About 38 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention. While diabetes is both treatable and preventable in many circumstances, it remains the eighth leading cause of death.
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When diabetes is left untreated, glucose builds up in the bloodstream, rather than entering into the cells. This excess glucose damages the delicate lining of the blood vessels, leading to narrowing and scarring over time. Small blood vessels, such as those in the extremities, eyes, brain and kidneys, are particularly vulnerable to complications.
Although it takes consistency, you can avoid these complications by strictly monitoring and controlling blood sugar levels.
Why You Should Monitor Your Blood Sugar Levels
Untreated diabetes can lead to devastating health consequences, such as:
— Stroke
— Diabetic neuropathy, or nerve damage that causes numbness or tingling
— Diabetic retinopathy, or damage to the back of the eye, causing floaters, blurriness or blindness in severe cases
— Non-healing wounds
Additionally, in a 2024 meta-analysis published in Diabetology & Metabolic Syndrome, researchers analyzed 15 studies that included more than 8 million individuals with diabetes. The researchers concluded there is a substantial link between diabetes and dementia.
“We have a growing set of data indicating that the more ‘time in range’ a person’s glucose levels are, the lower their risk of diabetes complications are,” says Dr. Jessica Perini, a professor of medicine in the division of endocrinology at West Virginia University Medicine and program director for the WVU Medicine endocrine fellowship program.
On a daily basis, you’ll also feel better if your blood sugars are neither too high nor too low, referred to as hyperglycemia and hypoglycemia, respectively, Perini says.
High blood sugar effects
— Excessive thirst
— Excessive urination
— Dry mouth
— Blurry vision
— Daytime tiredness
“I explain to patients that the oxygen in their blood is trying to swim through a sea of sugar, so it’s no wonder they’re tired,” Perini says.
Low blood sugar effects
— Confusion
— Anxiety
— Shakiness
— Hypoglycemic shock, which can lead to loss of consciousness, seizures and coma. It can be fatal if untreated.
[READ: How Do You Know If You Have Diabetes? ]
How to Monitor Your Blood Sugar Levels
Technologies for measuring blood sugar range from traditional blood glucose meters to advanced insulin pumps and continuous glucose monitors
. Work with your doctor and diabetes educator to find the right option for you:
— Glucometer. A blood glucose meter, or glucometer, with finger-sticks is the tried-and-true method for self-monitoring your blood sugar.
— Continuous glucose monitor. A CGM is attached to the skin anywhere from seven to 14 days at a time and can sense sugar levels every few minutes without painful finger-sticks, Perini explains.
Finger-stick steps
Here are the basics of monitoring your blood sugar with a blood glucose meter:
— Wash and dry your hands thoroughly.
— Place a disposable test strip into the device.
— Use a sterile lancet on the side of your fingertip to draw a drop of blood.
— Touch the blood drop to the edge of the test strip until the target area fills.
— Check the display for your blood glucose level.
— Log your result.
Steps may vary depending upon the type of glucometer you have and manufacturer instructions. For instance, some devices let you stick areas other than your fingertip, such as the fleshy part of your palm, your forearm or thigh.
“Checking morning fasting glucose levels helps a person know what sugar level they are setting themselves up for as a baseline for the day,” Perini says. “Checking finger-sticks at other times helps people know what effects different types of meals and activities are having on their sugars.”
CGM devices
CGM technology is a helpful tool to manage diabetes daily, if not hourly, says Dr. Thomas Grace, head of clinical advocacy and outcomes at Dexcom, a CGM device company, and director of Blanchard Valley Diabetes Center. Grace is based in Findlay, Ohio.
Grace says that CGMs:
— Provide real-time insights on glucose levels
— Help individuals understand how their body reacts to specific foods and physical activity
— Empower individuals to make informed decisions about their insulin dosing based on their glucose data
CGM devices also provide information regarding trends in sugars overnight or during times when you may not have time to do a finger-stick, Perini notes.
“The sugar data is then visible to the wearer of the device on their phone and can be available to others as well, such as a parent or caregiver, and to the medical provider helping manage their diabetes,” she adds.
The devices can alarm when blood sugar moves beyond upper or lower limits that you’ve set.
However, whether or not insurance will cover the CGM device is a significant limiting factor, Perini notes.
[READ: Questions to Ask Your Doctor About Diabetes]
What Your Blood Sugar Range Should Be
Target blood sugar guidelines vary by diabetes groups and possibly by your individual situation, such as during pregnancy.
According to American Diabetes Association guidelines, these are general glucose targets to aim for:
— Fasting: 80 to 130 milligrams per deciliter
— Two hours after meals: Less than 180 mg/dL
Some clinicians might use different guidelines. According to the American Association of Clinical Endocrinologists, these are (slightly stricter) glucose targets:
— Fasting: Less than 110 mg/dL
— Two hours after meals: Less than 140 mg/dL
What is hemoglobin A1C?
