blood sugar is also called hypoglycemia. The numbers below represent values in the hypoglycemic range and require action to bring blood sugar levels up into a normal range.

Anytime your symptoms don’t match the number on your blood sugar meter, repeat the test. Don’t count on your body to tell you if your blood sugar is high or low — many of the symptoms of highs and lows are similar.

Discussing your unique health goals and challenges with your healthcare provider can provide customized target ranges for normal blood sugar levels and action plans based on your needs. Maintaining healthy blood sugar levels is important to your overall health, so remember to check your blood sugar frequently. Taking immediate action when blood sugar is above range can help reduce your risk of health complications, and if low, keep you safe.

Blood sugar test

Definition

A blood sugar test measures the amount of a sugar called glucose in a sample of your blood.

Glucose is a major source of energy for most cells of the body, including brain cells. Glucose is a building block for carbohydrates. Carbohydrates are found in fruit, cereal, bread, pasta, and rice. Carbohydrates are quickly turned into glucose in your body. This can raise your blood glucose level.

Hormones made in the body help control blood glucose level.

Alternative Names

Random blood sugar; Blood sugar level; Fasting blood sugar; Glucose test; Diabetic screening – blood sugar test; Diabetes – blood sugar test

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

The test may be done in the following ways:

• After you have not eaten anything for at least 8 hours (fasting)
• At any time of the day (random)
• Two hours after you drink a certain amount of glucose (oral glucose tolerance test)

How the Test will Feel

adam.com”>When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.

Why the Test is Performed

Your doctor may order this test if you have signs of diabetes. More than likely, the doctor will order a fasting blood sugar test.

The blood glucose test is also used to monitor people who already have diabetes.

The test may also be done if you have:

• An increase in how often you need to urinate
• Recently gained a lot of weight
• Blurred vision
• Confusion or a change in the way you normally talk or behave
• Fainting spells
• Seizures (for the first time)
• Unconsciousness or coma

SCREENING FOR DIABETES

This test may also be used to screen a person for diabetes.

High blood sugar and diabetes may not cause symptoms in the early stages. A fasting blood sugar test is almost always done to screen for diabetes.

If you are over age 45, you should be tested every 3 years.

If you’re overweight (body mass index, or BMI, of 25 or higher) and have any of the risk factors below, ask your health care provider about getting tested at an earlier age and more often:

• High blood sugar level on a previous test
• Blood pressure of 140/90 mm Hg or higher, or unhealthy cholesterol levels
• History of heart disease
• Member of a high-risk ethnic group (African American, Latino, Native American, Asian American, or Pacific Islander)
• Woman who has been diagnosed with gestational diabetes
• Polycystic ovary disease (condition in which a woman has an imbalance of female sex hormones causing cysts in the ovaries)
• Close relative with diabetes (such as a parent, brother, or sister)
• Not physically active

adam.com”>Children age 10 and older who are overweight and have at least two of the risk factors listed above should be tested for type 2 diabetes every 3 years, even if they have no symptoms.

Normal Results

If you had a fasting blood glucose test, a level between 70 and 100 mg/dL (3.9 and 5.6 mmol/L) is considered normal.

If you had a random blood glucose test, a normal result depends on when you last ate. Most of the time, the blood glucose level will be 125 mg/dL (6.9 mmol/L) or lower.

The examples above show the common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different specimens. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

If you had a fasting blood glucose test:

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• A level of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) means you have impaired fasting glucose, a type of prediabetes. This increases your risk of developing type 2 diabetes.
• A level of 126 mg/dL (7 mmol/L) or higher usually means you have diabetes.

If you had a random blood glucose test:

• A level of 200 mg/dL (11 mmol/L) or higher often means you have diabetes.
• Your provider will order a fasting blood glucose, A1C test, or glucose tolerance test, depending on your random blood glucose test result.
• In someone who has diabetes, an abnormal result on the random blood glucose test may mean that the diabetes is not well controlled.

