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Blood Sugar & Glucose Management

Maintaining optimal blood sugar levels is an extremely important aspect of staying healthy if you have diabetes.

Glucose Control Goals

The American Diabetes Association recommends that blood sugars before meals should be 80-120 mg/dl. In addition, the glycosolated hemoglobin (HgbA1c) should be less than 7%.

These goals for control are based on research studies proving that optimal glucose control significantly reduces the risk for long-term diabetes complications. Glucose goals may need to be individualized depending on your situation, so talk with your health care team members to determine the best goal range for you.

Recommended Monitoring Guidelines

The minimum monitoring and screening guidelines according to the American Diabetes Association Standards of Care are as follows:

Screening or Exam Frequency of Testing
Glycosolated hemoglobin (HgbA1c) Every 6 months
Blood fats (total cholesterol, HDL, LDL and triglycerides) Yearly
Kidney tests - blood test for blood urea nitrogen (BUN) and creatinine and urine test Yearly
Eye exam with dilated pupils Yearly
Dental exam Every 6-12 months

Glycosolated Hemoglobin (HgbA1c) Test

This test indicates the average blood sugar over the past 2-3 months by measuring the amount of sugar attached to hemoglobin in red blood cells. You can think of a HgbA1c as similar to a bowling or batting average. Your daily blood sugar tests indicate your level of glucose control at that point in time, while the HgbA1c indicates your overall glucose control.

Normal values for a HgbA1c vary slightly from lab to lab, so find out the normal range at your clinic or hospital. The American Diabetes Association recommends the goal for a HgbA1c is less than 7%.

How Often Should Blood Sugar be Checked?

Home glucose monitoring is an essential part of quality diabetes care. The following minimum guidelines can be used to help determine which testing routine is best for you.

Your Diabetes Treatment Minimum Blood Sugar Monitoring
Diet control 2-3 times per week
Diabetes pills 2 times per day to several times per week
Insulin 2-4 times per day

The best times to test are before meals and at bedtime. If you do not test four times a day, be sure to rotate testing times. For example, test before breakfast and supper one day and before lunch and at bedtime the next day. Testing two hours after eating can also be helpful to determine the effects of different types and amounts of food on your glucose levels. Talk with your doctor or diabetes educator to help develop an individualized testing routine for you.

Hypoglycemia (low blood sugar)

Hypoglycemia occurs when the blood sugar falls below the normal range. A blood sugar below 70mg/dl is considered too low and should be treated. Here are some causes of hypoglycemia:

  • Too much diabetes medicine
  • Eating meals or snacks at the wrong time
  • Skipping or delaying meals or snacks
  • Excess exercise

It's important to recognize symptoms of low blood sugar so you can act quickly and bring your levels back to a safe range.

Symptoms of Low Blood Sugar
  • Crabby or confused
  • Headaches
  • Blurred vision
  • Fast heartbeat
  • Mouth/lips numbness or tingling
  • Shaking
  • Sweating
  • Dizziness
  • Hunger
  • Feeling tired

Treatment Steps for Hypoglycemia

  1. Test your blood sugar. Follow step 2 if it is below 70 mg/dl.
  2. Take a fast acting sugar that has approximately 15 grams of carbohydrate. Try one of these:
    Good examples of fast acting Sugars
    1/2 cup of juice3-4 glucose tablets (depends on brand)1 tablespoon of sugar
    1 cup of milkGlucose gel (see package for amount)2-3 pieces of hard candy
    1/2 cup of regular soda1 small box of raisins7 lifesavers
  3. Wait 15 minutes. If you don't feel better, take one of the above foods/beverages again.
  4. If there is no improvement in 20-30 minutes, retest your blood sugar and repeat step two again if your blood sugar is not rising. If you are unable to swallow, have someone give you Glucagon (if trained) or call for help. Have someone stay with you.
  5. Once you feel better, if you won't be eating a meal or snack in the next hour, eat one of the following after you take the quick-acting sugar: 1/2 meat sandwich, 6 crackers and cheese, 6 crackers and peanut butter.
  6. Resume your usual eating pattern with your next meal or snack. DO NOT count foods used to treat hypoglycemia in your total calories for the day.

Notify your doctor if you experience problems with your blood sugar, especially if your levels are severely low and require treatment assistance from someone else.

Additional Information

If you have any questions or would like to find out more about our diabetes services, call the Avera McKennan Diabetes Center at 605-322-8995.