How To Avoid Diabetic Ketoacidosis
It might have been a really long time since youve been in diabetic ketoacidosis , or maybe youve never had it.
But if you have Type 1 diabetes, you are at risk. Sometimes when you havent recently experienced a situation, you kind of forget about what you were told to do for prevention or treatment. Thats why a refresher might be a great idea!
What Should My Blood Sugar Level Be
When you’re first diagnosed with diabetes, your diabetes care team will usually tell you what your blood sugar level is and what you should aim to get it down to.
You may be advised to use a testing device to monitor your blood sugar level regularly at home.
Or you may have an appointment with a nurse or doctor every few months to see what your average blood sugar level is. This is known as your HbA1c level.
Target blood sugar levels differ for everyone, but generally speaking:
- if you monitor yourself at home with a self-testing kit a normal target is 4 to 7mmol/l before eating and under 8.5 to 9mmol/l 2 hours after a meal
- if your HbA1c level is tested every few months a normal HbA1c target is below 48mmol/mol
The Diabetes UK website has more about blood sugar levels and testing.
Sweetened Or Unsweetened Fruit Juices
Although 100 percent fruit juice is fine in moderation, and is a source of nutrients like vitamin C, all fruit juices can add a high amount of carbohydrates to your diet and are pure sugar. This combination can wreak havoc on your blood sugar and increase your risk for weight gain.
If you have a fruit juice craving that wont fade, be sure you pick up a juice thats 100 percent pure and contains no added sugars.
Also, limit your portion size to 4 ounces , which will reduce your sugar intake to only 3.6 teaspoons .
You might consider adding a splash or two of your favorite juice to sparkling water instead.
- increased weight gain
- high blood sugar levels
Upon further analysis, the study participants who had overweight or obesity, which are risk factors for metabolic syndrome, had likely been swapping no-calorie soda for the full-sugar versions.
They likely took this step to cut their calorie intake. This was an association, but it wasnt considered cause and effect.
A 2016 study seemed to show that those drinking diet sodas had increased blood sugar levels and waist circumference.
However, this study did not control for meals or physical activity or other variables before each round of testing was done.
Further, the authors stated that individuals with higher insulin levels at the beginning of the study may have already had metabolic issues not related to their intake of sugar-free sodas.
For most people living with diabetes, sugar-free sodas are safe in moderation.
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What Are The Different Types Of Diabetes
The types of diabetes are:
- Type 1 diabetes: This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people who have diabetes have Type 1. Its usually diagnosed in children and young adults . It was once better known as juvenile diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes.
- Type 2 diabetes: With this type, your body either doesnt make enough insulin or your bodys cells dont respond normally to the insulin. This is the most common type of diabetes. Up to 95% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it having a touch of sugar.
- Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
- Gestational diabetes: This type develops in some women during their pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes you’re at higher risk of developing Type 2 diabetes later on in life.
Less common types of diabetes include:
Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.
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.
Read more about improving your A1c in DiabetesStrongs guide, How to Lower Your A1c.
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What Does Insulin Do In Our Body
Insulin is a vital hormone in the human body. It is produced in the pancreas. After a meal, small sugar components enter our blood the pancreas reacts to this and releases insulin into the blood.Insulin transports the sugar from the blood into our body cells. The cells, in turn, use sugar as their main source of energy, enabling vital bodily functions such as movement, breathing, and brain and cardiac activity.
Blood Glucose And A1c Targets For Frail Elderly People
The Diabetes Canada clinical practice guidelines were recently updated to recommend different blood glucose targets in the frail elderly. These are seniors who have three or more of the following conditions:
- Unintended weight loss of more than 4.5 kilograms during the past year
- Constant fatigue or exhaustion
- Weakness in their arms and legs
- A slow walking speed
- Low levels of physical activity
In these people, the A1C target is 8.5% , and pre-meal blood sugar levels should be 5.0 to 12.0 mmol/L .
One of the main reasons why blood sugar and A1C targets are higher for frail elderly people is that studies have shown that tighter blood sugar control is associated with mortality in this population. The Action to Control Cardiovascular Risk in Diabetes study a very large trial of more than 10,000 adults with type 2 diabetes found that very tight glycemic control in older patients was associated with an increased risk of death.
