Diagnosing Prediabetes Type 2 And Type 1 Diabetes
Depending on which country or medical organization you ask, the qualifying numbers for normal versus prediabetes versus diagnosed type 1 or type 2 diabetes can vary slightly.
The following blood sugar and A1c results are used to diagnose prediabetes and diabetes according to sources including the American Diabetes Association and Diabetes UK:
Prediabetes
- HbA1c: 5.7 to 6.4 percent
- Fasting: 100 to 125 mg/dL
- 2 hours after a meal: 140 mg/dL to 199 mg/dL
Type 1 or 2 diabetes
- HbA1c: 6.5 percent or higher
- Fasting: 126 mg/dL or higher
- 2 hours after a meal: 200 mg/dL or higher
Please note:Type 1 diabetes tends to develop very quickly which means that by the time symptoms are felt, blood sugar levels are generally well above 200 mg/dL all the time. For many, symptoms come on so quickly that they are dismissed as the lingering flu or another seemingly ordinary virus.
By the time blood sugar levels are tested, many newly diagnosed type 1 patients will see levels above 400 mg/dL or higher. If you do suspect that you or a loved one has type 1 diabetes, visit your primary care or urgent care immediately and ask for a urine test to measure ketones in addition to testing blood sugar levels and A1c.
Read more about ketones at diagnosis in ourDiabetic Ketoacidosis Guide.
Blood Sugar Level Chart By Age
Blood sugar levels tend to rise with age due to an increase in insulin resistance and decrease in insulin sensitivity. In one study by the National Health Institute , each extra decade of age was linked to a 2.7 mg/dl increase in fasting glucose, and a 4.5 mg/dl increase in 2-hour post-prandial glucose levels.
Still Frustrated With Your Blood Sugar And A1c Results
Your blood sugars and your insulin or medication needs never stay in one place. If you gain weight or lose weight, your insulin and medication needs will change. If you become more active or less active, your needs will change. If you make drastic or even small changes to your nutrition, your needs will change!
Working with your diabetes healthcare team, and diabetes coaches who can teach you how to make changes in your overall diabetes management plan are essential. Diabetes is a lifelong learning process.
Take a deep breath and be patient. If you dont like what youre seeing on your glucose meter, dont get madget studying! Take good notes and work with your team to make changes to reach your goals.
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/ 120 Blood Sugar Level
Although 120 is not too high, ideally you do want to gain very good control of your blood sugar levels by following a healthy diet and doing regular exercise.
If you can get your fasting level between 90-100 mg/dl , and your 2 hour reading between 120-140 mg/dl then that is optimal.
These are goals to work towards.
Hope this has helped answer your question.
Wishing you the best in health
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%.
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Target Hgb A1C is 7.5% for all children and adults with diabetes. |
The chart below shows the Hemoglobin A1C result compared with the blood glucose number.
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How Can I Measure My Blood Sugar Levels
You can measure your blood glucose levels with a glucometer. First, you prick your finger with a small device called a lancet to get a drop of blood. Your blood goes on a test strip which you put into the glucometer. Then, the device tells you your blood sugar levels.
You can also use a continuous glucose monitoring device, which uses a sensor that’s placed under your skin to automatically check your levels every few minutes.
How To Reduce Blood Sugar
You can take steps to reach your blood sugar goals as soon as you find out that it is high. This is how to reduce blood sugar if you have a single high reading that may be dangerous:
- Ask your doctor what to do if you missed a dose of insulin or another diabetes medication
- Ask your doctor if your medication types and doses are still appropriate for you
- Drink water to dilute the sugar
- Exercise for 15 minutes
- Eat a small protein snack, such as a hard-boiled egg, ½ ounce of peanuts or pistachios or other nuts, ½ cup of beans, or ½ cup of plain yogurt or cottage cheese
If you have chronically high blood sugar in prediabetes or diabetes, you can follow this treatment plan:
- Exercise regularly, assuming your doctor approves it
- Lose weight if you are overweight or obese
- Eat a higher proportion of vegetables, whole grains, lean proteins, healthy fats, and fruit
- Limit sugary foods and beverages, fried foods, refined starches, and processed and fatty red meats
- Beware of starchy vegetables such as sweet potatoes, which can spike your blood sugar. Check out our guide of which veggies to avoid!
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Several Factors May Cause A Persons Postprandial Blood Sugar To Remain Elevated
Smoking after the meal: Studies show that smoking raises blood sugar levels in people with diabetes. Extreme stress: Stress produces the bodys fight-or-flight response triggering the release of stress hormones such as cortisol. These hormones cause the body to release the glucose it has previously stored for energy. Eating or drinking after the meal and before testing the blood sugar: Continuing to eat will keep blood sugars closer to their immediate post-meal levels.
Studies show that 15 to 20 minutes of moderate exercise, such as walking, shortly after a meal may improve glucose metabolism and reduce postprandial glucose levels.
What Are The Treatments For Prediabetes
If you catch it early, prediabetes can usually be reversed with diet and exercise. Depending on how high your blood sugar is when youre first diagnosed, your doctor might elect to put you on one medication or a combination in order to get your glucose back down to a healthy level.
