Managing your blood sugar when you have diabetes

To minimize complications when you have diabetes, you should always keep an eye on your blood sugar levels. This will help you live a healthier life.

The range depends on 3 factors: age, current health situation and the lifestyle.

You can check your blood sugar using a blood glucose monitor where an individual pricks their finger or with a continuous glucose monitor (CGM), or via an A1C. A1C is a blood test that provides a 3-month retrospective look at blood sugar averages. This test is often used as a diagnostic tool in combination with other tests when diagnosing diabetes.

• Typical Glucometer & CGM general targets for people living with diabetes

Before meals (fasting blood sugar): 80-130 mg/dL
2 hours post-meal: less than 180 mg/dL

• Hemoglobin A1C

Expected or normal range: < 5.7%
Prediabetes: 5.7 to 6.4%
Diabetes ≥ 6.5%

To check if the diabetes medications or a diabetic friendly meal plan are working, fasting blood sugar should be measured.

• Normal: <100 mg/dL

• Prediabetes: 100- 125 mg/dL

• Diabetes: ≥ 126 mg/dL

Goal for people living with diabetes: 80 - 130 mg/dL

A person may experience elevated blood sugars(hyperglycemia) in response to nutrition, stress and/or illness. Symptoms may include:

• Extreme fatigue

• Difficulty in concentrating

• Increased thirst

• Increased urination

• Dry mouth

• Blurry vision

Some ways to help bring your blood sugars down:

• Go for a quick walk to use up some of that excess glucose in your system
• Drink water
• Take insulin(if you're usually taking )

If you are regularly experiencing hyperglycemia, you will need to consult your health care team to safely bring your blood sugars back within target range.

Hypoglycemia or low blood sugars below 70 mg/dL can occur when you skip meals or unintentionally take too much medicine, and increasing exercise can also cause low blood sugars.

Some symptoms of low blood sugar may include:

• Dizziness

• Shaking

• Confusion

• Hunger

• Unintentional sweating

The CDC recommends drinking 120ml of 100% juice or taking 4 glucose tablets, waiting 15 minutes and rechecking your blood sugars.

If your blood sugars remain low, repeat with a snack and wait 15 minutes then recheck your blood sugars.

It's always recommended to follow up with your health care team when you regularly experience hypoglycemia.

Exercising has numerous benefits including:

• Better cardiovascular health
• Blood sugar management
• Lowering insulin resistance
• Building lean body mass
• Supporting mood and cognition.

It's important to time medication intake and meals so that exercise doesn't increase the risk of hypoglycemia.

For people taking insulin, have a piece of fruit if your blood sugar reading is below 100 mg/dL before exercise and testing again after exercising.

For people who are experiencing hyperglycemia, 250 mg/dL or above, the recommendation is not to exercise as it can further increase high blood sugars and cause unwanted complications.

Medications can improve how much insulin your pancreas creates (insulin secretion), how effective the cells are at utilizing insulin (insulin sensitivity) and more. They include:

• 1st-generation sulfonylureas (chlorpropamide)

• 2nd-generation sulfonylureas (glipizide, glyburide)

• Meglitinides (repaglinide, nateglinide)

• Biguanides (metformin)

• Thiazolidinediones, aka TZDs or glitazones (rosiglitazone, pioglitazone)

• Alpha-glucosidase inhibitors (acarbose, miglitol, voglibose)

• DPP-4 inhibitors (sitagliptin, saxagliptin, vildagliptin, linagliptin, alogliptin)

• Bile acid sequestrant

• Dopamine agonist

• SGLT2 inhibitors (dapagliflozin, canagliflozin)

• GLP-1 receptor agonists