Two ways to measure blood sugar

There are two ways to measure blood sugar.

1. The A1C is a lab test that measures your average blood sugar level over the last 2 to 3 months. It shows whether your blood sugar stayed close to your target range most of the time, or was too high or too low.


2. Self-tests are the blood sugar checks you do yourself. They show what your blood sugar is at the time you test.

Both ways help you and your health care team to get a picture of how your diabetes care plan is working.

About the A1C test

Why should I have an A1C test?
The A1C tells you and your health care team how well your diabetes care plan worked over the last 2 to 3 months. It also helps decide the type and amount of diabetes medicine you need.

What is a good A1C target for me?
For many people with diabetes, the A1C target is below 7. You and your health care team will decide on an A1C target that is right for you.

If your A1C stays too high, it may increase your chances of having eye, kidney, nerve, and heart problems.

How often do I need an A1C?
You need an A1C at least twice a year. You need it more often if it is too high, if your diabetes treatment changes, or if you plan to become pregnant.

What if I plan to become pregnant?
Talk with your doctor before you get pregnant. Your doctor can help you reach an A1C target that allows a healthy baby to develop. If you are already pregnant, see your doctor right away.

About self-tests for blood sugar

Why should I do self-tests?
Self-tests can help you learn how being active, having stress, taking medicine and eating food can make your blood sugar go up or down. They give you the facts you need to make wise choices as you go through the day.

Keep a record of your results. Look for times when your blood sugar is often too high or too low. Talk about your results with your health care team at each visit. Ask what you can do when your sugar is out of your target range.

How do I check my blood sugar?
Blood sugar meters use a small drop of blood to tell you how much sugar is in your blood at that moment. Ask your health care team how to get the supplies you need. They will also show you how to use them.

What is a good target range for my self-tests?
Many people with diabetes aim to keep their blood sugar between 70 and 130 before meals. About 2 hours after a meal starts, they aim for less than 180. Your target ranges may be different if you are an older adult (over 65), have other health problems like heart disease, or your blood sugar often gets too low. Talk with your health care team about the best target range for you.

Can my blood sugar get too low?
Yes it can. If you feel shaky, sweaty, or hungry, do a check to see if it is below your target range.

Carry something sweet with you at all times, such as 4 hard candies or glucose tablets. If your blood sugar is too low, eat the candy or glucose tablets right away. Let your health care team know if this happens often. Ask how you can prevent it.

How often should I check my blood sugar?
Self-tests are often done before meals, after meals, and at bedtime. People who take insulin need to check more than those who do not take insulin. Discuss your self-test schedule with your health care team.

Are there other numbers I need to know?
Yes, you need tests of your blood pressure and cholesterol (a blood fat). You and your health care team need to decide the best targets for these too. Keeping them in your target range can help lower your chances for having a heart attack or stroke.

How do I pay for these tests?
Medicare and most insurance pay for the A1C, cholesterol, and some self-test supplies. Check with your insurance plan or ask your health care team for help.

What is in it for me?
Finding the time to check your blood sugar can be a struggle. It is also hard when your sugar levels do not seem to match your efforts to manage your diabetes. Keep in mind that your self-test and A1C results are numbers to help you, not to judge you. Many people find that self-testing and using the results to manage their diabetes pays off. They are more able to take charge of their diabe-tes so that they can feel good today and stay healthy in the future.

 

 

 

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About the National Diabetes Prevention Program

 

The National Diabetes Prevention Program encourages collaboration among federal agencies, community-based organizations, employers, insurers, health care professionals, academia, and other stakeholders to prevent or delay the onset of type 2 diabetes among people with prediabetes in the United States.

The inaugural partners of the National Diabetes Prevention Program were the YMCA and UnitedHealth Group. These partners were instrumental in starting the national program and continue to expand the reach of this evidence-based lifestyle program. CDC is enthusiastic about other organizations becoming involved in the National Diabetes Prevention Program. Most recently, Viridian Health Management, Inc. has agreed to partner with CDC and others to expand the reach of the program.

The CDC-led National Diabetes Prevention Program is an evidence-based lifestyle change program for preventing type 2 diabetes.

• It can help people cut their risk of developing type 2 diabetes in half.


• The Diabetes Prevention Program research study showed that making modest behavior changes helped participants lose 5% to 7% of their body weight—that is 10 to 14 pounds for a 200-pound person.


• These lifestyle changes reduced the risk of developing type 2 diabetes by 58% in people with prediabetes.


• Participants work with a lifestyle coach in a group setting to receive a 1-year lifestyle change program that includes 16 core sessions (usually 1 per week) and 6 post-core sessions (1 per month).