Other medical problems can also cause a higher-than-normal blood glucose level, including:

• Overactive thyroid gland
• Pancreatic cancer
• Swelling and inflammation of the pancreas (pancreatitis)
• Stress due to trauma, stroke, heart attack, or surgery
• Rare tumors, including pheochromocytoma, acromegaly, Cushing syndrome, or glucagonoma

adam.com”>A lower-than-normal blood glucose level (hypoglycemia) may be due to:

• Hypopituitarism (a pituitary gland disorder)
• Underactive thyroid gland or adrenal gland
• Tumor in the pancreas (insulinoma – very rare)
• Too little food
• Too much insulin or other diabetes medicines
• Liver or kidney disease
• Weight loss after weight loss surgery
• Vigorous exercise

Some medicines can raise or lower your blood glucose level. Before having the test, tell your provider about all the medicines you are taking.

For some thin young women, a fasting blood sugar level below 70 mg/dL (3.9 mmol/L) may be normal.

Risks

There is little risk involved with having your blood taken.Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

• Excessive bleeding
• Fainting or feeling lightheaded
• Multiple punctures to locate veins
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes – 2019. Diabetes Care. 2019;42(Suppl 1):S13-S28. PMID: 30559228 www.ncbi.nlm.nih.gov/pubmed/30559228.

Chernecky CC, Berger BJ. Glucose, 2-hour postprandial – serum. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:585.

Chernecky CC, Berger BJ. Glucose tolerance test (GTT, OGTT) – blood. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:591-593.

Monitoring Blood Glucose

Blood sugar is also called blood glucose.

Why do I Need to Check My Blood Glucose?

• To keep you safe
• To help you and your health care team manage your blood glucose levels
• To help you change your insulin doses
• To help you manage your daily activities, like school, work, exercise, and the food you eat

Always Check at these Times:

• Before breakfast, lunch, and dinner
• Before bed
• When you have signs of low blood glucose (see ‘Low Blood Glucose’ on page 46)
• Each time you get in a car to drive

Sometimes You will Need to Check at these Times:

• Middle of the night
• Before, during, and after exercise

Check More Often:

• When you are sick
• Check blood glucose between 2 a. m. and 4 a.m. if there is a chance your blood glucose may be low.
• Check for 2 to 3 nights after changing your Lantus® insulin dose.
• When you have an unusual amount of exercise late in the day.
• When you are sick.
• When your blood glucose is low before bed.

What Supplies do I Need?

How do I Check My Blood Glucose?

1. Wash your hands.
2. Put the lancet in the lancet device.
3. Put the test strip into the blood glucose meter.
4. Stick the finger on its side near the top of the finger (Picture 1).
5. Squeeze the finger so a drop of blood comes up on the skin.
6. Touch the blood sample to the test strip.
7. Read the blood glucose number on meter.

Picture 1: Poke the side of the finger with the lancet

Important Tips

• Use a new lancet every time you check your blood glucose.
• Throw away the lancet right after it is used. Put it in the container.
• When the container is almost full, tape the lid on tightly.
• Write “SHARPS” on the front, and put it in the trash.

What Number should My Blood Glucose be?

Blood glucose is measured in mg/dl. The normal range for blood glucose for people without diabetes is 70 to 120 mg/dl.

The Diabetes Center has guidelines for blood glucose readings. This is called a target range. There may be times when your healthcare provider gives you a different target range, like for bedtime, with exercise, or after eating.

Nationwide Children’s Hospital Diabetes Center Target Blood Glucose Ranges

The goal is to keep the blood glucose within the target range most of the time.

What Should I do After I Check my Blood Glucose?

Write the blood glucose number in a log book or on a log sheet (page 18), and:

• Include all of your blood glucose numbers.
• Write a comment if there is a reason the blood glucose is above or below target.

Important Tips

• Take your blood glucose meter with you when you are away from home.
• Know your blood glucose numbers when you call the clinic or the doctor.
• Bring your blood glucose meter and blood glucose records to all your appointments.
• Bring a list of any questions that you may have.

How do I Take Care of My Blood Glucose Meter?

• Set the date and time when you get a new meter.
• Make sure the date and time are right each time you use your meter.
• Use the control solution as needed. This will let you know the meter and test strips are working right. Use it:
  • When you get a new meter.
  • When you get new test strips.
  • When you think that the meter is not giving you the right blood glucose number.
• Keep the meter and test strips out of very hot or very cold temperatures. This can cause blood glucose numbers to be wrong.
• Keep meter and test strips in a case, away from sunlight.
• Keep test strips in the container they come in. Keep the lid closed.
• Keep extra batteries with your meter.
• There is a phone number on the back of each blood glucose meter. Call that number if your meter is not working or you have questions about how to use your meter.

