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Top Blood Sugar Questions and Answers

Our experts answer your questions on how to maintain blood glucose control with diabetes. Plus, learn more about blood sugar basics, such as what high blood sugar is and the best times to check your blood glucose.
  • Answers to Your Top Questions

    When you have diabetes, monitoring your blood sugar is important. But it can be confusing. Our experts answer common questions to help you make the best decisions.

    From defining A1C to discovering if vinegar and cinnamon really lower blood sugar, top diabetes educators explain what you should know about blood glucose checks and control.

  • When Is the Best Time to Check Blood Glucose After a Meal?

    Q: I was recently diagnosed with type 2 diabetes. Should I check my blood sugar two hours from when I start eating or after I finish eating my meal?

    A: Most of the food you consume will be digested and raise blood sugar (blood glucose) one to two hours after you start to eat. To capture the peak level of your blood glucose, check it during this window of time.

    The American Diabetes Association recommends a target of below 180 mg/dl one to two hours after a meal. The American Association of Clinical Endocrinologists recommends a lower target: below 140 mg/dl two hours after a meal.

    Ask your health care provider or diabetes educator what target is right for you. Postmeal blood glucose monitoring (and record keeping) is important because it helps you see how your body responds to the foods you eat and the blood glucose-lowering medications you take, particularly those designed to improve postmeal blood glucose levels. Controlling postmeal blood sugar can help reduce your risk of developing heart and circulation problems.

    Virginia Zamudio Lange, R.N., M.S.N., CDE, is a registered nurse, certified diabetes educator, and a past president of the American Association of Diabetes Educators.

  • What Is A1C?

    Q: The doctor told my mother she has diabetes and her blood glucose is out of control. He said her A1C was 9. What does that mean?

    A: Glycosylated hemoglobin, often referred to as HbA1c or simply A1C, is the measure of a person's average blood glucose level over the last two to three months. The purpose of the A1C test is to give you a sense of your blood glucose control. It is reported as a percentage.

    The American Diabetes Association recommends that most people get their A1C down to 7 percent or less. Other diabetes organizations, such as the International Diabetes Federation and the American Association of Clinical Endocrinologists, suggest 6.5 percent. If your mother's A1C level is 9 percent, this means her blood glucose level, on average, is about 210 mg/dl. This result is high and unhealthy. She should take action to improve her blood glucose control, such as eating more healthfully, being more active, and changing or adding blood glucose-lowering medications. To find out what steps are right for her, encourage her to talk to her health care providers.

    Jeannette Jordan, M.S., R.D., CDE, works for the Medical University of South Carolina in Charleston and consults with the Centers for Disease Control and Prevention.

  • Can the Glycemic Index Help Control Blood Glucose?

    Q: I've read a lot about the glycemic index. Can this help me control my blood sugar?

    A: The glycemic index is a system that ranks carbohydrate-containing foods according to how much they cause blood glucose to rise within two hours after eating compared with the same amount of carbohydrate in glucose or white bread. The premise is that foods with a high glycemic index may cause blood sugar to rise to a higher level than foods with a low glycemic index.

    Unfortunately, this concept doesn't consider many other variables about food, including the ripeness of the food (such as a banana), how much or little it's cooked (such as pasta), and the nonfood variables that affect blood sugar, such as what your blood glucose is when you eat, how much exercise you get, and blood glucose-lowering medications you take.

    Several studies have found a small amount of improvement in blood glucose control and some reduction in postprandial (after-meal) glucose levels when individuals incorporated low-glycemic-index foods into their diets. Other studies suggest no significant difference. The American Diabetes Association says the glycemic index may provide modest additional benefit over what you observe when you only consider the total amount of carbohydrate you eat.

    Jeannette Jordan, M.S., R.D., CDE, works for the Medical University of South Carolina in Charleston and consults with the Centers for Disease Control and Prevention.

  • Do Fruits and Veggies Raise Blood Sugar?

    Q: Why do you give so many recipes with fruits and vegetables? I can't eat them because they raise my blood glucose.

    A: All foods with carbohydrate (including fruits and vegetables) will raise blood glucose. That doesn't mean you should avoid them. Clearly fruits and vegetables are healthy. But one way to keep your blood glucose under control is to make sure your portions aren't too large. Before you give up on these valuable sources of nutrients, carefully examine your meals and the portions you eat.

    The Dietary Guidelines for Americans recommend that everyone, including people with diabetes, eat 2-1/2 cups of vegetables and 2 cups of fruit per day. Fruits and vegetables are important parts of a healthful eating plan. They provide vitamins, minerals, and fiber, and they're relatively low in calories.

    * One serving of a nonstarchy vegetable (1/2 cup cooked) has 5 grams of carbohydrate and 25 calories.

    * One serving of a starchy vegetable (1/2 cup cooked) has 15 grams of carbohydrate and 80 calories.

    * One serving of fruit (1 small piece or 1/2 large piece) has 15 grams of carbohydrate and 60 calories.

    Madhu Gadia, M.S., R.D., is a certified diabetes educator.

  • Does Cinnamon Lower Blood Sugar?

    Q: I've heard cinnamon helps lower blood glucose. Is it true?

    A: Regular ground cinnamon and cinnamon sticks have been used in studies on this question. The amount suggested was 1/2 teaspoon per day. However, the research on cinnamon is inconclusive, and the use of cinnamon has not become part of common clinical practice. More research is needed before conclusions can be made about cinnamon's role in treating diabetes.

    Madhu Gadia, M.S., R.D., is a certified diabetes educator.

  • Why Is Blood Sugar High in the Morning?

    Q. Why does my blood sugar go up in the morning when I've eaten right and taken my blood glucose-lowering medicines the night before?