• Explore this site to learn more about prediabetes and how to prevent or delay type 2 diabetes. Get ready to make a change for life!
  
  The National Diabetes Prevention Program teaches participants strategies for incorporating physical activity into daily life and eating healthy. Lifestyle coaches work with participants to identify emotions and situations that can sabotage their success, and the group process encourages participants to share strategies for dealing with challenging situations.
  
  Learn more about how the National Diabetes Prevention Program can help you reduce your risk of developing type 2 diabetes.

 

 

 

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National Diabetes Prevention Program Video

 

National Diabetes Prevention Program Video

 

Lifestyle change classes are helping people with prediabetes prevent or delay the onset of type 2 diabetes. Research studies have shown that such classes can reduce the risk of type 2 diabetes by 58% in people at high risk for developing the disease.

In this video, class participants, lifestyle coaches and healthcare professionals talk about how type 2 diabetes can be prevented or delayed by making lifestyle changes that include modest weight loss and increasing physical activity. People with prediabetes share their experience as participants in group lifestyle change classes and their journey to learn and keep healthy habits.

 

[youtube https://www.youtube.com/watch?v=mRVZ9lkubag?autohide=0&enablejsapi=1&playerapiid=309720&modestbranding=1&rel=0&origin=http://www.cdc.gov&showinfo=0&wmode=opaque]

Read the transcript  [PDF–39KB].

The video was filmed at a Y location in Louisville, Kentucky, one the growing number of sites where the Y offers lifestyle intervention classes. The Y is one of the original providers of the lifestyle program.

 

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Prediabetes: Am I at risk?

Prediabetes: Am I at risk?

 

The Centers for Disease Control and Prevention (CDC) estimates that 1 of every 3 US adults had prediabetes in 2010. That is 79 million Americans aged 20 years or older. The vast majority of people living with prediabetes do not know they have it. A person with prediabetes has a blood sugar level higher than normal, but not high enough for a diagnosis of diabetes.

Prediabetes is a serious health condition that increases the risk of developing type 2 diabetes, heart disease, and stroke.

• 79 million Americans—35% of adults aged 20 years and older—have prediabetes.


• Half of all Americans aged 65 years and older have prediabetes.


• Without lifestyle changes to improve their health, 15% to 30% of people with prediabetes will develop type 2 diabetes within 5 years.

 

 

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How can type 2 diabetes be prevented?

How can type 2 diabetes be prevented?

 

Research shows that modest weight loss and regular physical activity can help prevent or delay type 2 diabetes by up to 58% in people with prediabetes. Modest weight loss means 5% to 7% of body weight, which is 10 to 14 pounds for a 200-pound person. Getting at least 150 minutes each week of physical activity, such as brisk walking, also is important.

The lifestyle change program offered through the National Diabetes Prevention Program—led by CDC—can help participants adopt the healthy habits needed to prevent type 2 diabetes. Trained lifestyle coaches lead classes to help participants improve their food choices, increase physical activity, and learn coping skills to maintain weight loss and healthy lifestyle changes.

Many factors increase your risk for prediabetes and type 2 diabetes. To find out more about your risk, see which characteristics in this list apply to you.

• I am 45 years of age or older.


• I am overweight.


• I have a parent with diabetes.


• I have a sister or brother with diabetes.


• My family background is African-American, Hispanic/Latino, American-Indian, Asian-American, or Pacific-Islander.


• I had diabetes while I was pregnant (gestational diabetes), or I gave birth to a baby weighing 9 pounds or more.


• I am physically active less than three times a week.

It is important to find out early if you have prediabetes or type 2 diabetes, because early treatment can prevent serious problems that diabetes can cause, such as loss of eyesight or kidney damage.

Find out if you could have prediabetes by taking the online quiz on this page. If the quiz shows you could have prediabetes, talk to a health care provider as soon as possible. You also can download and print a copy at Prediabetes Screening Test  [PDF-758 KB] or Cuestionario para la detección de la prediabetes  [PDF-455 KB].

If you are 45 years of age or older, you should consider getting a blood test from a health care provider for prediabetes and diabetes, especially if you are overweight.

 

 

 

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How to diagnose type 2 diabetes and prediabetes

How to diagnose type 2 diabetes and prediabetes

• Fasting glucose test. This measures blood glucose in people who have not eaten anything for at least eight hours. Fasting glucose levels of 100 to 125 mg/dL are diagnostic of impaired fasting glucose (IFG), also called prediabetes. People with IFG often have had insulin resistance for some time and are at high risk for developing type 2 diabetes

 

• Glucose tolerance test. This test measures blood glucose after people fast for at least eight hours, and two hours after they drink a sweet liquid provided by a doctor or laboratory. A blood glucose level between 140 and 199 mg/dL is called impaired glucose tolerance (IGT) also called prediabetes. Like IFG, it points toward a history of insulin resistance and a risk for developing type 2 diabetes.

