Your Guide To Diabetes
- Diabetes affects roughly two and a half million Canadians. Left untreated, diabetes can lead to many serious complications, including: heart disease, kidney disease, vision loss, and lower limb amputation.
- The Public Health Agency of Canada estimates that 5 million Canadians over the age of 20 are currently pre-diabetic. An additional 1 million new cases of pre-diabetes are expected by 2016. Pre-diabetes is a key risk factor for type 2 diabetes, and if left untreated more than half of the people with pre-diabetes will develop type 2 diabetes within 8 to 10 years.
- Although diabetes can lead to serious complications and premature death, there are steps that can be taken to prevent or control the disease and lower the risk of complications. This guide is intended to help you understand diabetes, how certain types can be prevented or managed, and how to live with the condition.
Did You Know?
You may be pre-diabetic and not know it. Pre-diabetes occurs when blood sugar levels are high, but not high enough to diagnose diabetes. Talk to your health care provider to learn more.
What Are The Other Tests Used To Analyze Blood Sugar Levels
Apart from the random blood sugar test that we have discussed above, diabetes mellitus can also be diagnosed by anyone of the following blood tests:Fasting blood sugar test Two successive values of this test that are equal to or greater than 126 mg/dl confirm diabetes mellitus. Glycosylated hemoglobin testA value equal to or greater than 6.5 percent is confirmative. This test holds significance as it conveys a three-month average of blood sugar status of your body. A two-hour oral glucose tolerance test with any value over 200 mg/dl clinches the diagnosis.
Other Severe Symptoms Of Hyperglycaemia Include:
- Nerve damage
- Kidney damage
- Blood vessel damage
Mild hyperglycaemia, depending on the cause, will not typically require medical treatment. Most people with this condition can lower their blood sugar levels sufficiently through dietary and lifestyle changes.
Those with type 1 diabetes will require the administration of insulin , while those with type 2 diabetes will often use a combination of injectable and oral medications , although some may also require insulin.
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Causes Of Blood Sugar Levels
Whilst the liver and muscles produce some glucose, most comes from the foods we eat. Food and drinks that are high in carbohydrates are most impactful on blood sugar level. What we eat provides us most of the nutrients our body needs and sometimes, does not need. That is not to say that food is a major cause of blood sugar level increasing or decreasing too dramatically.
Typically, if a person has health conditions or poor nutrition, this will lead to a spike or decline in blood sugar level. The causes differ from high to low blood sugar levels and are as follows:
When To See A Healthcare Provider
Getting professional medical advice from a healthcare provider like an endocrinologist is the best way to learn more about whether your blood sugar levels are where they should be. Not getting proper treatment for low or high blood sugar levels can be serious and lead to health complications, especially for those with diabetes. Diabetes complications include nerve damage, kidney disease, heart disease, or heart attacks.
If you see a healthcare provider about your blood sugar levels, be prepared to answer questions about risk factors like what you eat, how much you exercise, and about your family history. Some healthcare providers may want to take a blood sample to test your blood sugar levels. They may also order an A1C test, which is a blood test that measures blood sugar levels over several months. You may have to fast eight hours beforehand to get accurate test results, so its always a good idea to check before your appointment.
If your blood sugar level goes above 250 mg/dL, you should go to the ER for immediate medical attention, says Dr. Tarugu. Emergency rooms are equipped to handle high blood sugar levels and can administer treatments like insulin therapy and fluid or electrolyte replacement.
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Talk To Your Doctor Or Nurse
If you use insulin and your blood sugar is frequently or consistently low, ask your doctor or nurse if you:
- Are injecting your insulin the right way
- Need a different type of needle
- Should change how much insulin you take
- Should change the kind of insulin you take
DO NOT make any changes without talking to your doctor or nurse first.
Sometimes hypoglycemia can be due to taking the wrong medicines. Check your medicines with your pharmacist.
