Type 2 diabetes is a complex condition that can interfere with daily activities and well-being. Fortunately, researchers know more about type 2 diabetes now than ever, which gives those with the condition more treatment options and hope of living a long, healthy life.
One of the best ways to reduce the unpleasant symptoms that can accompany type 2 diabetes is by keeping your blood sugars at normal levels But what blood sugar readings are considered normal?
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Type 2 diabetes prevents glucose sugar from entering your body's cells to properly use for energy. Insulin is a hormone released by your pancreas (an organ behind your belly button), which helps glucose get into your cells to carry out body functions.
However, in those with type 2 diabetes, the cells become resistant to insulin. This makes it more difficult for the glucose in your bloodstream to get into the cells to provide your body with the energy it needs for many of its functions. This can lead to high levels of sugar in your blood that can't get into your cells, which over time may result in dangerous health consequences.
You can check your blood sugar levels several times a day at home with a blood glucose monitor, which uses a drop of blood from your finger. A better measure of how well your diabetes is being managed, however, is a blood test called the A1C.
The A1C test (or HbA1C) involves a blood test that measures the percentage of hemoglobin proteins in your blood that are bound to sugar. In a more practical sense, these tests show how well your blood sugar levels have been managed in the last two to three months.
Instead of relying on occasional blood glucose tests that can spike or drop for many reasons, A1C tests provide a more accurate picture of how well your diabetes has been managed on average across the preceding three months.
Some people are diagnosed with diabetes using the A1C test, and doctors often recommend that those with prediabetes should get a yearly A1C test. Those with diabetes who don't use insulin may only need two of these tests per year. People who use insulin, or struggle to keep blood sugar levels within their target range, may get four A1C tests per year.
A1C tests don't require any preparation for fasting beforehand, so you can have this blood test any time of the day, even after eating and drinking normally.
The American Diabetes Association¹ recommends the following blood sugar levels in those with type 2 diabetes:
Between 80 and 130 mg/dL before meals
Less than 180 mg/dL two hours after meals
Your doctor, however, may recommend goals more tailored to your unique situation. If you have other medical conditions, such as heart disease, or are above 60 years old, your blood sugar goals may be higher than those outlined above.
For those with type 2 diabetes, it is usually recommended to check your blood sugar before meals and just before you go to bed if you take insulin injections. If you use long-acting insulin, you may only need to test at breakfast and bedtime. Those who don't use insulin and rely on other medications and lifestyle changes may not need to test their blood sugar every day.
Your doctor will help you determine how often you should check your blood sugar levels, and they may ask you to write the information in a logbook for your next appointment.
After receiving a diagnosis of type 2 diabetes, it can take some time to learn how to better manage blood sugars and keep them at a healthy level. Unfortunately, if blood sugar levels are not properly managed in the long term, there are several health complications that can arise, such as:
When your blood consistently contains high levels of glucose, it can lead to nerve damage, called diabetic neuropathy. This typically leads to injured nerves in the legs and feet, usually first felt as a tingling or numb sensation.
Besides legs and feet, nerve damage can also occur in the hands and arms or lead to digestive issues, facial paralysis, double vision, cramping, and more. Nerve damage is currently estimated to impact 50% of people that have diabetes, but it can be slowed or prevented with proper lifestyle habits.
High blood glucose can lead to diabetic eye disease. In the beginning, diabetic eye disease can start with blurry vision for short periods of time during bouts of high blood sugar, but this usually doesn't lead to permanent damage. In the short term, high blood glucose can also lead to changes in fluid levels throughout your body, which can cause swelling in your eye tissues.
If a person has high blood glucose levels for a longer duration, it can cause damage to the blood vessels within your eyes. This can lead to increased swelling and leaked fluids, as well as high pressure inside the eye, which can alter your field of vision permanently.
Those most at risk for diabetic eye disease are people with untreated diabetes and high blood pressure, as well as people that have high cholesterol levels or are smokers.
People who have type 2 diabetes, especially those with consistently high blood sugars, are at an increased risk of developing kidney disease. This is because high blood glucose over time can cause kidney damage.
Your kidneys are responsible for filtering your blood using clusters of small blood vessels. High blood sugars can damage these blood vessels, causing your kidneys to be less efficient, potentially leading to decreased kidney function and eventual kidney failure.