What is Hemoglobin A1C?

Hemoglobin A1C is a lab test. It indicates an average blood glucose reading for the last 90 days. It is done when you find out you have diabetes, and every 3 months after that at clinic visits. A person without diabetes has a Hemoglobin A1C of less than 5.6%.

The chart below shows the Hemoglobin A1C result compared with the blood glucose number.

Download the Diabetes Blood Glucose/Insulin Record 

Back to the Managing Your Diabetes Resource Book Table of Contents

Why should I know my blood sugar levels?

Our Associate Medical Director Dr Mike Knapton tells Senior Cardiac Nurse Emily Reeve why it can be important to know your numbers.

Why do my blood sugar levels matter? 

We all need sugar in our blood to provide cells with energy. The hormone insulin allows sugar (glucose) in your bloodstream to enter your cells, where it can used for energy. If you don’t have enough insulin, sugar stays in the bloodstream. Over time, high blood sugar levels damage your blood vessels. This can cause other problems, such as coronary heart disease, kidney disease and diabetic eye disease.It’s important to know whether you have high blood sugar so that this can be controlled, reducing the risk of damage.

If you don’t have enough insulin, sugar stays in the bloodstream

A high blood sugar level would mean you either have diabetes (type 1 or type 2) or have a high risk of developing type 2 diabetes. Although diabetes can have symptoms, such as thirst, urinating a lot, blurred vision, weight loss, recurrent infections and tiredness, you may only get these mildly, or not at all. That’s why it’s important to get tested.

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If I’ve had a heart attack, should I get my blood sugar checked?

If you have heart and circulatory disease, this should be done as part of your routine blood checks. If you are concerned, talk to your GP.

What about people who don’t have any existing conditions?

If you are at risk, your blood sugar will be tested as part of an NHS Health Check in England (for those aged 40–74 with no existing condition). Arrangements vary in the rest of the UK, but again, ask your GP if you are concerned.

Am I at risk of diabetes?

Any of the following can mean you’re at risk, especially if more than one of these applies:

• being over the age of 40
• south Asian, Chinese, African-Caribbean or black African background
• a close relative has diabetes
• overweight or large waist size
• high blood pressure
• pregnancy or previous gestational diabetes
• polycystic ovary syndrome, schizophrenia, bipolar illness or depression, or you are taking antipsychotic medication.

Learn more about your diabetes risk using the Diabetes UK online tool.

What if I have diabetes?

Monitor your blood sugar levels at home using a glucose meter. This involves pricking your finger and applying a drop of blood to a test strip.

Self-monitoring can be a helpful part of diabetes management. Regular blood sugar tests help you see how specific changes, for example around diet and physical activity, affect blood sugar levels. Monitoring can also help your healthcare team adjust your treatment to best prevent any long-term complications. Your doctor should also check HbA1c levels at least yearly to assess long-term blood sugar control

What do my blood sugar numbers mean?

Self-monitoring can be a helpful part of diabetes management

Persistently high blood sugar usually means you have diabetes. If HbA1c is more than 48 mmol/mol or fasting blood glucose is more than 11 mmol/L, your blood sugar is high. For most people without diabetes, normal blood sugar levels are: 

• between 4 and to 6 mmol/L before meals
• less than 8 mmol/L two hours after eating.

If you have diabetes, it’s key for your blood sugar levels to be as near normal as possible.

How is blood sugar measured?

Your GP can test your blood for a substance called HbA1c (glycated haemoglobin), to diagnose type 2 diabetes, or to monitor long-term blood sugar control if you have diabetes. This is different from the finger-prick blood sugar test.

Measuring HbA1c gives a picture of your average blood sugar levels over the past eight to 12 weeks. If you have diabetes, your HbA1c should be tested every three, six or 12 months. The higher the HbA1c, the greater the risk of developing complications.

The test for gestational diabetes is a bit different and is called an oral glucose tolerance test. Usually you’ll be given a glucose drink and your blood sugar will be tested before and after.