 

• Hemoglobin A1c test. This test measures the amount of glucose that is on the red blood cells. Fasting is not necessary. An A1c value of 5.7% to 6.4% indicates prediabetes.

If your blood test results indicate you have prediabetes you should enroll in an evidence-based lifestyle change program to lower your chances of getting type 2 diabetes. Studies show that people with prediabetes can prevent or delay type 2 diabetes by losing 5% to 7% of their weight—that is 10 to 14 pounds for a 200-pound person. Weight loss should be achieved by making modest lifestyle changes to improve nutrition and increase physical activity.

 

People whose test results indicate they have prediabetes should have their blood glucose levels checked again in 6 months to 1 year.

 

 

 

 

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Good Diabetes Control

Blood Glucose Levels

Good diabetes control means having blood glucose (sugar) values within these limits:

• Before Breakfast : 4.0 - 8.0 mmol/l


• 2 hours after meals : 6.0 - 10.0 mmol/l


• Randomly, at any time : below 10.0 mmol/l

However, because of individual differences, your target blood glucose level is best decided by your doctor.

It is very useful to do home blood glucose monitoring if you wish to have good control of your diabetes.

Glycosylated Haemoglobin (HBA1c)

Glycosylated haemoglobin, or HBA1c, measures the average blood glucose in the blood over the past 6 to 8 weeks.

• Excellent : less than 6%


• Satisfactory : 6% to 8%


• Poor : more than 8%


• Urine Glucose

Urine glucose is measured with a special test strip which changes colour after being dipped into urine depending on the amount of glucose in the urine. For various reasons it is not as accurate as blood glucose monitoring which is preferred.

For good control of your diabetes, keep your urine free of glucose always.

Blood fats

In all people, cholesterol should be below 5.2 mmol/l (200 mg/dl) and certainly not above 6.5 mmol/l (250 mg/dl).

Blood Pressure

Blood pressure should be below 140/85 mm Hg in young people, and below 160/95 mmHg in older people.

Weight and Height

Tall people naturally weigh more, so weight has to be interpreted in relation to height. This is done by the 'Body Mass Index' or BMI.

BMI = Weight (kg) / Height(m)2

The ideal BMI is between 20 to 25, and the health risk increases steadily above this level.

Smoking

Among other problems, smoking causes diseases of the heart and circulation. As diabetes also carries a risk of damage to the heart and circulation, smoking is particularly dangerous to people with diabetes, and greatly increases the risk of a heart attack, stroke and foot gangrene.

 

 

 

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About Diabetes

About Diabetes

Insulin is a hormone produced by the pancreas that allows your body cells to use blood glucose (sugar) for energy. Food is converted into glucose before it is absorbed into our bloodstream. The pancreas then releases insulin to move the glucose from the bloodstream into the body cells for use or storage. People with diabetes are unable to fully use the glucose in their bloodstream due to:

• lack of insulin in the body


• insulin is ineffective

There are three major types of diabetes:

• 
  

  Type 1 Diabetes

  
  
  
  
  • no insulin is produced due to damaged pancreatic cells
  
  
  • usually diagnosed in children or young adults although it can occur at any age
  
  
  • insulin is needed for treatment
  
  
  • complications are sudden and life-threatening
  
  
  
  


• 
  

  Type 2 Diabetes

  
  
  
  
  • insulin produced is not enough or not effective (insulin resistance)
  
  
  • occurs more frequently in people over 40 years old, particularly those who are overweight and physically inactive
  
  
  • more younger adults and children are developing Type 2 Diabetes
  
  
  • can be controlled with proper diet and exercise but most diabetics also need oral medication
  
  
  
  


• 
  

  Gestational Diabetes Mellitus (GDM)

  
  
  
  
  • Occurs in about 2-5% of all pregnancies. Women who were not diagnosed to have diabetes previously show high blood glucose levels during pregnancy.
  
  
  • needs specialised obstetric care to reduce serious complications to the unborn baby
  
  
  
  

Signs & symptoms

The common symptoms of diabetes are:

• frequent thirst despite drinking lots of water


• constant hunger


• constant tiredness


• itchy skin especially around the genital area


• passing excessive urine during day and night


• weight loss despite good appetite


• poor healing of cuts and wounds

Complications

Uncontrolled diabetes can lead to high blood glucose (hyperglycaemia) and low blood glucose (hypoglycaemia).Both situations can cause a diabetic to become very sick very quickly and even go into a coma.

