Guide To Prediabetes: Symptoms Causes And Treatments
Approximately one in three Americans have prediabetes, according to the CDC. However, the majority of cases go undiagnosed and untreated. Prediabetes is when your blood sugar levels are higher than normal, but not yet high enough to be classified as diabetes. Prediabetes symptoms often go undetected, and without prediabetes treatment, blood vessels and nerves can be damaged. This can lead to heart disease and stroke, and eventually, develop into type 2 diabetes.
Type 2 diabetes, the next stage after prediabetes, is when your body cannot regulate blood sugar levels correctly because you can no longer produce or properly use the hormone insulin. When your body cannot properly use insulin, its known as insulin resistance. Without the proper use of insulin, blood glucose levels can get dangerously high. This is because insulin is a hormone that helps your cells use and process glucose.
What Should Your Blood Sugar Be When You Wake Up
Whenever possible, aim to keep your glucose levels in range between 70 and 130 mg/dL in the morning before you eat breakfast, and between 70 and 180 mg/dL at other times. For some people, including older adults or pregnant women, a slightly looser or tighter glucose range might be best, and you should discuss with your healthcare provider what your goals may be.
Managing your glucose levels is key to preventing short and long-term complications. Though the occasional high blood glucose wont put you in immediate danger consistently high glucose levels over a long period of time are associated with complications of diabetes such as heart disease and stroke, chronic kidney disease, nerve damage, eye disease and more.
Additionally, high glucose levels especially in people with type 1 diabetes can put you in immediate danger. These high levels, if combined with high blood ketone levels, can cause diabetic ketoacidosis , a potentially life-threatening condition that occurs when a person has high blood ketones and not enough insulin. Symptoms of DKA include shortness of breath, fruity-smelling breath, nausea and vomiting, confusion, or loss of consciousness.
How To Stabilize Your Blood Sugar Overnight
The most important thing you can do to stabilize your blood sugar is monitor your glucose levels at bedtime, during the night, and when you wake up to look for patterns. This will help you determine whats going on in your body and how you can fix it. While there are many strategies people use to stabilize blood sugar at night, every person is different youll have to look for trends in your body, experiment with ways to lower glucose levels over a period of time, and learn what works best for your body.
Check your blood sugar before bed. If its already high, your blood sugar levels may remain high throughout the night. To address this, youll want to start by adjusting when you eat your evening meal and what it consists of, and how much mealtime insulin you take to cover it.
Avoid eating lots of food close to bedtime. For diaTribe writer Adam Brown, the key to staying in range overnight is low-carb, early dinners, with no snacking after dinner.
Consider eating less food at night and taking more basal insulin to cover your evening meal.
Check your blood sugar during the night, between midnight and 3am. If you were in range before bed but have high glucose levels between midnight and 3am, you may need to adjust your basal insulin dosage and timing. If you are low during that time, you may experience a rebound high blood sugar later on this is usually associated with overcorrecting the low.
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How Do Carbs Affect Blood Sugar
Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.
Causes Of High Blood Sugar At Night
There are many causes of high blood sugar at night, including:
- A dinner or bedtime snack high in carbohydrates: Eating starchy or high-sugar foods late in the day can lead to high blood sugar at night, as well as high blood sugar in the morning.
- Illness or injury: Trauma can trigger a hypermetabolic response , leading to high blood sugar.
- Too little exercise: Exercise helps the body more effectively use insulin, so lack of exercise could contribute to high blood sugar.
- Too little insulin or diabetes medicine: When the body does not produce insulin or does not use insulin effectively and you dont properly take your injectable insulin or diabetes medicine, glucose can accumulate in the bloodstream.
- Menstruation: Estradiol and progesterone are two hormones linked to a decreased production of insulin, which affects glucose metabolism and can potentially lead to high blood sugar.
- Pregnancy: Hormone levels fluctuate during pregnancy. Diabetes that occurs during pregnancy is known as gestational diabetes.
