BLOOD SUGAR - How You Can Control Blood Sugar

Thursday, October 09, 2014

By Clara Schneider MS, RD, RN, CDE, LDN

People are told when they are diagnosed with diabetes or pre-diabetes that they need to control blood sugar or blood glucose values. Actually, everyone with diabetes needs to control their blood glucose. This article will focus on 8 important measures to help you do just this!

Know your blood glucose goals and if you are within these established levels

Ask your doctor if he/she would like you to strive for goals recommended by the American Diabetes Association, the American Association of Clinical Endocrinologists or if other goals are determined by your doctor.
To know your blood glucose levels you must carry a glucometer with you and test your blood. If you do not have a glucometer, call your insurance to see if they cover meters (of any particular brand) and how many strips would be provided. Most likely you will need a doctor’s prescription to get your supplies.  Make sure you are properly trained to use your meter. Wash your hands with soap and water before testing and dry thoroughly. It is best to perform your blood glucose tests as follows:

First thing in the morning before you eat or drink anything (water is OK) for at least 8 hours. The result will be your fasting glucose level. This level will tell you what your blood glucose is without eating. It is often the first one doctors will try controlling.

The American Diabetes Association recommends fasting levels for non-pregnant adults with diabetes of 70-130 mg/dl (3.9-7.2 mmol/L). (1) 

The American Association of Clinical Endocrinologists (AACE) recommends below 110 mg/dl (6.1 mmol/L). (2) 

Your physician needs to know what your fasting levels are in order to evaluate if a medication is needed to control overnight levels.

One to two hours after the first bite of a meal -(referred to as "Post-prandial")

To properly control your diabetes, the American Diabetes Association recommends achieving results less than 180 mg/dl ( 10.0 mmol/L) 1-2 hours after the first bite of a meal. (1)

The American Association of Clinical Endocrinologists (AACE) recommends achieving results less than 140 mg/dl (7.8 mmol/L) 2 hours after the first bite of a meal. (2)

Pre-prandial (before eating a meal) I tell my patients, if they are having a problem controlling their blood glucose after a meal, they must know what their blood glucose is before eating that meal. Did they start with a high glucose level before the meal or was it good going into the meal but high after the meal? If it was good before the meal and high after, it may be due to what they ate or perhaps because they forgot their prescribed mealtime medication.

Know how to count carbohydrates

See your diabetes educator for help in the basics. Ask for a meal plan and learn how to count the carbohydrates you eat at meals and snacks. Here is more information on reading food labels for carb-counting.

Watch a video on carbohydrate counting. 

If you eat more carbohydrates than recommended, usually your blood glucose will be elevated. If you don’t eat enough, you might develop hypoglycemia or low blood glucose.

Know how exercise affects your blood glucose

Test your blood glucose before you exercise, during and after. If you are on insulin or another medication that can cause a low, you need to know how exercise affects you. Always carry your meter, strips, glucose tabs and your cell phone when exercising. For information on how to treat a low blood glucose read my blog - How to Treat Low Blood Glucose.  

Illness affects your blood glucose

If you are ill, call your doctor and report how you are feeling. It is helpful for the doctor to have a complete picture of what is going on. Have your blood glucose levels available and take your temperature. What to do if you’re ill with diabetes.  

Stress and lack of sleep can affect your blood glucose levels

Think about what is causing the stress. Test your blood glucose levels to see how it affects your blood glucose. Talk to your diabetes team about ways to help control stress and ways to relax to help you sleep.

Body hormones

Women of child bearing age will find that there is a change in their blood glucose levels at different times of the month. Chart your blood glucose levels and ask your physician if you need to make any changes based on your results.

Medications

Talk to your doctor and pharmacist when starting a new medication. Some medications that are not taken for diabetes will affect your blood glucose levels. Ask your medical team if there is a substitution that does not affect the levels or if not, do you need a diabetes medication added or adjusted to control your glucose.

Dehydration

Make sure you drink the amount of fluids and the kind of fluids that your medical team advises. For most people this is mainly water. Dehydration will most likely increase your blood glucose levels.

To stay within your blood glucose goals your need to know what your goals are and what affects your levels. When your levels are out of target, ask yourself what the cause can be. Talk to your medical team to see what recommendations they have to get you back within target. Blood glucose control is important to help you prevent complications of diabetes. We at diabetescare.net wish for you healthy glucose readings so you can control your diabetes! 

Source: http://www.diabetescare.net/