Understanding blood glucose (blood sugar)

Print

If you have a student with type 1 diabetes in your classroom, even for part of the day, it’s useful to learn the basics about blood glucose (abbreviated as BG, and also called “blood sugar”). 

Blood sugar—knowing what affects it, and what to do when it’s too low or too high—is at the heart of diabetes management.

What is blood glucose?

Glucose is an essential source of energy for the body. Our bodies make it, but mostly it comes from the food we eat (for more information, see Food and type 1 diabetes). 

Glucose is important because:

• It can be quickly turned into energy.
• The brain and nerves need a constant supply.

Your blood glucose level is the amount of glucose (sugar) in your blood at a given point in time. 

Watch our video on Understanding blood glucose (blood sugar)

What is insulin?

Insulin is a hormone made in the pancreas that keeps blood glucose levels in a healthy range. Insulin allows the glucose from food to enter the body’s cells, where it can be used for energy. 

When someone has type 1 diabetes, their pancreas does not produce insulin. Without insulin, blood sugar will eventually rise to dangerously high levels. So people with type 1 diabetes must take insulin several times a day, either by injection or through an insulin pump.

The amount of insulin a person needs depends on how much food they eat, their activity levels, their age and size, and other factors. Insulin doses may vary from day to day.

For more detail, see Insulin: What school staff need to know.

What is a typical blood sugar level?

In Canada, blood sugar levels are measured in mmol/L (millimoles per litre). A person who doesn’t have diabetes usually has a blood sugar level somewhere between 3.5 mmol/L and 7.8 mmol/L, depending on when they last ate. 

Diabetes is diagnosed when someone’s blood sugar is greater than 11 mmol/L.

People with type 1 diabetes have a “target range” for their blood sugar level. The range is determined with their health care team. Typically, a target range will be between:

• 6 to 10 mmol/L for children younger than 6 years
• 4 to 10 mmol/L for children 6 to 12 years old
• 4 to 7 mmol/L for teenagers

Remember:

Having a target doesn’t mean blood sugar will always be within that range—lows and highs are part of living with type 1 diabetes. They are nearly impossible to avoid. 

What affects blood sugar levels?

While many things affect blood sugar levels, these are the major factors:

People without diabetes usually don’t think about their blood sugar because their pancreas is always working to keep it in a healthy range. People with type 1 diabetes must check their blood sugar several times a day using a glucometer (or “meter”), which measures a small drop of blood from a finger:

• If blood sugar is too low, they need a source of fast-acting glucose (sugar).
• If blood sugar is too high, they need insulin.

What should teachers and school staff know about blood sugar levels?

When it comes to managing blood sugar, information is essential. The more teachers and school staff know, the better they can support students. The more parents know about their child’s school day, the better they can plan.

How do people with type 1 diabetes manage their blood sugar levels?

Doing the job of a healthy pancreas is hard work.

In people without type 1 diabetes, the pancreas automatically releases just the right amount of insulin to keep the blood sugar in a healthy range. It is constantly adjusting, minute to minute, in response to the amount of food eaten, activity, stress levels, and so on. The pancreas is a very complex organ. 

Even with careful attention, healthy eating and physical activity, it is impossible to match the perfect minute-to-minute adjustment of a healthy pancreas. For children and youth with type 1 diabetes, there will be highs and lows. It’s important not to refer to blood sugar readings as either “good” or “bad”. They are just numbers, and they help guide what action to take next.

Blood sugar levels change constantly, and families have to be flexible and vigilant. Because children and youth spend so much time in school, the supports outlined in the care plan are an important part of a student’s overall diabetes management. In particular, students need:

• Consistency: a predictable routine and people familiar with the nature and timing of daily tasks.
• Communication: a timely and reliable way to communicate between home and school, especially to identify any trends that may be affecting blood glucose.

Last updated: April, 2018

Diabetes: Blood Sugar Levels | HealthLink BC

Topic Overview

Keeping your blood sugar in a target range reduces your risk of problems such as diabetic eye disease (retinopathy), kidney disease (nephropathy), and nerve disease (neuropathy).

Some people can work toward lower numbers, and some people may need higher goals.