Having uncontrolled diabetes and high blood pressure also increases your risk of developing kidney disease. Kidney disease is surprisingly common, yet only about 10%² of the estimated population that suffers from kidney disease has received a diagnosis. If you think you may have kidney problems, make an appointment with your doctor as soon as possible.
Uncontrolled blood sugars can also cause problems with your heart over time. Because high levels of blood glucose can damage blood vessels and nerves, those in your heart can be negatively impacted, raising your risk of developing heart disease. Similarly, having high blood pressure along with diabetes further increases your risk of heart disease, as does having high cholesterol levels.
Quitting smoking, getting enough physical activity, limiting alcohol consumption, and having a healthy weight can all substantially lower your risk of developing heart disease, even if you already have diabetes.
These are just a few of the many complications that can arise from uncontrolled blood sugars. However, there are several things that you can do to lower your risk of these complications from occurring.
The good news is that lifestyle changes can be combined with modern medicine to produce better blood sugar control than ever in those that suffer from type 2 diabetes. Some people may be able to manage their diabetes completely with lifestyle changes alone, though others may require medical interventions to better control blood sugar levels.
Here are some of the most common ways that people can keep their blood sugars at healthy levels:
One of the best ways that you can manage your blood sugars is by implementing a diabetes-friendly diet. For those with diabetes, a balanced diet is one that contains plenty of fruits, vegetables, whole grains, and a moderate amount of lean protein and low-fat dairy. It also means limited amounts of saturated fat, sugar-sweetened beverages, and foods high in cholesterol and salt.
Adapting your eating habits can be overwhelming at first, but you can start with small changes that build on one another over time. For example, instead of trying to completely overhaul your current way of eating, you could try to switch from sugary cereal for breakfast to a bowl of rolled or steel-cut oats a few times per week.
Once you see that you can make small tweaks like this, you will feel more motivated and confident that you can make other small changes to your diet to keep your blood sugars at healthy levels.
If you need more help with managing your diet, your doctor can refer you to a registered dietician (RD). RDs are experts in nutrition, and they can help you create a plan to eat a more balanced diet.
Another excellent way to keep blood sugars at their optimal levels is with physical activity. Physical activity can help your body use insulin more efficiently, which can help your blood sugars stay at healthy levels even when you're at rest.
Physical activity can mean going for a run or lifting weights at the gym, but it can also include yard work, playing with your kids, or anything that gets your body moving. Many people avoid physical activity because it feels overwhelming to start a workout routine, but you can start with something as simple as a walk around the block.
If you have trouble standing, you can also try doing chair workouts that allow you to stay seated yet still get many of the same benefits other forms of exercise can provide.
Weight loss to improve diabetes symptoms doesn't have to be drastic. Even losing a few pounds can help your body better manage its blood sugars, and some studies have shown that significant weight loss in people with type 2 diabetes can help them achieve remission. Not everyone with type 2 diabetes is overweight, and this may not be a viable option for those who are currently at a healthy weight or are considered underweight.
There are several diabetes medications available that can help you keep your blood sugars at healthy levels. Some medications work by preventing your body from breaking down starches into glucose, while others decrease how much glucose is made in the liver. Others still increase the release of insulin from your pancreas or encourage your kidney to absorb and excrete more glucose.
It may take time for you and your doctor to find the medication that works best for you.
Insulin therapy consists of adding supplemental insulin to your body, which will help your cells better absorb the glucose in your blood. This brings blood sugar levels back down to normal levels. There are a few different types of insulin: long, intermediate, and rapid-acting insulin, which work on lowering blood sugars for different durations.
It can take a while for you and your doctor to determine the right insulin regimen and combination that works best to bring your blood sugars to normal levels. Insulin therapy is typically used when lifestyle changes and other treatments haven't been successful in managing blood glucose levels.
Type 2 diabetes can impair your ability to maintain healthy blood sugar levels, but that doesn't mean all hope is lost. Through various lifestyle changes, medical interventions, and having adequate knowledge of how diabetes works, you can keep your blood sugar at healthy levels and reduce your diabetes-related symptoms.
One of the best ways to keep your blood sugars in check is by working closely with your doctor, who can recommend different treatment options, help you manage side effects, and suggest other lifestyle changes to improve your diabetes symptoms and overall quality of life.
The big picture: Checking your blood sugar | American Diabetes Association
Does type 2 diabetes increase your risk for kidney disease? Yes | National Kidney Foundation
Achieving type 2 diabetes remission through weight loss | National Institute of Health
What are my options? | American Diabetes Association
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