What Is Random Blood Sugar Test
A random blood sugar test is the testing of the blood sugar level at any time or random time of the day. It is a test performed outside the regular testing schedule. RBS test is performed to confirm diabetes mellitus, during the treatment and after the treatment of diabetes mellitus. A level of 200 mg/dl or higher is an indication of diabetes mellitus.
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When Should You Check Your Blood Sugar Levels
Its important that people who suspect they have diabetes or pre-diabetes monitor their glucose levels regularly, checking at least once daily and charting the results in order to know what is normal for themselves. If it seems like something isnt quite right with ones blood glucose. It may be time to talk to a doctor about getting a diabetes diagnosis. Its also important that parents make sure their children are well aware of any symptoms of high or low blood sugar. So they know when they need to alert an adult about what might be going on if their parents are not around.
How Should I Prepare For The Rbs Test
No specific preparation is required. You need to discuss with the physician your medical history as well as family history. As RBS test is a blood test and involves the standard techniques of venipuncture, you need to inform your physician if- You are taking any blood thinners You are suffering from any coagulopathy You also need to give your physician in-depth information regarding the medicines that you might be consuming. Many medicines including steroids have the potential to hamper the results of the RBS test by either elevating or decreasing the glucose levels in the blood depending on the drugs profile.
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Are Some Canadians At Higher Risk For Elevated Blood Sugar Levels Than Others
You may have a higher risk for elevated blood sugars and type 2 diabetes if you:
- Are 40 or years of age or older
- Have a close relative with diabetes
- Are of African, Arab, Asian, Hispanic, Indigenous or South Asian descent
- Are overweight
- Have been diagnosed with prediabetes
Some medical conditions can also increase your risk of type 2 diabetes, such as:
- High blood pressure or cholesterol levels
- Polycystic ovary syndrome
- Psychiatric disorders
- Sleep apnea
What Is The Random Blood Sugar Level
Random blood sugar level is the measurement of the level of glucose in your blood. The random blood sugar test is done to detect diabetes in a patient. Diabetes is a metabolic condition in which the person has high blood sugar levels. The rise in the sugar level is due to inadequate insulin functioning or if the body cells are not responding properly to insulin or both.
Early symptoms of diabetes are excessive urination , excessive hunger , and excessive thirst . It occurs as the sugar build up in the blood is not being absorbed and is filtered out through kidney in large amounts. This can lead to dehydration.
- Tingling in arms and legs
- Constantly being tired
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Controlling Blood Glucose Levels
Uncontrolled blood sugar can result in regular episodes of hyperglycemia . This can cause a variety of symptoms including:
- Dry mouth
These symptoms are uncomfortable to experience but there are things you can do at home to reduce your blood sugar. In terms of drinks, water is the best as it will help to maintain hydration and dilute excess sugar in the blood. Also, try to add more fiber to your diet to reduce your blood sugar apples, bananas, oranges, and strawberries are all fibrous fruits.
However, uncontrolled blood sugar levels can also lead to more severe, long term disease. Poorly managed diabetes leads to vision loss, kidney problems, nerve damage, heart attack, and stroke. Therefore, if your blood sugar level reaches 16.7mmol/L, this could be dangerous and you need to seek immediate medical attention.
When To Call For Medical Advice
It is important to note that very high blood glucose levels can be dangerous and it is important to be aware of the symptoms and risk factors of the following conditions:
- Diabetic ketoacidosis a short term complication most commonly associated with type 1 diabetes
- Hyperosmolar Hyperglycaemic State a short term complication most commonly associated with type 2 diabetes
If you are struggling to keep your blood glucose levels under control, speak to your GP or consultant who can advise you or refer you onto a diabetes education course.
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Fasting Plasma Glucose Test
A fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning.
The NICE guidelines regard a fasting plasma glucose result of 5.5 to 6.9 mmol/l as putting someone at higher risk of developing type 2 diabetes, particularly when accompanied by other risk factors for type 2 diabetes.