    A. The main thing that affects fasting blood sugar is the amount of glucose the liver releases during the night -- not the food you ate the night before. In type 2 diabetes, the liver tends to produce and release too much glucose during sleeping hours. The body cannot process all that glucose properly because there isn't enough insulin available, and the body resists the action of the insulin that is present. Insulin resistance tends to be more of a factor in the early morning. So fasting blood sugar levels can be hard to control, as well as the levels after your first meal. Work with your health care provider to find an eating plan and blood glucose-lowering medications that help you keep your blood glucose within target levels.

    Some people with type 1 diabetes have high blood glucose levels in the early morning because of the dawn phenomenon, in which the release of hormones that are antagonists to insulin, such as cortisol and growth hormone, elevates levels. With type 1 diabetes, the body does not produce insulin, which can counteract these other hormones. Or a high glucose level may be a rebound from an overnight episode of hypoglycemia (low blood glucose).

    Virginia Zamudio Lange, R.N., M.S.N., CDE, is a registered nurse, certified diabetes educator, and a past president of the American Association of Diabetes Educators.

    Learn more about high fasting blood sugar in the mornings.

  • Do OTC Pain Relievers Affect Blood Sugar?

    Q. Do Advil, Aleve, and Tylenol or other generic over-the-counter pain relievers have any effect on blood sugar? Should they be taken with or without food?

    A. Advil (ibuprofen) and Aleve (naproxen sodium) are nonsteroidal anti-inflammatory over-the-counter pain relievers. In general, they do not have a marked effect on blood sugar levels. If a person takes diabetes medication from the sulfonylurea class (glyburide, glipizide, glimepiride, etc.) at the same time, there is some risk of low blood sugar. Tylenol (acetaminophen) does not have an effect on blood sugar levels.

    Virginia Zamudio Lange, R.N., M.S.N., CDE, is a registered nurse, certified diabetes educator, and a past president of the American Association of Diabetes Educators.

  • How Do I Know If I'm On Too Much Blood Glucose-Lowering Medication?

    Q. Several times a day I get very shaky and light-headed. I usually grab a glass of orange juice and some peanut butter crackers. This helps, but what else can I do?

    A. You may be taking too much of a blood glucose-lowering medication that can cause low blood glucose (hypoglycemia). Not all of these medications can cause hypoglycemia. Talk to your health care provider as soon as possible to help you adjust the amount of medication you take. This can happen if you're prescribed a medication that can cause low blood sugar (70 mg/dl or below) and at the same time you begin to follow a healthful eating plan and become more physically active. The body becomes more sensitive to insulin, and blood glucose levels decrease. You don't want to have to eat so much to raise your blood glucose that you're defeating the purpose of following a healthful eating plan and being active.

    It's important to realize that fewer blood glucose-lowering medications available today have the potential to cause hypoglycemia when not taken with one that can cause hypoglycemia. Talk to your provider about whether the blood glucose-lowering medication you take can cause low blood glucose.

    Common symptoms of hypoglycemia include:
    * sweating
    * pounding heart
    * fast pulse
    * hunger
    * weakness
    * headache
    * general sense of something not feeling right

    Some behaviors that increase the risk of hypoglycemia are:
    * taking too much medication or insulin
    * skipping or delaying meals
    * eating too little carbohydrate at a meal
    * increasing physical activity without adjusting carbohydrate intake

    To help prevent hypoglycemia, do not skip or delay meals, and make sure you follow a balanced eating plan that includes carbohydrate in your meals and snacks. Talk with your health care provider about whether you need to adjust your medication or eat additional carbohydrate when you're physically active.

    To treat hypoglycemia, raise your blood sugar level quickly by eating or drinking something that contains 15 grams of carbohydrate or carbohydrate-containing glucose. The following are a few good options:
    * 4-6 ounces of fruit juice
    * 3-4 glucose tablets
    * 3-5 peppermint hard candies
    * 8-10 small Life Savers candies
    * 4-6 ounces of a regular (not diet) soft drink

    Hypoglycemia is serious and shouldn't be taken lightly. Review your diabetes management with your health care providers to make sure you're balancing food, exercise, and medication properly.

    Jeannette Jordan, M.S., R.D., CDE, works for the Medical University of South Carolina in Charleston and consults with the Centers for Disease Control and Prevention.

    Madhu Gadia, M.S., R.D., is a certified diabetes educator.

  • What Does It Mean When My Blood Sugar Fluctuates?

    Q. My doctor is not helpful when I ask about fluctuation in blood glucose readings. Can someone help me?

    A. It's perfectly normal for blood sugar levels to fluctuate in people who have diabetes. Ask your doctor or diabetes educator for target ranges for fasting, before meals, and two hours after meals. When you eat, it's likely that your blood glucose will rise -- but strive to follow the goals you've set with your health care provider.

    Eating, especially eating foods that contain carbohydrate, raises your blood glucose. It peaks one to two hours after the first bite, then should drop to premeal levels. Diabetes medications work to lower the glucose level or prevent it from going too high. Physical activity also lowers blood sugar. Stress and illness typically raise blood glucose.

    While you sleep, your liver releases stored glucose to keep the level from dropping too low. In people with diabetes, the liver tends to overcompensate, releasing more than you need. This can lead to a high morning blood glucose reading.

    Virginia Zamudio Lange, R.N., M.S.N., CDE, is a registered nurse, certified diabetes educator, and a past president of the American Association of Diabetes Educators.

  • Tips to Lower Blood Glucose

    You can achieve lower blood glucose numbers! Doing so can help you live a healthier life with diabetes. Feel better and reduce your risk of diabetes complications when you lower your blood sugar levels to your target range. You can help yourself get there.

    Tips to Lower Blood Glucose

    Naturally Lower Blood Sugar

    Get Your A1C Where You Want It!

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