What Hba1c Do I Aim For
The goal for most people with diabetes will be in the 6.5-7 percent range however this may need to be higher for some people including children and the elderly. Your doctor or Credentialled Diabetes Educator can help you decide on a target that is both appropriate and realistic for your individual circumstances.
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How Is Blood Sugar Calculated
There are two formulas for calculating blood sugar levels. In the US, the most popular measurement is milligrams per deciliter . In the UK, its millimoles per liter .
If you need to convert measurements, use these formulas:
To go to mmol/L from mg/dL: mmol/L = mg/dL / 18
To go to mg/dL from mmol/L: mg/dL = 18 × mmol/L
Continuous Glucose Monitoring Systems
Continuous glucose monitoring systems measure glucose concentrations in the interstitial fluid. Two types of devices are available. The real time CGM provides information directly to the user by displaying moment-tomoment absolute glucose levels and trending arrows, and by providing alarm notifications in the event that the glucose level is above or below a preset limit. A blinded CGM captures, but does not display, the glucose readings, which are then downloaded onto a computer for viewing and retrospective analysis by the health-care provider .
CGM technology incorporates a subcutaneously inserted sensor, an attached transmitter and, in the case of real-time CGM, a display unit . In professional CGM, the transmitter captures and retains the data. In Canada, 2 real-time CGM and 2 professional CGM are available. Real-time CGM has been consistently shown to reduce A1C in both adults and children with type 1 diabetes with and without CSII, and to reduce A1C in adults with type 2 diabetes . Real-time CGM also has been shown to reduce the time spent in hypoglycemia . Professional CGM has been shown to reduce A1C in adults with type 2 diabetes and in pregnant women with type 1 or type 2 diabetes .
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What To Eat To Reduce Blood Sugar Level Immediately
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Controlled Means Different Things To Different People
Theres no one-size-fits-all recommendation for blood sugar control.
The ADA says that a reasonable goal for many nonpregnant adults is to aim for an A1C level of less than 7. Yet some patients may be given a more stringent goal by their healthcare providers, such as 6.5, if thats reachable without harmful side effects, including hypoglycemia.
On the other hand, if you are elderly, managing other health complications, or reliant on insulin, you may be given less stringent goals. It really becomes more important to just keep in the same place, says Rahil Bandukwala, DO, an endocrinologist at MemorialCare Saddleback Medical Center in Laguna Hills, California. Keeping A1C between 7.5 and 8.5 may be very reasonable for such a patient, Dr. Bandukwala adds, echoing the ADAs recommendations.
Because elderly people are more likely to have blood sugar that swings too far downward, with fewer warning signs, managing their glucose too tightly can put them at greater risk for hypoglycemia, says Bandukwala. When you have low blood sugar, youre at a higher risk for becoming dizzy and falling or passing out, notes the ADA.
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Can Type 2 Diabetes Be Reversed
Yes! The good news is that several studies have shown that type 2 diabetes can be reversed. You are considered in remission from type 2 diabetes when you have had normal blood sugar levels for a year without medication.
One of the most important components in reversing type 2 diabetes is early detection. Dr. Bergquist explains, The pancreas produces insulin. The longer you have diabetes, the more damage your insulin resistance causes to your pancreas, and the less likely your pancreas is to recover. Hence, the possibility for remission decreases the longer you have diabetes. But theres a wide window during which you can be successful.
What Meds For Type 2 Diabetes
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What Is High Blood Sugar
The is the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat, and its also formed and stored inside the body. Its the main source of energy for the cells of our body, and its carried to each cell through the bloodstream.
Hyperglycemia is the medical word for high blood sugar levels. High blood sugar levels happen when the body either cant make insulin or cant respond to insulin properly . The body needs insulin so glucose in the blood can enter the cells of the body where it can be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia.
Having too much sugar in the blood for long periods of time can cause serious health problems if its not treated. Hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems. These problems dont usually show up in kids or teens who have had the disease for only a few years. But they can happen in adulthood in some people with diabetes, particularly if they havent managed or controlled their diabetes well.
Blood sugar levels are considered high when theyre above your target range. Your diabetes health care team will let you know what your target blood sugar levels are.
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Favorite Alternative Medicine Resource
Want to give the ketogenic diet a whirl to better manage diabetes? This pioneering program from the Cleveland Clinic offers a way to do just that, with trained counselors who can help you adjust your diet and medication along the way.
The FOMO on diabetes products ends now. This feature by the magazine and website Diabetes Forecast rounds up the best of the best in CGMs , glucagon kits, insulin pens, and more.
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Are There Factors In Your Life That Limit Your Ability To Test Often
How often do you check your blood sugar with type 2 diabetes if there are any limitation factors? There may be different cases when you cant test often. In such situations, doctors advise their patients to try at least once a day. However, the final decision on the testing procedures should be discussed with your doctor.
