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.
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.
What Is The A1c Test
The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctors office in addition tonot instead ofregular blood sugar testing you do yourself.
A1C testing is part of the ABCs of diabetesimportant steps you can take to prevent or delay health complications down the road:
- A: Get a regular A1C test.
- B: Try to keep your blood pressure below 140/90 mm Hg .
- C: Manage your cholesterol levels.
- s: Stop smoking or dont start.
The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines youre taking, and other factors. Work with your doctor to establish a personal A1C goal for you.
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Blood Sugar: When Its Too Low Or Too High
The hormone insulin takes sugar from food and uses it for energy. With type 2 diabetes, you dont have enough insulin or your body isnt effective at using insulin, and excess sugar continues to circulate in your bloodstream.
A target blood sugar range for most people with type 2 diabetes is 80 to 130 milligrams per deciliter before a meal and less than 180 mg/dl one to two hours after starting a meal, according to the American Diabetes Association.
A reading of 160 mg/dl or higher is typically considered high blood sugar . Over time, blood sugar in the range of 160 to 250 mg/dl can affect every organ in your body, Dr. Reddy says. Its associated with heart disease, eye disease, kidney disease, neuropathy, stroke, and vascular disease. If blood sugar goes as high as 500 mg/dl, you may experience symptoms such as thirst, the urge to urinate more often, weight loss, low energy, and drowsiness, he says.
Low blood sugar occurs when levels fall to less than 70 mg/dl. This is a risk when you take insulin or other diabetes medications, have gone too long without a meal, have been active, or have been drinking alcohol.
If your blood sugar goes too low, youll probably feel shaky and sweaty and you may develop tremors, Reddy says. Other symptoms may include a racing heart, headache, weakness, confusion, hunger, irritability, lack of coordination, and pale skin. If your blood sugar continues to drop to 30 mg/dl and below, you could slip into a diabetic coma.
Inconsistent Highs & Lows
Sometimes you may get a lower or higher blood glucose reading than usual and you may not be able to figure out the reason. When you are sick with a virus or flu, your blood glucose levels will nearly always go up and you may need to contact your doctor. There are a number of other common causes for blood glucose levels to increase or decrease. These include:
- Food time eaten, type and amount of carbohydrate for example: bread, pasta, cereals, vegetables, fruit and milk
- Exercise or physical activity
- Other medications
- Blood glucose checking techniques.
Contact your doctor or Credentialled Diabetes Educator if you notice that your blood glucose patters change or are consistently higher or lower than usual.
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What Is Diabetic Ketoacidosis
If you think you may have low blood sugar, check it even if you dont have symptoms.
When too many ketones are produced too fast, they can build up in your body and cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death. Common symptoms of DKA include:
- Fast, deep breathing.
- Nausea and vomiting.
If you think you may have DKA, test your urine for ketones. Follow the test kit directions, checking the color of the test strip against the color chart in the kit to see your ketone level. If your ketones are high, . DKA requires treatment in a hospital.
DKA happens most in people with type 1 diabetes and is sometimes the first sign of type 1 in people who havent yet been diagnosed. People with type 2 diabetes can also develop DKA, but its less common.
What Is The Target Blood Sugar Level Everyone Should Achieve
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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 in 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.
How Can I Check My Blood Sugar
Use a blood sugar meter or a continuous glucose monitor to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, youll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.
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What Should My Bgl Be
For a person without diabetes, throughout the day blood glucose levels will generally range between 4.0 7.8 millimoles of glucose per litre of blood regardless of how they eat or exercise, or what stress theyre under.
When youre living with diabetes your body cannot, or finds it hard to, keep your BGLs within a healthy range.
Because each person living with diabetes is different, your GP or specialist will set target BGLs that are right for you. However, here is some information you can use as a general guide. The information below is a general guide for target blood glucose levels before meals and after eating.
How Do You Know What Your Blood Glucose Level Is
For the most part, you cant feel what your blood glucose level is unless its fairly high or its low. You may not even always have symptoms of either high or low blood glucose in fact, many people with type 2 diabetes dont have the usual symptoms of high blood glucose, and for this reason, its not uncommon for people to go undiagnosed for many years.
The best way to know your blood glucose level is to check it with a glucose meter. This means doing a finger-stick with a lancet and getting a drop of blood onto a test strip, then inserting the strip into the meter for a reading. Your doctor may be able to give you a meter free of charge, but youll likely need to pay for test strips and lancets. But check with your health plan, as there are likely one or two preferred meters that they want you to use.
Another way to know what your glucose levels are up to is to use a continuous glucose monitor, or CGM, which reads glucose in the interstitial fluid about every five minutes. Continuous glucose monitoring is expensive and may or may not be covered by your health plan.
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Normal Blood Sugar Ranges In Healthy Non
For a person without any type of diabetes, blood sugar levels are generally between 70 to 130 mg/dL depending on the time of day and the last time they ate a meal.
Newer theories about non-diabetic blood sugar levels have included post-meal blood sugar levels as high as 140 mg/dL.