For example, some children and adolescents with type 1 or type 2 diabetes, people who have severe complications from diabetes, people who may not live much longer, or people who have trouble recognizing the symptoms of low blood sugar may have a higher target range.

And some people, such as those who are newly diagnosed with diabetes or who don’t have any complications from diabetes, may do better with a lower target range.

Work with your doctor to set your own target blood sugar range. This will help you achieve the best control possible without having a high risk of hypoglycemia.

Diabetes Canada suggests the following A1c and blood glucose ranges as a general guide.

• Most adults (non-pregnant)
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  • A1c: 7.0% or less
  • Blood glucose:
    • Fasting and before meals: 4.0 to 7.0 millimoles per litre (mmol/L)
    • 2 hours after meals: 5.0 to 10.0 mmol/L or 5.0 to 8.0 mmol/L if A1c targets are not being met
• Women with type 1 or type 2 diabetes who become pregnant
  ^{footnote 2}
  • A1c: 6.5% or less (6.1% or less if possible)
  • Blood glucose:
    • Fasting and before meals: Less than 5.3 mmol/L
    • 1 hour after meals: Less than 7.8 mmol/L
    • 2 hours after meals: Less than 6.7 mmol/L
• Women with gestational diabetes
  ^{footnote 2}
  • Blood glucose:
    • Fasting and before meals: Less than 5.3 mmol/L
    • 1 hour after meals: Less than 7.8 mmol/L
    • 2 hours after meals: Less than 6.7 mmol/L
• Children with type 1 diabetes (0 to 18 years old)
  ^{footnote 3}
  • A1c: 7.5% or less
  • Blood glucose:
    • Fasting and before meals: 4.0 to 8.0 mmol/L
    • 2 hours after meals: 5.0 to 10.0 mmol/L
• Children, adolescents, and young adults with type 2 diabetes (up to 18 years old)
  ^{footnote 4}

References

Citations

1. Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Targets for glycemic control. Canadian Journal of Diabetes, 42(Suppl 1): S42–S46. DOI: 10.1016/j.jcjd.2017.10.030. Accessed October 15, 2018.
2. Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Diabetes and pregnancy. Canadian Journal of Diabetes, 42(Suppl 1): S255–S282. DOI: 10.1016/j.jcjd.2017.10.038. Accessed October 15, 2018. [Erratum in Canadian Journal of Diabetes 42(3): 337. DOI: 10.1016/j.jcjd.2018.04.006.] Accessed October 12, 2018.
3. Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Type 1 diabetes in children and adolescents. Canadian Journal of Diabetes, 42(Suppl 1): S234–S246. DOI: 10.1016/j.jcjd.2017.10.036. Accessed October 15, 2018.
4. Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Type 2 diabetes in children and adolescents. Canadian Journal of Diabetes, 42(Suppl 1): S247–S254. DOI: 10.1016/j.jcjd.2017.10.037. Accessed October 15, 2018.

Other Works Consulted

• American Diabetes Association (2017). Standards of medical care in diabetes—2017. Diabetes Care, 40(Suppl 1): S1–S135.
• Inzucchi SE, et al. (2015). Management of hyperglycemia in type 2 diabetes, 2015: A patient-centered approach: Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 38(1): 140–149. DOI: 10.2337/dc14-2441. Accessed February 18, 2015.

Credits

Current as of:
August 31, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Donald Sproule MDCM, CCFP – Family Medicine
Kathleen Romito MD – Family Medicine
Adam Husney MD – Family Medicine
Rhonda O’Brien MS, RD, CDE – Certified Diabetes Educator

Current as of: August 31, 2020

Author: Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Donald Sproule MDCM, CCFP – Family Medicine & Kathleen Romito MD – Family Medicine & Adam Husney MD – Family Medicine & Rhonda O’Brien MS, RD, CDE – Certified Diabetes Educator

Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Targets for glycemic control. Canadian Journal of Diabetes, 42(Suppl 1): S42-S46. DOI: 10.1016/j.jcjd.2017.10.030. Accessed October 15, 2018.

Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Diabetes and pregnancy. Canadian Journal of Diabetes, 42(Suppl 1): S255-S282. DOI: 10.1016/j.jcjd.2017.10.038. Accessed October 15, 2018. [Erratum in Canadian Journal of Diabetes 42(3): 337. DOI: 10.1016/j.jcjd.2018.04.006.] Accessed October 12, 2018.

Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Type 1 diabetes in children and adolescents. Canadian Journal of Diabetes, 42(Suppl 1): S234-S246. DOI: 10.1016/j.jcjd.2017.10.036. Accessed October 15, 2018.

Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Type 2 diabetes in children and adolescents. Canadian Journal of Diabetes, 42(Suppl 1): S247-S254. DOI: 10.1016/j.jcjd.2017.10.037. Accessed October 15, 2018.

90,000 High blood sugar in a child

04/21/2020

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

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

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

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

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

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

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

Be healthy!

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90,000 High blood sugar linked to doubling risk of death from COVID-19 – Science

TASS, July 11.Doctors from China have found that high blood sugar doubles the likelihood of death from severe forms of coronavirus infection, even if the patient does not suffer from diabetes or obesity. Their findings were published in the scientific journal Diabetologia.

“Our observations have shown for the first time that elevated blood glucose levels at the time of hospitalization were themselves associated with an increased risk of death or complications associated with COVID-19. We recommend testing blood glucose levels for every patient admitted to hospital. with coronavirus infection, even if they have not previously suffered from diabetes, “the researchers write.

After the outbreak of COVID-19, physicians and biologists found that the causative agent of this disease SARS-CoV-2 is much more likely to affect people who suffer from diabetes, obesity, chronic heart disease, as well as smokers. In particular, scientists found that cardiac problems increased the likelihood of death of patients from coronavirus infection by more than four times, and obesity and diabetes – from three to five times.

In a new work, doctors led by Professor Yang Jin of Huazhong University of Science and Technology (China) found that high blood glucose levels can increase the chances of death from COVID-19.They came to this conclusion after studying the medical records of more than 600 patients who were admitted to hospitals in Wuhan between January 24 and February 10.

Over a hundred of them could not fight the infection, so scientists were able to comprehensively study those factors and features of their body that caused the death of patients. By analyzing their medical history, Jin and his colleagues confirmed the existence of all known risk factors, and also came across another curious pattern.

New risk factors

Scientists found that people who had relatively high blood sugar levels – about 7 millimoles per liter – died from complications from COVID-19 about 2.3 times more often than other patients.

Likewise, people with average blood sugar died 71% more often than other patients. Moreover, this probability was not associated with the development of obesity, diabetes and other metabolic disorders. In addition, elevated blood sugar levels almost quadrupled the likelihood of developing severe COVID-19 and various complications.

“In this case, it is difficult to assume that all these people suffered from previously undetected diabetes, since the total number of patients with high glucose levels was close to 29%, while only 12% of the Chinese population are diabetics. that their insulin resistance was due to infection with SARS-CoV-2 or other diseases, “the researchers note.

How exactly high blood sugar levels increase the likelihood of death for carriers of COVID-19, scientists do not yet know.But they speculate that excess blood glucose can contribute to blood clots and inflammation and impair blood vessel function.

Therefore, Jin and his colleagues urge all doctors and specialized medical authorities to begin large-scale observation of how blood sugar affects the health of patients and to consider its relationship with increased mortality from COVID-19 when developing strategies to combat the disease.

90,000 Signs of Diabetes | How to Detect Diabetes Mellitus in Time | Diabetes symptoms

How to detect diabetes mellitus in time?

Determining the presence of diabetes mellitus is not always easy.The effectiveness of the treatment and the prospects for the further state of the body depend on how timely the disease is diagnosed. Early symptoms of diabetes mellitus can appear at any age, in both an adult and a child.

Several types of diabetes mellitus

There are several types of disease, such as diabetes of the young and diabetes of the elderly. However, the initial signs of the disease are about the same, since they are justified by an increased level of glucose in the blood of a person.

Symptoms of diabetes mellitus

If you notice any changes in the state of health, constantly recurring unpleasant symptoms, consult a doctor immediately. Signs of diabetes mellitus may include:

• feeling of unquenchable thirst and a metallic taste in the mouth,
• Frequent nighttime urination,
• increased appetite, constant hunger and the need for sweets,
• weight change, weight loss or weight gain,
• itching of the skin, feet, palms,
• violation of wound healing processes,
• susceptibility to dermatological diseases and fungal infections,
• loss and impaired hair growth,
• Constant weakness and drowsiness,
• dental problems, frequent stomatitis and periodontal disease.

