4. Monitoring: Monitoring Blood Sugar: What should my blood sugar be?

Keeping your blood sugar controlled most of the time is an important part of treating your diabetes. Your body is always burningcalories ("sugar"), and you eat during the day which addscalories. As a result, blood sugar levels change all day long, every day, for everyone.

For people without diabetes, blood sugar values should be:

Between 70 and 120 mg/dL

For people with diabetes, blood sugar levels should be:

Fasting: up to 130 mg/dL

After meals: less than 180 mg/dL

Why should I check my blood sugar?

Monitoring your own blood sugar levels with a meter is a good thing to do. It is especially important when you are first learning what it means to be diabetic, but also whenever changes in your medication or lifestyle are occurring. It helps you see how food, physical activity, and medicine affect your blood sugar levels. The readings can help you manage your type 2 diabetes day by day or even hour by hour. Your checks give you a snapshot of your blood sugar at that moment.

How do I test my own blood sugar?

You use a blood glucose meter and a tiny drop of blood. Be sure you know how to test your blood sugar levels the right way.

How often should I check my blood sugar levels?

Self -tests are usually done before meals, after meals, and/or at bedtime.

If I test my own blood sugar levels, do I still need the A1C test?

Yes. The results of both the blood sugar tests that you do yourself and A1C tests at the doctor’s office help you and your healthcare team get a complete picture of your control of type 2 diabetes by understanding how your blood sugar averages over a period of several weeks.

Healthy ABCs of Diabetes

To manage diabetes, you'll need to keep track of the ABCs of diabetes:

A is for A1C: Your A1C check tells you your average blood glucose for the past 2-3 months. It's the “blood check with a memory".

B is for blood pressure: Your blood pressure numbers tell you the force of blood inside your blood vessels. When your blood pressure is high, your heart has to work harder.

C is for cholesterol: Your cholesterol numbers tell you about the amount of fat in your blood. Some kinds, like HDL cholesterol, help protect your heart. Others like LDL cholesterol, can clog your blood vessels and lead to heart disease. Triglycerides are another kind of blood fat that raises your risk for heart attack or stroke.

A1C and eAG

The A1C test gives you a picture of your average blood glucose (blood sugar) control for the past 2 to 3 months. The results give you a good idea of how well your diabetes treatment plan is working. These are some ways the A1C test can help you manage your diabetes:

Confirm self-testing results or blood test results by the doctor.
Judge whether a treatment plan is working.
Show you how healthy choices can make a difference in diabetes control.

How Does it Work?

Hemoglobin, a protein that links up with sugars such as glucose, is found inside red blood cells. Its job is to carry oxygen from the lungs to all the cells of the body. Glucose enters your red blood cells and links up (or glycates) with molecules of hemoglobin. The more glucose in your blood, the more hemoglobin gets glycated. By measuring the percentage of A1C in the blood, you get an overview of your average blood glucose control for the past few months. Your doctor should measure your A1C level at least twice a year.

What is eAG?

Your health care provider may report your A1C test result as eAG, or "average glucose," which directly correlates to your A1C. eAG may help you understand your A1C value because eAG is a unit similar to what you see regularly through self-monitoring on your meter. A1C is reported as a percent (7% for example) and eAG uses the same units (mg/dl) as your glucose meters.

What's Your Number?

The American Diabetes Association suggests an A1C of 7%, which is an eAG of 154 mg/dl, but a more or less stringent glycemic goals may be appropriate for each individual. Ask your provider or care team what the right target is for you.

Calculate your eAG:

28.7 x A1C — 46.7 = eAG

Blood Pressure

Nearly 2 in 3 people with diabetes report having high blood pressure or take prescription medications to lower their blood pressure. Your heart has to work harder when blood pressure is high, and your risk for heart disease, stroke and other problems goes up. Studies show that controlling blood pressure is just as important for diabetics as controlling blood sugar.

What Is Blood Pressure?
Blood pressure is the force of blood flow inside your blood vessels. Your doctor records your blood pressure as two numbers, such as 120/80. Both numbers are important.

The first number is the pressure as your heart beats and pushes blood through the blood vessels. Health care providers call this the "systolic" pressure.

The second number is the pressure when the vessels relax between heartbeats. This is "diastolic" pressure. Here's what the numbers mean:

Healthy blood pressure: below 120/80
Early high blood pressure: between 120/80 and 140/90
High blood pressure: 140/90 or higher

The lower your blood pressure, the better your chances of delaying or preventing a heart attack or a stroke. When your blood moves through your vessels with too much force, you have high blood pressure or hypertension. High blood pressure raises your risk for heart attack, stroke, eye problems and kidney disease. High blood pressure won't go away without treatment and changes to your diet and lifestyle.

How will I know if I have high blood pressure?
High blood pressure is a silent problem — you won't know you have it unless your health care provider checks your blood pressure. Have your blood pressure checked at each regular health care visit.

What can I do about high blood pressure?

Nearly everyone with high blood pressure requires medication to help control it. But just like controlling blood sugar, there are important things you can do to help reduceyour blood pressure. Eating well and being physically active will not only help you manage your diabetes, they also help lower your blood pressure.

Cholesterol

Cholesterol is a form of fat that is carried through the body in two kinds of bundles, or lipoproteins. It's important to have healthy levels of both. Cholesterol is also affected by blood pressure and blood glucose. If your blood glucose and blood pressure are high, your cholesterol numbers may be off as well. Take steps to lower your risk so you can live a longer, healthier life.

Low-density lipoproteins (LDL), or "bad" cholesterol, can lead to a buildup of cholesterol in the arteries. In general, the lower your LDL the better. Reaching your LDL target is the most effective way to protect your heart and blood vessels.

Recommendation
LDL Cholesterol: Less than 100 mg/dl (you may have seen a higher number reported as a goal on your lab results, but for you, since you have diabetes, this is your target!)

High-density lipoproteins (HDL), or "good" cholesterol, helps remove cholesterol from your body. In general, the higher your HDL the better.

Recommendation
HDL Cholesterol: Higher than 40 mg/dl for men and 50 mg/dl for women is good, but an HDL 50 mg/dl or higher helps everyone lower their risk for heart disease.

What are Triglycerides?

Triglycerides are another kind of blood fat that raises your chances for a heart attack or stroke if your levels are too high.

Recommendation
Triglycerides: Less than 150 mg/dl

What Can I Do to Improve My Numbers?

Have your cholesterol checked every 5 years, or more often if there's a problem.
If you smoke, quit.
Lose weight, if needed.
Exercise most days of the week.
Eat a low-fat, low-cholesterol diet with plenty of fresh veggies, whole grains, and fruit.
Increase “healthy” fats in your diet. “Healthy” fats include canola oil, avocado oil, or olive oil.
Talk with your doctor about whether you need a medication to help lower your cholesterol.