Here are the normal blood sugar ranges for a person without diabetes according to the American Diabetes Association:
- Fasting blood sugar : Less than 100 mg/dL
- 1-2 hours after a meal: Less than 140 mg/dL
- 2-3 hours after eating: Less than 100 mg/dL
Levels After Youve Eaten
Many foods have types of carbohydrates called starches and sugars. When you eat foods with these types of carbohydrates, your body breaks them down into glucose, which is a type of simple sugar, and releases the glucose into your bloodstream. Aside from glucose produced by your liver, food is the main source of plasma glucose.
Two hours after eating, your blood sugar levels rise. They rise more when you eat more carbohydrates, when you do not eat fiber, fat, or protein with your carbs, and when you eat certain types of carbohydrates, such as refined sugars and starches.
These are target values from The Joslin Diabetes Center, which include levels for people with diabetes:
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Why Is It Important To Reduce The Size And Duration Of These Spikes
Reducing these spikes may help you to increase the amount of time you spend in your target blood sugar range , which will have a positive impact on your future health. You should consult your healthcare team to understand the best target range for you, as this will differ from person to person. However, the International Society for Paediatric and Adolescent Diabetes recommends a target of 5.0-10.0 mmol/L .
Symptoms of a high blood sugar level also vary in individuals, but they may cause you to feel thirsty, tired, stressed and need to go to the toilet a lot. In the short term, by avoiding prolonged high blood sugar readings after eating, you should also reduce the occurrence of these symptoms and improve your energy, cognitive and athletic ability and overall mood.
Is A Keto Diet Safe For People With Diabetes
While there hasnt been a lot of research done on the long-term effect of following a keto diet, its generally considered safe for most people with diabetes.
The main risks when following a keto diet are related to mental health. ANY restrictive diet can potentially lead to an unhealthy relationship with food, and, in some cases, eating disorders.
If you find yourself constantly thinking about food, avoiding social situations where food is involved, or struggle with a negative body image, please seek professional help.
NOTE: Its important to stress that this risk isnt related specifically to a keto diet but dieting in general!
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How To Test Your A1c
Your doctor or endocrinologist should test your A1c regularly . The doctor simply pricks your finger and takes a tiny blood sample. If the doctors office has an A1c kit, you should get your result before your consultation is over.
You can also buy home A1c kits and do the test yourself. Home A1c kits can be useful if you go for more than three months between doctor visits and want to keep an eye on how your A1c is developing yourself.
The home kits are generally accurate within plus/minus 0.5 percentage points, which is more than good enough to give you a trustworthy result. The downside of the home kits is that they require a larger amount of blood than a regular blood sugar test, and if you dont apply enough blood, youll get an error message and will have lost a test strip.
You can find and in some pharmacies.
What Is A Normal Blood Sugar Level
According to the American Diabetes Association, a normal fasting blood sugar is less than 100 mg/dL.
A fasting blood sugar reading of 100-125 mg/dL indicates prediabetes, and a reading above 125 indicates diabetes.
|Fasting Blood Sugar|
|100 mg/dl to 125 mg/dl||Prediabetes|
|126 mg/dl or higher||Diabetes|
If you test your blood sugar two hours after eating or drinking something containing sugar instead , the numbers to look for are:
|Oral Glucose Tolerance Test|
|140 mg/dl to 199 mg/dl||Prediabetes|
You can learn more in the in-depth article: What Are Normal Blood Sugar Levels?
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Target Blood Sugar Levels For People With Diabetes
People with diabetes have difficulty creating or using enough insulin, which is the hormone that helps convert glucose into energy. Although there is no universal blood sugar chart for everyone with diabetes, clinical organizations like the ADA and American Association of Clinical Endocrinologists offer guidelines on target blood sugar levels as a starting point.
Healthcare providers typically tailor normal blood sugar target ranges to an individual diabetes care plan. This includes considering your:
Normal And Diabetic Blood Sugar Ranges
For the majority of healthy individuals, normal blood sugar levels are as follows:
- Between 4.0 to 5.4 mmol/L when fasting
- Up to 7.8 mmol/L 2 hours after eating
For people with diabetes, blood sugar level targets are as follows:
- Before meals : 4 to 7 mmol/L for people with type 1 or type 2 diabetes
- After meals : under 9 mmol/L for people with type 1 diabetes and under 8.5mmol/L for people with type 2 diabetes
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Why You Shouldnt Lower Your A1c Too Quickly
It can be a good idea to approach lowering your A1c with a bit of caution. Just as crash dieting isnt healthy, there can be some serious health risks associated with lowering your A1c too quickly. I turned to Dr. Peters for an explanation:
If you lower your A1c too quickly, many bad things can happen. First, weight gain and total body swelling. Next, it can cause bleeding in the retina which can lead to blindness, and third, it can cause painful neuropathy that never goes away. Its slightly different for newly diagnosed patients, but, in general, no one should try to go from an A1c of 10% to 6% quickly. Take slow steps. Wanting to get to a low number very fast only causes harm. Diabetes is a long-term disease, so slow steps to establish new habits that can last a lifetime is the way to go. Anything too sudden and the body reacts badly.
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