Going on medication for prediabetes treatment is not cut and dry, Antonucci says. Your blood sugar levels, A1C, medical history, and other complications might put you in a situation where medication should be added to your treatment plan to avoid type 2 its case by case, so work with your doctor to arrive at the best treatment for you.
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Determining The Right A1c Goal For You
Just because a normal blood sugar range of 70 to 130 mg/dL is considered the healthiest doesnt necessarily mean thats the appropriate goal range for you especially if you have type 1 diabetes, or take insulin as a person with type 2 diabetes.
The reason this may not be the right goal for you is that extremely tight blood sugar management in people taking insulin can potentially lead to frequent low blood sugars which can be dangerous.
Achieving extremely tight blood sugar management, like a range of 70 to 130 mg/dL, also often requires a strict nutrition plan, more frequent than usual blood sugar monitoring, precise medication management, and most importantly, years of experience studying your blood sugar levels.
Beyond Normal Goals: Whats An Optimal Glucose Level And Why Does It Matter
Exact numbers for what is considered optimal glucose levels to strive for while using CGM to achieve your best health are not definitively established this is a question that is individual-specific and should be discussed with your healthcare provider. With that said, research shows that there is an increased risk of health problems as fasting glucose increases, even if it stays within the normal range, making finding your optimal glucose levels all the more important.
While the International Diabetes Federation and other research studies have shown that a post-meal glucose spike should be less than 140 mg/dL in a nondiabetic individual, this does not determine what value for a post-meal glucose elevation is truly optimal for your health. All that number tells us is that in nondiabetics doing an oral glucose tolerance test, researchers found that these individuals rarely get above a glucose value of 140 mg/dL after meals.
So, while this number may represent a proposed upper limit of whats normal, it may not indicate what will serve you best from a health perspective. Many people may likely do better at lower post-meal glucose levels. Similarly, while the ADA states that a fasting glucose less than 100 mg/dL is normal, it does not indicate what value is optimal for health.
Repeated high glucose spikes after meals contribute to inflammation, blood vessel damage, increased risk of diabetes, and weight gain.
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What Are Abnormal Glucose Levels And Why Do They Matter
Why is it unhealthy for glucose levels to be too high or too low ?
Hyperglycemia refers to elevated blood glucose levels. This usually occurs because the body does not appropriately remove glucose from the blood this can happen due to many complex reasons. Elevated glucose levels can damage blood vessels and nerves over time this can then lead to problems in the eyes, kidneys, and heart, as well as numbness in the hands and feet. Very high levels can lead to coma and even death in some cases. People with fasting glucose levels higher than 100 mg/dl have impaired glucose tolerance and should speak with their healthcare provider.
Some people may think that to avoid all these issues, they should just keep their blood glucose levels as low as possible. If too high is bad, then low must be good, right? Not exactly. When glucose gets too low, its called hypoglycemia. The threshold for hypoglycemia is typically thought to be when glucose falls below 70 mg/dl. When this happens, the body may release epinephrine , the fight or flight hormone, which can lead to a fast heart rate, sweating, anxiety, blurry vision, and confusion, but also helps the body mobilize glucose into the blood. If blood glucose levels stay too low for too long, it can cause seizures, coma, and in very rare instances, death.
What Is Blood Sugar
Blood sugar, also known as blood glucose, comes from the food you eat. Your body creates blood sugar by digesting some food into a sugar that circulates in your bloodstream.
Blood sugar is used for energy. The sugar that isnt needed to fuel your body right away gets stored in cells for later use.
Too much sugar in your blood can be harmful. Type 2 diabetes is a disease thats characterized by having higher levels of blood sugar than whats considered within normal limits.
Unmanaged diabetes can lead to problems with your heart, kidneys, eyes, and blood vessels.
The more you know about how eating affects blood sugar, the better you can protect yourself against diabetes. If you already have diabetes, its important to know how eating affects blood sugar.
Your body breaks down everything you eat and absorbs the food in its different parts. These parts include:
- vitamins and other nutrients
The carbohydrates you consume turn into blood sugar. The more carbohydrates you eat, the higher the levels of sugar youll have released as you digest and absorb your food.
Carbohydrates in liquid form consumed by themselves are absorbed more quickly than those in solid food. So having a soda will cause a faster rise in your blood sugar levels than eating a slice of pizza.
Fiber is one component of carbohydrates that isnt converted into sugar. This is because it cant be digested. Fiber is important for health, though.
- white grain products, such as pasta and rice
- cold processed cereals
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Fasting Glucose Goal: 72
Why? Previously we discussed that the ADA considers normal fasting glucose as anything < 100 mg/dl. However, multiple research studies show that as fasting glucose increases, there is an increased risk of health problems like diabetes and heart disease even if it stays within the normal range. The highlights of some of the study results include:
- Men whose fasting blood glucose was greater than 85 mg/dl had a significantly higher mortality rate from cardiovascular diseases than men with blood sugars less than 85 mg/dl.
- People with fasting glucose levels in the high normal range had significantly increased cardiovascular disease risk than people whose levels remained below 80 mg/dl.