As well, frail elderly adults are more inclined to suffer from moderate to severe hypoglycemia. This is because they may not be eating a nutritionally balanced diet they are also more likely to have other ailments for which they take medications that may contribute to episodes of hypoglycemia.
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Symptoms Signs Causes Of Levels Of High Blood Sugar In The Blood
High blood sugar or hyperglycemia is an abnormally high blood sugar level in the blood. Hyperglycemia is a hallmark sign of diabetes and prediabetes.
Signs and symptoms of hyperglycemia include blurred vision, headaches, hunger, and …
The normal ranges for blood sugar levels in adults who do not have diabetes before eating or fasting the range begins at 72-99mg/dL while fasting ranges for those being treated for type 1 or type 2 diabetes range from 80 -130 mg/dL. According to the American Diabetes Association normal blood sugar levels before and after eating should be 80-130 mg/dL before eating a meal , and less than 180 mg/dL about 1-2 hours after eating a meal
High blood sugar ranges for people who dont have diabetes begins at 140 mg/dL or greater while for those being treated for diabetes, the high range begins at 180 mg/dL , called hypoglycemia.
A Bananas Effect On Blood Sugar Depends On Its Ripeness
Yellow, or ripe, bananas contain less resistant starch than green bananas, as well as more sugar, which is more quickly absorbed than starch.
This means fully ripe bananas have a higher GI and will cause your blood sugar to rise faster than green unripe bananas .
Summary
Green bananas contain resistant starch, which doesnt raise blood sugar levels and may improve long-term blood sugar management. Yellow bananas contain more sugar, so they may cause a bigger rise in blood sugar.
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What Can You Do If Your Blood Sugar Levels Are Too Low
It is important to react quickly enough and eat or drink something, like dextrose sugar or a sugary drink .
If someone has severe hypoglycemia they may feel drowsy and confused, and might even become unconscious. People who have type 1 diabetes often carry a pre-filled syringe on them in case that happens, containing the hormone glucagon. Glucagon makes the liver release sugar into the bloodstream. Someone else can then inject the hormone if necessary. If this is not possible, it is important to call the emergency services immediately and ask for medical help.
If your blood sugar levels keep on dropping too low, you should see your doctor. It could then be a good idea to change your lifestyle or medication.
What Causes Low Blood Glucose In People With Diabetes
Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.
Two types of diabetes pills can cause low blood glucose
- sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
- meglitinides, taken before meals to promote a short-term increase in insulin
The following may also lower your blood glucose level
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What Causes Blood Sugar To Be High
Many things can cause high blood sugar , including being sick, being stressed, eating more than planned, and not giving yourself enough insulin. Over time, high blood sugar can lead to long-term, serious health problems. Symptoms of high blood sugar include:
- Feeling very tired.
- Having blurry vision.
- Needing to urinate more often.
If you get sick, your blood sugar can be hard to manage. You may not be able to eat or drink as much as usual, which can affect blood sugar levels. If youre ill and your blood sugar is 240 mg/dL or above, use an over-the-counter ketone test kit to check your urine for ketones and call your doctor if your ketones are high. High ketones can be an early sign of diabetic ketoacidosis, which is a medical emergency and needs to be treated immediately.
Translating Your A1c To A Blood Sugar Level
Using this easy calculator from the ADA, you can translate your most recent A1C result to an eAG or estimate average glucose level.
You can also use this translation when working to improve your A1c and achieving closer to normal blood sugar levels. If you know an A1c of 6.5 is an average blood sugar level of 126 mg/dL or a range of 100 to 152 mg/dL, then you can look at your current blood sugar results on your CGM and meter and pinpoint which time of day youre frequently higher than this range.12% = 298 mg/dL or range of 240 347 11% = 269 mg/dL or range of 217 31410% = 240 mg/dL or range of 193 2829% = 212 mg/dL or range of 170 2498% = 183 mg/dL or range of 147 2177% = 154 mg/dL or range of 123 1856% = 126 mg/dL or range of 100 1525% = 97 mg/dL or range of 76 120
Normal blood sugar levels in a person without diabetes can result in an A1c as low as 4.6 or 4.7 percent and as high as 5.6 percent.