- Stress: Stress, as measured by levels of a hormone called cortisol, is linked to decreased insulin production. When your body doesn’t have enough insulin, glucose cannot get into your cells and be used for energy. As a result, glucose builds up in the bloodstream, leading to high blood sugar. When people are stressed, they may also overeat sugary foods or adopt other unhealthy eating habits.
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How Do I Treat Low Blood Glucose
If you begin to feel one or more symptoms of low blood glucose, check your blood glucose level. If your blood glucose level is below your target or less than 70 mg/dL, follow these steps
How Accurate Are A1c Tests
A1C levels rise well before the clinical onset of diabetes, making early diagnosis possible according to the 2017 Standards of Medical Care in Diabetes by the American Diabetes Association . Sometimes, however, in the early stages of diabetes, blood sugar levels are not high enough to show up as problematic. Testing environments, such as temperature in the lab, equipment used, and handling of samples, can affect the results however, this is more common in the fasting plasma glucose and the OGTT than in the A1C. Strict quality controls and advancements in testing have made the A1C test more precise than in the past, according to the NIDDK. Doctors should be aware of laboratories that use an NGSP-certified method of testing for A1C levels. The NIDDK warns that blood samples taken at home or analyzed in a healthcare providers office should not be used for diagnosis.
There are some health conditions and situations that might skew the results of the test. These include:
- Blood loss or blood transfusions
Also, the test can be unreliable for people of African, Mediterranean, or Southeast Asian descent, people with a family member with sickle cell anemia, and those with thalassemia. For those who fall into these groups, a healthcare provider might suggest a different test or a specialized A1C.
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What Should You Do If You Are Prediabetic
If youve been to see your doctor, and a blood test confirms you are prediabetic, there are many simple steps you can take to reverse the condition and prevent it from developing into diabetes.
Your healthcare providers will suggest help and guidance, like the best lifestyle changes considering your medical history and circumstances. Steps they may recommend include cutting out processed sugar, consuming more vegetables and whole grains, and taking a walk every morning.
A valuable resource for many prediabetic patients in the United States is the National Diabetes Prevention Program . Through private and public partnerships, it aims to prevent or delay type 2 diabetes by making it easier for Americans to make the lifestyle changes they need.
In some cases, they may even recommend medication. Whatever your doctor suggests, remember prediabetes can be reversed and its great you caught it early.
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What Are Blood Sugar Targets
A blood sugar target is the range you try to reach as much as possible. These are typical targets:
- Before a meal: 80 to 130 mg/dL.
- Two hours after the start of a meal: Less than 180 mg/dL.
Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.
Always Follow Up With The Doctor
It is very important to call your doctor as soon as possible after experiencing nocturnal hypoglycemia. The patient and doctor should try to figure out what caused the episode and how to prevent it from happening again.Often the doctor will suggest:
Changing the dose or timing of insulin or other medications
Setting an alarm for the early morning so that the patient can test their blood glucose levels and determine how often the episodes occur
Having the person wear a continuous glucose monitor that checks blood glucose every five minutes with an alarm that wakes the patient from sleep if levels start to drop too low. This option is usually reserved for patients who experience frequent or severe nocturnal hypoglycemia
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Easy Before Bed Routines For People With Diabetes
You might be surprised to learn what your blood sugar should be at bedtime. The range is usually 5.0-8.3 mmol/L , and its important to check what yours is before going to bed. Checking your blood sugar before you go to sleep will give you information about what caused any spikes or dips in the day that you might not have noticed. For instance, if your nighttime reading were high, this would tell us that something may have happened during the day that could affect your diabetes management plan.