- Children with fasting glucose levels 86-99 mg/dl had more than double the risk of developing prediabetes and Type 2 diabetes as adults when compared with children whose levels were less than 86 mg/dl.
- People with fasting glucose levels between 91-99 mg/dl had a 3-fold increase in Type 2 diabetes risk compared to those with levels less than 83 mg/dl.
- Among young, healthy men, higher fasting plasma glucose levels within the normal range constitute an independent risk factor for Type 2 diabetes. This means that as fasting glucose increases, even if the level is still considered normal, it could indicate a significantly higher risk of developing diabetes, and this is particularly pronounced if BMI is greater than 30. .
What Should My Blood Sugar Level Be When I Wake Up
These are goal levels, according to The Joslin Diabetes Center:
- Under 100 mg/dl if you do not have diabetes.
- 70 to 130 mg/dl if you have diabetes.
The dawn effect can often lead to a high morning measurement in diabetes. This is your bodys tendency to get ready for the day by raising blood sugar by increasing levels of counter-regulatory hormones the ones that counteract insulin as in normal blood sugar. For people with diabetes, you do not have the capacity to counterbalance this rise in blood sugar, so levels can be dangerously high.
Ways to lower your morning blood sugar value include:
- Eating dinner earlier
- Checking your medications making sure you are taking them properly and asking your doctor if they are correct
- Going for a walk after dinner
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Risks Of High Readings
If you experience spikes in blood glucose after you eat high-carbohydrate meals, your levels will be higher than normal for as much as six to nine hours out of each day. High blood glucose damages blood vessels, which leads to complications such as diabetic retinopathy and neuropathy, or nerve damage. High blood glucose levels after meals also increases your risk of developing atherosclerosis, a build-up of plaque in the arteries that can cause heart attack or stroke.
The Nuances Of Low Glucose
In a recent study, researchers reviewed the published literature to see if low fasting glucose levels affected healthy peoples long term risks of health problems, like strokes and heart attacks. They found that healthy non-diabetic people who had baseline fasting glucose levels of less than 72 mg/dl had a 56% increase in all-cause mortality compared to people with normal fasting blood glucose levels. Also, the risks for heart attacks and strokes were higher in people with baseline fasting glucose levels less than 72 mg/dl. This result is likely due to the body releasing more epinephrine to counteract the low glucose levels too much epinephrine for too long leads to heart problems. Interestingly, people with low fasting glucose levels of less than 83 mg/dl but higher than 72 mg/dl did not have an increased risk of future heart attacks and strokes.
While there has been an association between low fasting plasma glucose levels and worse health outcomes, it is not clear whether transient dips in glucose levels during a continuous 24-hour period are unhealthy for nondiabetic individuals. Part of the reason that this is unknown is that continuous glucose monitoring is a relatively new technology and has been studied more extensively in diabetic individuals than in healthy individuals.
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What Should Glucose Levels Be 2 Hours After Eating
A rise in blood glucose levels is normal after eating a meal, particularly a meal loaded with carbohydrates. People who have diabetes will have higher spikes in blood glucose–and for longer periods. Function Carbohydrates convert to glucose in the bloodstream. The pancreas secretes insulin, which bonds with the blood glucose to supply the body with energy. Someone with diabetes either has an insufficient supply of insulin or the body does not process the insulin efficiently, resulting in too much glucose in the bloodstream. Normal Levels Normal blood glucose levels are 70 mg/dl to 120 mg/dl . A blood glucose level above 120 mg/dl could result in a condition known as hyperglycemia–high blood sugar. Postprandial Levels Postprandial blood glucose levels, or blood glucose levels after eating a meal, should be 120 mg/dl two hours after the start of a meal for healthy people. The National Diabetes Information Clearinghouse states that someone with diabetes could see blood glucose levels as high as 180 mg/dl one to two hours after the start of a meal. Cause The rise in blood glucose levels after eating is directly related to the amount and types of carbohydrates included with the meal. Implications If postprandial blood glucose levels are consistently higher than 120 mg/dl two hours after the meal, diabetes, pre-diabetes or insulin resistance might be indicated. Consult your physician for testing and diagnosis.Continue reading > >
Why You Should Care About Your A1c
Multiple studies have shown that high average blood sugars increase the risk of diabetes-related complications. Lowering your A1c to the recommended range will reduce the risk of diabetes-related complications significantly:
- Eye disease risk is reduced by 76%
- Kidney disease risk is reduced by 50%
- Nerve disease risk is reduced by 60%
- Any cardiovascular disease event risk is reduced by 42%
- Nonfatal heart attack, stroke, or risk of death from cardiovascular causes is reduced by 57%
Achieving an A1c in the recommended range is, therefore, one of the most important things you can do to improve your long-term health when you live with diabetes.
However, the closer you get to the recommended A1c target, the less benefit you will get from lowering your A1c further. Taking your A1c from 12% to 11% makes a big difference while lowering your A1c from 7% to 6% provides a much smaller benefit. In fact, lowering your A1c too much may not be a good idea if it means that you increase how often you experience hypoglycemia .
I will explain why time-in-range is just as important as a low A1c later in this guide.
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