What Is Your Blood Sugar Level
The food we intake breaks down into glucose. This glucose is responsible for providing energy to our bodies. It travels through our bloodstream to different parts of our bodies.
Thus, the amount of glucose travelling through our blood is known as our blood sugar level. We identify this blood sugar level via blood test or using a glucometer. A normal blood sugar level indicates a healthy and maintained body.
However, when the glucose in our blood increases, the pancreas produces insulin to rectify it. But, the bodys inability to produce insulin leads to a health condition called diabetes. The lack of glucose in our blood can also lead to chronic diseases like hypoglycemia, kidney and heart diseases.
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Whats My Target Range
You might be asking, what’s the normal range for blood sugar levels? The answer is, there is a healthy range that you should ideally be aiming for. The infographics above show the general guidelines, but your individual target range for your blood sugar levels may be different. Youll healthcare team will agree with you what it is.
Youll get different readings at different times of the day, depending on things like what youve eaten and how much you are moving around. Heres a guide to help you get started on finding your target range:
If youre a child with Type 1 diabetes
- when you wake up and before meals: 4 to 7mmol/l
- after meals: 5 to 9mmol/l
If youre an adult with Type 1 diabetes
- when you wake up and before meals: 5 to 7mmol/l
- before meals at other times of the day: 4 to 7mmol/l
If you have Type 2 diabetes
- before meals: 4 to 7mmol/l
- two hours after meals: less than 8.5mmol/l
Recommended Target Blood Glucose Level Ranges
The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes.
In addition, the International Diabetes Federations target ranges for people without diabetes is stated.
The table provides general guidance. An individual target set by your healthcare team is the one you should aim for.
*The non-diabetic figures are provided for information but are not part of NICE guidelines.
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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!
Low Blood Sugar: What To Watch Out For
Hypoglycemia 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. Its 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.
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How To Treat Someone Who’s Unconscious Or Very Sleepy
Follow these steps:
They may need to go to hospital if they’re being sick , or their blood sugar level drops again.
Tell your diabetes care team if you ever have a severe hypo that caused you to lose consciousness.
Preventing A Low Blood Sugar Level
If you have diabetes, you can reduce your chance of getting a low blood sugar level if you:
- Check your blood sugar level regularly and be aware of the symptoms of a low blood sugar level so you can treat it quickly.
- Always carry a sugary snack or drink with you, such as glucose tablets, a carton of fruit juice or some sweets. If you have a glucagon injection kit, always keep it with you.
- Do not skip meals.
- Be careful when drinking alcohol. Do not drink large amounts, check your blood sugar level regularly, and eat a carbohydrate snack afterwards.
- Be careful when exercising eating a carbohydrate snack before exercise can help to reduce the risk of a hypo. If you take some types of diabetes medicine, your doctor may recommend you take a lower dose before or after doing intense exercise.
- Have a carbohydrate snack, such as toast, if your blood sugar level drops too low while you’re asleep
If you keep getting a low blood sugar level, talk to your diabetes care team about things you can do to help prevent it.
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Normal Blood Sugar Levels
It is important to work with your healthcare provider to maintain healthy blood sugar levels. The following is a list of healthy blood sugar levels.
If an individual has type 1 diabetes the blood sugar should be the following:
- Before meals: From 90 to 130 mg/dL for adults
- After meals : Less than 180 mg/dL for adults
- At bedtime: From 90 to 150 mg/dL for adults
If an individual has type 2 diabetes, levels should be the following:
- Before meals: From 70 to 130 mg/dL for adults
- After meals : Less than 180 mg/dL for adults
Target A Range Not A Single Number
Note that the CPGs recommend a realistic range for blood glucose levels, rather than a single number at any particular point in time. This is an important concept to grasp since diabetes management is far from a perfect science, and blood glucose levels can be expected to swing occasionally. Sometimes this can be for no seeming reason at all. On this topic, you may find it interesting to read our article Not all blood glucose levels need to be perfect.
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