Just a decade or two ago, it was rare for a person with type 1 diabetes to achieve an A1c result below 6 percent. Thanks to new and improved insulin and better technology like continuous glucose monitors and smarter insulin pumps, more people with diabetes are able to safely achieve A1c levels in the higher 5 percent range.
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A1c Goals Should Be Individualized
A1c goals should be individualized based on the individual capabilities, risks, and prior experiences, explains Gary Scheiner, MS, CDE, founder of Integrated Diabetes, and author of Think Like a Pancreas.
For example, we generally aim for very tight A1c levels during pregnancy and more conservative targets in young children and the elderly.
However, Scheiner highlights important factors that could justify aiming for a higher A1c, like hypoglycemia unawareness, which is described as when a person with diabetes no longer feels the oncoming warning signs of low blood sugar. This can put you at significant risk for severe low blood sugars resulting seizures or death. To reduce that risk, you would aim for higher target blood sugar ranges.
Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively, adds Scheiner. And certainly, someone who has been running A1cs in double digits for quite some time should not be targeting an A1c of 6% better to set modest, realistic, achievable goals.
Learn how to lower your A1c in DiabetesStrongsA1C Guide.
How Is Diabetes Managed
Diabetes affects your whole body. To best manage diabetes, youll need to take steps to keep your risk factors under control and within the normal range, including:
- Keep your blood glucose levels as near to normal as possible by following a diet plan, taking prescribed medication and increasing your activity level.
- Maintain your blood cholesterol and triglyceride levels as near the normal ranges as possible.
- Control your blood pressure. Your blood pressure should not be over 140/90 mmHg.
You hold the keys to managing your diabetes by:
- Planning what you eat and following a healthy meal plan. Follow a Mediterranean diet or Dash diet. These diets are high in nutrition and fiber and low in fats and calories. See a registered dietitian for help understanding nutrition and meal planning.
- Exercising regularly. Try to exercise at least 30 minutes most days of the week. Walk, swim or find some activity you enjoy.
- Losing weight if you are overweight. Work with your healthcare team to develop a weight-loss plan.
- Taking medication and insulin, if prescribed, and closely following recommendations on how and when to take it.
- Quitting smoking .
You have a lot of control on a day-to-day basis in managing your diabetes!
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Your Blood Sugar Isnt Just Because Of What You Eat
Mainstream media would have you believe that your blood sugar levels are impacted only by what you eat and how much you exercise, but people with type 1 and type 2 diabetes who test their blood sugars frequently could tell you otherwise.
Its especially important to keep this mind when looking at your own blood sugars and your goals because there are certain variables and challenges that impact blood sugar levels that you cant always control.
For example:
- Menstrual cycles: raises blood sugar and insulin needs
- Adrenaline rushes from competitive sports, heated arguments, rollercoaster rides: raises blood sugar and insulin needs
- The common cold and other illnesses: usually raises blood sugar and insulin needs
- Hormonal changes due to puberty and healthy growth in young adults: raises blood sugar and insulin needs
- An injury which raises overall inflammation levels: raises blood sugar and insulin needs
- Glucogenesis during anaerobic exercise: raises blood sugar
While you cant necessarily prevent these factors that affect your blood sugar from occurring, you can work with your diabetes healthcare team to adjust your insulin, other diabetes medications, nutrition and activity levels to help compensate for them when they do occur.
For example, when engaging in anaerobic exercise like weightlifting many people with type 1 diabetes find it necessary to take a small bolus of insulin prior to or during their workout because anaerobic exercise can actually raise blood sugar.
Prediabetes And Diabetes Prevention
A person with blood sugar levels of 100125 mg/dl will receive a diagnosis of prediabetes. This means that their blood sugar levels are high, but they do not have diabetes. Taking action at this stage can prevent diabetes from developing.
According to a 2016 report published in The Journal of the American Board of Family Medicine, 33.6 percent of people aged 45 years and older had prediabetes in 2012.
The CDC estimate that around
Diabetes may cause a number of health complications if people do not manage it properly. Many of these are chronic, or long-term, but they can become life-threatening. Others need immediate medical attention as soon as they appear.
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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