While everyone’s blood sugar goals differ based on factors like age and overall health, the American Diabetes Association (ADA) recommends these target levels:
Before a meal: 80 to 130 mg/dlOne to two hours after the start of a meal: less than 180 mg/dl
Keeping your blood sugar levels as close to your target as possible is key to preventing complications and living well with type 2 diabetes. Insulin moves glucose into cells to be used for energy. When you have type 2 diabetes, your body doesn’t produce enough insulin or can’t effectively use the insulin it does produce. Without insulin, glucose builds up in the blood, leading to high blood sugar levels. You may also experience a rise in blood sugar if you eat a meal high in carbs, if you don’t take enough insulin or other diabetes medication, or if you experience physical or emotional stress. Low blood sugar can occur when you take too much insulin or other diabetes medication, skip a meal or eat fewer carbohydrates than usual, or increase your physical activity. Monitoring your blood sugar — by making sure it doesn’t spike too high or dip too low — is an important part of managing your type 2 diabetes. And you can start by learning the signs of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) and what steps to take to bring those levels back to normal: Hypoglycemia: If blood sugar is too low — usually below 70 milligrams per deciliter (mg/dl) — you may have symptoms such as confusion, sweating, nervousness, nausea, and dizziness. You could even pass out, according to the ADA. What to do: Follow the 15–15 rule. Have 15 grams of fast-acting carbohydrate — such as three to four glucose tablets, 4 ounces of fruit juice or regular soda, or a tablespoon of sugar — to raise your blood sugar, wait 15 minutes, and then check your blood sugar. If you’re still not in your target range, have 15 more grams of carbs. Repeat these steps until your blood sugar is back up to normal. Hyperglycemia: Signs of high blood sugar include excessive thirst and urination, blurry vision, and fatigue. High blood sugar can be a problem for two reasons. Over the long term, high blood sugar quietly damages the small vessels of the eyes, kidneys, and nerves, leading to serious complications like blindness, kidney damage, and nerve damage. In the short term, it can cause weight loss and excessive urination. It also may pose a threat of coma or death. If you have blood sugar over 240 mg/dL, you may be at risk for ketoacidosis (when your body produces high levels of blood acids called ketones), which requires emergency care, according to the ADA. What to do: If your blood sugar levels are too high, exercise can help bring them down. One note: If your blood sugar is above 240 mg/dl and you have ketones, you should not exercise. Exercising when you have ketones may make your blood sugar go even higher, according to the ADA. Talk to your doctor about the safest way to lower your blood sugar if this is the case. Testing your blood sugar throughout the day is the best way to keep track of your levels and discover the impact food, exercise, and other activities have on your blood sugar. You should also see your doctor at least twice a year for an A1C test, which gives an overall picture of your blood sugar control for the previous two to three months. “We strive to keep A1C under 7 percent for most people with diabetes,” says Dr. Wexler. Blood sugar that isn’t well controlled can make it hard to hit that goal.
Strategies to Control Blood Sugar
There are steps you can take to control blood sugar every day. Educate yourself The more you know about type 2 diabetes, the more confident you’ll feel about diabetes management. That feeling of “self-efficacy” is linked with better blood sugar control, taking medication as prescribed, and making lifestyle changes such as improving your diet and exercising, researchers reported in the Summer 2014 issue of Ethnicity & Disease. Test your blood sugar on schedule When researchers followed adults with type 2 diabetes over the course of a year, they found that those who used a structured blood sugar testing approach throughout the day had better blood sugar control than those who did not, according to an October 2013 study published in Diabetes Care. Common times to test your blood sugar include when you first wake up, before and after meals and exercise, and at bedtime. Talk to your doctor about when and how often you should test. Exercise Physical activity increases insulin sensitivity, which can help control blood sugar. Get at least 30 minutes of moderate exercise at least five days during the week. How to tell if your intensity level is moderate? You should be able to talk but not be out of breath or able to sing out loud, according to the ADA. And for best results, do both aerobic exercise and strength training throughout the week, researchers reported in the September 2014 issue of Diabetologia. The ADA recommends strength training at least twice a week, in addition to your 150 minutes of aerobic exercise. Because exercise can lower blood sugar, you should keep a source of fast-acting carbohydrate on hand in case you need to treat hypoglycemia. Test your blood sugar before and after exercise to make sure it’s in a safe range. Count your carbs Carbohydrates have the biggest impact on your blood sugar, so monitoring the amount of carbs in your meal plan can help keep blood sugar levels steady. The ADA recommends aiming for 45 to 60 grams of carbohydrate at each meal. Working with a certified diabetes educator or registered dietitian can help you set your personal goals for meals and snacks and master carb counting, notes Wexler. Take medications as prescribed Skipping doses of your diabetes medication or taking too much can cause swings in your blood sugar levels. Always take your medication as prescribed. If you’re having trouble sticking to your medication plan, talk to your doctor about changes that can make it easier for you. He or she may recommend keeping a medication log or setting an alarm or other reminder to take your medication at the same time each day. Improve sleep quality. “There’s evidence that people with sleep apnea and sleep deprivation have impaired glucose tolerance,” Wexler says. Health and sleep data from a study involving 6,616 European adults revealed that people with diabetes who also have obstructive sleep apnea have worse blood sugar control. The findings were published in the May 20014 issue of Chest. Most adults should aim for seven to eight hours of shut-eye per night. Ask your doctor about undergoing a sleep study if you wake up several times during the night or have frequent trouble getting out of bed in the morning. Getting your blood sugar under control may seem like work, but you’ll soon get used to your new habits and enjoy a healthier future.