In addition to increased fatigue, the patient may experience a loss in the quality of vision. This is how the toxic effect of sugar on all cells of the body is manifested. The level of acetone in the urine rises, and especially attentive relatives may notice the smell of acetone from the mouth of a person with diabetes.

If you notice the signs of a dangerous illness listed above, immediately go to a medical facility to measure your blood sugar level and start drug therapy.

How to prevent the development of diabetes

It is important to understand that the symptoms of the disease are clearly manifested during the period when the level of glucose in the blood significantly exceeds the permissible values. In the early stages of diabetes, symptoms are almost invisible. For this reason, all adult patients who have reached the age of 40 are recommended to donate blood for sugar annually in order to diagnose the onset of the disease in time and prevent its further development.

Contact the Unimed Medical Center, and you will be provided with qualified medical assistance from an endocrinologist in the diagnosis and treatment of diabetes mellitus in children and adults.

90,000 Why is it necessary to control glucose levels in patients with diabetes mellitus?

One of the most important conditions for the successful treatment of diabetes mellitus is self-monitoring of blood glucose levels. This is the most reliable means of preventing the development of diabetic complications. From the first day of treatment, patients learn to inject insulin and measure blood glucose. However, this knowledge is far from sufficient. It is necessary to be trained in a diabetes school, and possibly more than once.

What is self-control?

This is the conduct of regular measurements of blood sugar and, most importantly, the ability to analyze the results obtained and take the necessary measures to correct glucose-lowering therapy. In addition, this is a mandatory consideration of the regime and characteristics of nutrition and physical activity, as well as the ability to independently change the dose of insulin depending on the blood sugar level and changing conditions of the day.

In order to lead the same lifestyle that was habitual before the disease, it is necessary for the patient himself and his family members to learn the basic rules of self-control.If you are able to independently detect changes in your state, regularly measuring the level of blood glucose, acetone in the urine, you can achieve good control of diabetes and various complications will be prevented.

Why is blood glucose control necessary?

If you know the blood glucose level at any given time, then you can solve several questions at once:

• Is the patient’s dose of insulin sufficient?

• How much insulin is currently injected based on the glucose level?

• Should I change my insulin dose or food before exercise?

• How do I change my insulin dose during illness?

What is necessary for self-control?

Today there is a large selection of portable devices for determining blood glucose – glucometers, which are produced by various companies.All of them are quite easy to use, provide high accuracy of the results and allow you to get the result in a short time. Therefore, the main task is to choose the most appropriate glucometer for each individual patient.

Glucometers differ in the calibration of the device (plasma or whole blood), the size required to obtain a blood drop analysis, the speed of obtaining the result, the size of the memory for the tests already performed, the presence of additional functions (communication with the computer, calculation of the average glycemic value, illumination of the test zone and the display of the device ), and, of course, the cost of the device and test strips.

The small size of modern glucometers and the minimum time for determining the blood sugar level (5-10 seconds) allow you to determine the blood sugar level not only at home, but also in any other place – at a party, in a cafe, on a walk. At any time, you can quickly and with minimal effort independently assess the value of blood sugar at a particular point in time.

How often should blood glucose be monitored?

Daily self-monitoring is optimal for most patients on insulin therapy, including 4 glycemic tests, three of which are performed before meals and the fourth at bedtime.

However, there are situations when blood glucose should be monitored much more often:

• on days when you feel unwell – every 2-3 hours.

• in case of unusual physical activity or changes in the usual rhythm of life – before and after activity.

• when changing the amount and time of meals – before and after meals.

• if symptoms of high or low blood glucose levels occur – at the time of the onset of symptoms.

• for air travel through time zones.

• if you suspect nocturnal hypoglycemia – at night from 02.00 to 04.00.

The fact that there may have been hypoglycemia at night can be indicated by to High glucose levels in the morning with good readings at the same time on other days, as well as headache and feeling fatigued in the morning.