Where Can I Find Help And Support For Managing My Type 2 Diabetes
Certified Diabetes Educators. The American Diabetes Association has a diabetes education finder, where you can find diabetes counseling in your zip code. You may also want to work with a diabetes dietitian to clarify questions about carbs, eating schedules, and more. A diabetes dietitian falls under the umbrella of medical nutrition therapy and is covered by Medicare and many insurance policies. Exercise is another crucial part of care, and you may be eligible for physical therapy as part of your diabetes medical management plan. You can find more information on state-by-state coverage here.
Type 2 diabetes isnt a solo condition. Its largely influenced by our culture and community health practices. Expanding your community to a healthy support system can also be an important part of managing your type 2 diabetes.
Family and friends. Get them on board by creating new food habits together. Often, we feel pressure to maintain the status quo for our families while adjusting our own diets. The changes youre making to improve your health will also improve the health of your family. Choose healthful meals that you can all enjoy together and try to resist making separate meals for yourself.
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Kidney Risks Related To Type 2 Diabetes
The risk for developing chronic kidney disease increases with time in people with diabetes. Diabetes is the most common cause of renal failure, making up about 44% of cases. Keeping your diabetes under control can reduce the risk of kidney failure. Medications are also used to reduce the risk of kidney disease in people with diabetes.
When Should I Call My Doctor
Its important to monitor diabetes very closely if youre sick. Even a common cold can be dangerous if it interferes with your insulin and blood sugar levels. Make a sick day plan with your healthcare provider so you know how often to check your blood sugar and what medications to take.
Contact your provider right away if you experience:
- Confusion or memory loss.
- Nausea and vomiting for more than four hours.
- Problems with balance or coordination.
- Severe pain anywhere in your body.
- Trouble moving your arms or legs.
A note from Cleveland Clinic
Type 2 diabetes is a disease where your body doesnt make enough insulin and cant use sugar the way it should. Sugar, or glucose, builds up in your blood. High blood sugar can lead to serious health complications. But Type 2 diabetes is manageable. Regular exercise and a healthy diet can help you manage your blood sugar. You may also need medication or insulin. If you have Type 2 diabetes, you should monitor your blood sugar at home regularly and stay in close communication with your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 03/25/2021.
References
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Normal Blood Sugar Levels After Eating For Diabetics
The American Diabetes Association recommends that the blood sugar 1 to 2 hours after the beginning of a meal be less than 180 mg/dl for most nonpregnant adults with diabetes. This is typically the peak, or highest, blood sugar level in someone with diabetes. Again, this target may need to be individualized for certain people based on such factors as duration of diabetes, age and life expectancy, cognitive status, other health conditions, cardiovascular complications, and hypoglycemia unawareness. Its important that people with diabetes discuss their target blood sugar goals with their healthcare provider.
What Are Treatments For Type 2 Diabetes
Unless its absolutely necessary, insulin should not be used to treat type 2 diabetes. Dr. Bergquist explains, Injecting insulin improves blood sugar but worsens underlying insulin resistance. Insulin is a fat-storage hormone. Higher insulin leads to more fat storage in organs where its toxic, making them more insulin resistant.
Insulin should only be used when the pancreas fails and the B cells cannot be regenerated, says Dr. Apovian. When type 2 diabetes is caught early enough, you can reverse it with lifestyle, medication, and bariatric surgery. In certain cases, when a person is severely overweight, bariatric surgery is a successful treatment for type 2 diabetes, because it effectively decreases a persons body weight set point and can reverse hormonal imbalances that underlie obesity and fuel type 2 diabetes.
Additionally, new type 2 diabetes medications have been approved by the FDA, including a class of drugs known as glucagon-like-peptides , which aid the pancreas in producing more insulin by decreasing glucose production in the liver. Researchers are also working to understand the role that inflammation and hormonal imbalances have in the development of T2D.
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Hba1c Test For Diabetes Diagnosis
An HbA1c test does not directly measure the level of blood glucose, however, the result of the test is influenced by how high or low your blood glucose levels have tended to be over a period of 2 to 3 months.
Indications of diabetes or prediabetes are given under the following conditions:
- Normal: Below 42 mmol/mol
- Prediabetes: 42 to 47 mmol/mol
- Diabetes: 48 mmol/mol
There are two types of blood sugar levels that may be measured. The first is the blood glucose level we get from doing finger prick blood glucose tests. These give us a reading of how high our levels are at that very point in time.
The second is the HbA1c reading, which gives a good idea of our average control over a period of 2 to 3 months. The target blood glucose levels vary a little bit depending on your type of diabetes and between adults and children.
Where possible, try to achieve levels of between 4 and 7 mmol/L before meals and under 8.5 mmol/L after meals. The target level for HbA1c is under 48 mmol/mol .
Research has shown that high blood glucose levels over time can lead to organ and circulation damage.
Keeping blood glucose above 4 mmol/l for people on insulin or certain medications for type 2 diabetes is important to prevent hypos occurring, which can be dangerous.
Your doctor may give you different targets. Children, older people and those at particular risk of hypoglycemia may be given wider targets.
FREE blood glucose level chart
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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.