Creating a bed routine can also be helpful if your blood sugar at bedtime is higher than what youd like it to be. For instance, rather than eating or drinking anything sweet before bedtime and then checking how what should happen next for diabetes management will depend on what the readings are in the morning, try adding this into a routine:
- Always check your bloog glucose levels with a glucose meter or your CGM
- Eat dinner earlier in the evening
- Don’t drink sugar-sweetened beverages before bedtime
- Eating a nitrile snack before bed helps maintain your blood sugar normal and prevents your liver from releasing excess glucose
- Limit alcoholic beverages to the extent they disturb sleep
- Too close to bed exercises often can cause poor sleeping habits
- Avoid eating caffeine within several hours of going to bed
- Take medicine if needed to lower your blood sugar levels, but dont take too much insulin so you wont have a low reading in the morning.
Continue Learning About Diabetes
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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What Is A Good A1c Level
Levels between 5.7 and 6.4 are considered prediabetes. For most people with diabetes, the general A1C goal is to have a level between 6.0 and 6.9. While it might sound like the ideal A1C target is under 6.0, for those with diabetes, this level can indicate low blood sugar levels, which can be just as dangerous as high blood sugar levels. If A1C results fall between 7.0 and 8.9, a doctor might suggest lifestyle changes or medications to help lower the levels to what is considered controlled. However, for some people, these levels might be appropriate, such as:
- Those with a limited life expectancy
- People with long-standing diabetes who have trouble reaching a lower goal
- Those with severe hypoglycemia or the inability to sense hypoglycemia
How Much Is Metformin Without Insurance
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Metformin hydrochloride is a generic prescription drug used along with diet and exercise to lower blood sugar levels in people diagnosed with Type 2 diabetes mellitus. It reduces blood glucose levels by increasing the uptake of blood sugar by the bodys cells. Metformin is typically prescribed not only as a first-line treatment for Type 2 diabetes but is often used with other antidiabetic drugs when metformin alone cannot adequately control blood sugar.
Usually taken twice per day, doses will be determined based on blood sugar levels. The standard dose is 850 to 1000 mg per day, but this could rise to as much as 2,550 mg per day. Metformin is most commonly prescribed as a generic, but there are brand-name versions of metformin and extended-releasemetformin: Glucophage, Glucophage XR, Fortamet, Glumetza, Riomet, and Riomet ER. Note that several of the brand-name versions, including Glucophage, Glucophage XR, and Fortamet, have been discontinued in the U.S. There are no over-the-counter drugs or supplements that can be effectively or safely substituted for prescription metformin.
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How Does Blood Glucose Affect Sleep
Just as sleep affects blood sugar levels, blood sugar levels may also impact sleep quality. A study of people with type 2 diabetes found that those with higher blood sugar levels experience poorer sleep. Another study found that 62% of people with glucose levels in the pre-diabetes range are likely to have poor sleep, compared to 46% of people with normal glucose levels.
Researchers arent certain why increased blood sugar may be associated with poor sleep and more study is necessary to understand the relationship.
How Lark Can Help
Lark Diabetes can provide additional support for lowering high morning blood sugar and keeping blood sugar levels within target ranges the rest of the time. The personalized coaching program includes medication reminders and tracking for blood glucose measurements so you can check your history and see how you have been doing with your blood glucose in the morning and at other times of the day.
Lark assists with weight loss coaching, healthy eating to lower blood sugar, and increasing physical activity with tips, logging, and in-the-moment insights to build healthy habits that are just as important for managing diabetes as taking your meds. You can chat with your Lark coach anytime via your smartphone.
High morning blood sugar can come as a surprise if you think you are doing everything right for your diabetes, but it can be a sign that there is room for improvement. With a little troubleshooting, and some help from your doctor, you may be able to lower morning blood glucose and get blood sugar in check the rest of the day, too. Lark for Diabetes can support your efforts to develop healthy habits that keep blood glucose under control for good.
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What Are Clinical Trials For Low Blood Glucose
Clinical trialsand other types of clinical studiesare part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of low blood glucose levels in diabetes, such as
- how to diagnose and treat low blood glucose among people with diabetes
- medicines that can treat symptoms of low blood glucose in people with hypoglycemia unawareness
- educational approaches to reduce fear of low blood glucose, which can make it harder for you to control your diabetes