Managing your blood sugar is very important if you have diabetes.
If your blood sugar is too high for a prolonged period of time you increase the risk of damaging many different parts of the body including your heart, nerves, kidneys, eyes and feet. But knowing what affects your blood sugar, and how to monitor and control this effectively will help to reduce the risk of these long-term complications.
What affects your blood sugar levels?
Blood sugar levels are affected by what you eat. Carbohydrates are broken down by your digestive system into sugars that enter the blood. Carbohydrates consist of starches, sugar and fiber. Starches are foods such as bread and pasta, while sugars include sweets and cakes.
Both starch and sugar carbohydrates cause blood sugar to rise, though the effect is slightly different depending on the types of food you eat. Some foods cause our blood sugar to rise slowly (for example, whole wheat bread and whole wheat pasta). And other foods cause a quick spike in blood sugar, followed by a decline (for example, cake and sweets).
How to monitor blood sugar levels.
Blood sugar control can be measured in two different ways:
- A finger prick test that can you tell what is happening immediately, for example I am at risk or blood sugar going to low or high (known as hypoglyceamia and hyperglycaemia respectively)
- A blood test known as HbA1c can help you know how your lifestyle changes affect blood sugar levels over time and helps you maintain control of your diabetes
HbA1c is a blood test performed by your GP to measure long term blood sugar levels, or glycemic control. Hb stands for haemoglobin, the part of your red blood cells that gives them their colour. Sugar in your blood is sticky and attaches to haemoglobin when it enters the blood stream. Red blood cells can live for around three months, so we can measure how much sugar has stuck to the haemoglobin in these cells throughout their lifetime. This test is a reliable way to gain a long term view of how well your sugars are being controlled.
Adults with type 2 diabetes should have this measured regularly (every 3-6 months). You and your GP or specialist diabetes nurse will work together to come up with a target that is individual to you. You should aim for a target that is achievable, but does not cause problems or impact on your quality of life. Adults are generally encouraged to aim for an HbA1c of 48-52mmol/mol (or 6.5-7%) because this is the level at which there is the lowest risk of complications for your health in the future; however everyone is different and you should stick to your individual plan. Diet, lifestyle and medications can all help with managing HbA1c and reducing the risk of long term complications.
What is the finger prick test?
The finger prick test is a quick and easy test that you can do at home if you have your own blood sugar monitor. It involves a small prick on your finger to get a drop of blood which you then apply to a test strip. The blood sugar glucose monitor is a machine that reads the test strip and will give you an almost instant result of at that particular moment. Remember that this test only gives a one-off reading and is not a reflection of long-term control.
Who needs to self-monitor using a sugar meter?
You will not need to routinely measure your blood sugar (glucose) levels using a blood glucose meter (glucometer) unless:
- You are using insulin therapy;
- You are at risk of very low blood sugar (hypoglycaemia);
- You are planning a pregnancy/ are already pregnant
If you need to start self-monitoring your blood sugar levels then your healthcare professional can discuss this with you and together you can set personalised targets, and agree on specific times to measure.