The long-term complications of diabetes include:

• coronary heart disease such as angina, heart attack


• stroke


• eye disease


• kidney disease


• foot disease such as numbness, ulcers and even gangrene


• nerve disease which can lead to problems such as impotence and diarrhoea

Screening & diagnosis

Diabetes can be detected through a blood glucose test.

You have diabetes mellitus if your

• Random Blood Glucose is 11.1 mmol/L or higher


• Fasting Blood Glucose is 7.0 mmol/L or higher

TEST (mmol/L)	Normal	Diabetic
Random blood glucose (check anytime of the day)	< 7.8	≥ 11.1
Fasting blood glucose (tested in the morning after 8 hours of overnight fast)	≤ 6.0	≥ 7.0

Treatment

Diabetes is a life-long disease. It can be controlled if you do the following:

Your diabetes may be controlled through diet or a combination of diet and medication. Follow your doctor's instructions on diet and/or medication.

Oral medication

All medicines must be taken regularly at the correct dosages at the given times as advised by your doctor

• Sulphonylureas (SUs)


• Non-SU Secretagogues


• Biguanides


• Alpha-Glucosidase Inhibitors


• Thiazolidinediones

As in all medicines, sometimes side effects such as skin rashes, eye swelling, vomiting, diarrhoea may occur and these have to be reported to your doctor at once.

Insulin

There are different types of insulin. Some are short-acting and others are long-acting, while still others are a mixture of both. Your doctor will prescribe the exact amount of the specific types of insulin you would need.

• Follow instructions carefully and do not make any changes without consulting your doctor


• Always keep all insulin bottles plus an extra spare bottle in the refrigerator when not in use


• Short acting insulins by themselves or as part of a mixture need to be injected about 30 minutes before a meal

Self-care

A diabetic person has to take extra care of his body to maintain good health.

Foot care

As a diabetic, you have a higher risk of foot problems. In serious cases, it can lead to amputations. Taking care of your feet is very important:



Wash your feet daily with soap and water.






After washing, dry them fully, especially in between the toes.






Keep your toe nails short, trimming them straight across to avoid ingrown toenails.






Moisturise your feet daily to prevent dryness and cracking of the skin.






Examine your feet daily for scratches, cuts, blisters and corns. Use a mirror to check the sole of your feet.






Use shoes that fit well and wear clean cotton socks which have loose fitting elastic tops.






See your family doctor for screening of your feet every year.






If you have any corns or any wounds that are not healing well, seek help from your doctor as soon as possible.

Eye care

Diabetes can cause severe eye problems where the small blood vessels in the eyes become damaged (diabetic retinopathy) and can lead to blindness.

It is important to have regular eye check-ups at least once a year.

You can get your retinae (inside surfaces of your eyes) photographed by a procedure called retinal photography to detect any damage to small blood vessels. The doctor might also perform laser photocoagulapathy, a form of highpowered light and heat energy, to prevent further damage.

Skincare

Avoid skin injury as diabetes makes the skin more prone to many problems such as rashes, infections and colour changes.

• Wash every part of the body while bathing using mild soap and warm water.


• Dry all parts of the body using a clean towel.


• Pay attention when washing and drying skin folds in areas such as under the breasts, abdominal folds and groin area.


• Apply moisturising cream to keep skin moist and soft.


• Treat all cuts and scratches at once, wash with soap and water and then apply mild antiseptic lotion.


• See a doctor if the skin injury does not heal in 2-3 days.

Dental care

Dental care is important as many infections start in the mouth.

• Brush your teeth twice a day – after breakfast and before bedtime.


• Use a soft toothbrush to prevent gum injury.


• Rinse your mouth after every meal or snack.


• Floss your teeth gently after meals to remove food particles between your teeth.


• Dental check-ups: Inform your dentist that you have diabetes and visit him at least once a year.

Prevention

Lead a healthy lifestyle

• 
  

  Have a proper diet

  
  Besides insulin and medicines, eating a healthy diet helps you keep your blood glucose under control. It also helps to maintain your weight at a healthy level. Use the Healthy Diet Pyramid.


• 
  

  Engage in regular physical activity

  
  Regular physical activity is an important part of your diabetes control. It helps to prevent the onset of complications. Exercise also helps to control your weight and keeps your heart healthy. Consult your family doctor before starting any exercise programme.


• 
  

  Do not smoke

  
  Smoking worsens the narrowing of blood vessels already caused by diabetes. It reduces blood flow to many organs and leads to many serious complications.


• 
  

  Limit your alcohol intake

  
  Alcohol interferes with your meal plan and blood glucose control, especially if you are taking insulin or medicines for your diabetes.

 

 

 

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