The hemoglobin A1C is a measure of longer-term glucose control — which is important because blood sugar constantly changes from day to day. Specifically, the A1C number indicates your average blood sugar for the previous two to three months. This is because glucose attaches to hemoglobin in red blood cells, and red blood cells live about 120 days.
A hemoglobin A1C test requires a blood sample from your vein, which must be taken by a health care provider and tested in a lab.
Latest A1C targets
The A1C value is a percentage, representing the proportion of hemoglobin molecules in the blood that have glucose attached to them. The higher the A1C, the higher the proportion of glucose in the blood. When you have diabetes, the goal is to lower your A1C, aiming for:
— Less than 7%, according to ADA guidelines
— 6.5% or less, according to AACE guidelines
[READ: What’s Type 4 Diabetes?]
Tips for Monitoring and Controlling Blood Sugar Levels
At a minimum, individuals must to be able to monitor their blood sugar and administer insulin regularly throughout the day as needed, says Dr. Leslie Touger, an endocrinologist at Phoenix Children’s in Arizona.
Adjust your diet
Learning how different foods and meal timing affect your individual blood glucose fluctuations is a complex, ongoing process. Your registered dietitian or diabetes educator can work with you. This is general dietary advice for diabetes:
— Eat low glycemic-index foods on a consistent basis.
— Balance your meals with fiber, such as fruits and vegetables, and protein. Both slow down the absorption of carbohydrates, helping to level off blood sugar spikes.
— Know how to quantify the amount of carbs you take in to help determine your insulin needs. “If a person can consume roughly similar amounts of carbohydrates at each meal, they can use roughly the same amount of insulin at each meal,” Perini says.
Exercise
Physical activity is important for maintaining a healthy weight
and keeping blood sugar under control. Exercising with diabetes does require extra awareness. Keep these pointers in mind:
— Exercise regularly. Walking is a great way to get started, the American Diabetes Association suggests.
— Get at least 30 minutes of physical activity per day. Check your blood sugar prior to exercise, and don’t exercise if your blood sugar is below 100 mg/dL.
— Check your blood sugar one to two hours after exercising as the glucose-lowering effect will continue.
If you have Type 1 diabetes, the ADA recommends the following exercise-related actions:
— Check your blood sugar before, during and after exercise.
— Have a pre-exercise snack if your blood sugar is low or trending downward.
— Always carry a carbohydrate or glucose food or drink.
— Consult your doctor if you have ongoing problems with blood sugar dropping with exercise.
Plan ahead
Individuals need to be prepared to treat an unexpected low blood sugar, says Touger, who primarily works with children who have Type 1 diabetes.
Touger, who also describes managing diabetes as “a full-time job,” recommends that you:
— Have all your medication and supplies packed and ready to go each morning
— Make sure your electronic devices, such as an insulin pump or CGM, are charged
— Have supplies to treat low blood sugar, such as juice boxes or glucose tablets
— Have backup supplies handy
Don’t forget your diabetes identification, such as a necklace, bracelet or ID card, as well as a glucagon kit, used to treat low blood sugar in an emergency situation.
Take medication
Finding the right diabetes medication and adjusting as needed are paramount for effective blood sugar control. Your health care provider may prescribe the following types of medications:
— Oral medications, such as metformin, sulfonylureas, meglitinides, DPP-4 and SGLT2 inhibitors, that act on the body to reduce blood sugar in various ways
— GLP-1 receptor agonists, such as Ozempic, that are typically injectable medications to reduce blood sugar in people with Type 2 diabetes
— Insulin, an injectable medicine that’s essential for treating Type 1 diabetes and may also be used with Type 2 diabetes. People inject themselves with insulin several times a day, or use an insulin pump that’s attached to the skin.
“Pumps which continuously provide insulin can be directed to give more, less or no insulin based on glucose data provided by the CGMs. This sort of system is what we often call the ‘bionic’ pancreas,” Perini says. “This takes away from the person the need for constant vigilance that can really weigh on someone with diabetes.”
Get help from your health care team
When it comes to keeping your blood sugar on target, rely on these health care experts for help:
— Diabetes educator
— Registered dietitian nutritionist
— Exercise physiologist
— School nurse
Family members and friends can provide meal planning assistance and moral support, act as exercise buddies and serve as watchful eyes for early symptoms of hypo- or hyperglycemia.
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Tips for Monitoring and Controlling Blood Sugar Levels originally appeared on usnews.com
Update 12/30/24: This story was previously published at an earlier date and has been updated with new information.
