By Amy Campbell, MS, RD, LDN, CDE
This blood sugar chart shows normal blood glucose levels before and after meals and recommended HbA1c levels for people with and without diabetes.
|BLOOD SUGAR CHART|
|Normal for person without diabetes||70–99 mg/dl (3.9–5.5 mmol/L)|
|Official ADA recommendation for someone with diabetes||80–130 mg/dl (4.4–7.2 mmol/L)|
|1 to 2 hours after meals|
|Normal for person without diabetes||Less than 140 mg/dl (7.8 mmol/L)|
|Official ADA recommendation for someone with diabetes||Less than 180 mg/dl (10.0 mmol/L)|
|Normal for person without diabetes||Less than 5.7%|
|Official ADA recommendation for someone with diabetes||Less than 7.0%|
Source: American Diabetes Association
A fasting blood sugar (sometimes called fasting plasma glucose or FPG) is a blood sugar that is measured after fasting (not eating or drinking anything, except water) for at least 8 hours. The purpose of doing a fasting blood sugar test is to determine how much glucose (sugar) is in the blood, and this test is commonly used to check for diabetes or prediabetes. The blood test is usually measured at a lab, at the doctor’s office or at a hospital. A blood sample may be drawn from a vein in your arm and collected in a tube which will then be analyzed by a lab. Or, a blood sample may be obtained by doing a fingerstick with a lancet.
A normal fasting blood glucose for someone who does not have diabetes ranges from 70 to 99 mg/dl. The American Diabetes Association recommends a routine screening for type 2 diabetes starting at age 45. If the results are normal, the screening should be repeated every 3 years.
If have diabetes risk factors, which include being overweight or obese, having a family history of type 2 diabetes, having a history of gestational diabetes, or being of a certain race/ethnicity (African American, Latino, Asian American, Pacific Islander, or Native American), you should be screened for diabetes sooner than age 45.
Children and adolescents who have diabetes symptoms or who are overweight and have a family history of type 2 diabetes, are of African American, Latino, Asian American, Native American or Pacific Islander descent, who have signs of prediabetes (acanthosis nigricans, high blood pressure, high cholesterol) or a mother who had gestational diabetes should be tested beginning at age 10 and then every 3 years thereafter.
A fasting blood sugar of 100 to 125 mg/dl is indicative of prediabetes, which is a condition where blood sugar levels are above “normal” but not high enough to be considered diabetes. Prediabetes is a risk factor for type 2 diabetes, heart disease and stroke. It’s managed by lifestyle changes and, in some cases, medication.
The American Diabetes Association recommends a fasting blood sugar target of 80 to 130 mg/dl for most nonpregnant adults with diabetes. However, the fasting blood sugar target may need to be individualized for certain people based on such factors as duration of diabetes, age and life expectancy, cognitive status, other health conditions, cardiovascular complications and hypoglycemia unawareness. It’s important that people with diabetes discuss their target blood sugar goals with their health-care provider.
A normal blood sugar is lower than 140 mg/dl. A blood sugar between 140 and 199 mg/dl is considered to be prediabetes, and a blood sugar of 200 mg/dl or higher can indicate diabetes. Someone who does not have diabetes is unlikely to be checking their blood sugars. However, one of the screening tests for diabetes is called an oral glucose tolerance test, or OGTT. (A slightly different version of the OGTT is also used to diagnose gestational diabetes, which is diabetes that develops during pregnancy). For this test, the person needs to fast overnight and go to the doctor’s office or a lab in the morning. A blood sample will be used to measure the fasting blood sugar. The person then drinks a sugary drink that contains 75 grams of sugar. Two hours later, blood sugar is checked again.
The American Diabetes Association recommends that the blood sugar 1 to 2 hours after the beginning of a meal be less than 180 mg/dl for most nonpregnant adults with diabetes. This is typically the peak, or highest, blood sugar level in someone with diabetes. Again, this target may need to be individualized for certain people based on such factors as duration of diabetes, age and life expectancy, cognitive status, other health conditions, cardiovascular complications and hypoglycemia unawareness. It’s important that people with diabetes discuss their target blood sugar goals with their health-care provider.
The HbA1C test is a blood test that provides average levels of blood glucose over the past 3 months. Other names for this test are hemoglobin A1C, A1C, glycated hemoglobin, and glycosylated hemoglobin test. A person does not need to fast before having their HbA1C test measured; in other words, it’s OK to eat or drink something beforehand. The HbA1C test may not be accurate for some people, including those with anemias and for those receiving treatment for HIV, and for people of African, Mediterranean or Southeast Asian descent. The HbA1C result is reported as a percentage; the higher the percentage, the higher the blood sugar level.
In addition to being a tool for diagnosing diabetes, the HbA1C test is used to help people who have diabetes manage their condition.
For someone who does not have diabetes, a normal HbA1C level is below 5.7%. An A1C between 5.7% to 6.4% is indicative of prediabetes.
It’s recommended that adults over the age of 45 — or adults under 45 who are overweight and have one or more risk factors for diabetes — have a baseline A1C checked. If the result is normal, the A1C should be checked every 3 years. If the result indicates prediabetes, the A1C should be checked every 1 to 2 years.
The American Diabetes Association recommends an HbA1C of less than 7% for most nonpregnant adults with diabetes. A lower goal, such as less than 6.5%, may be appropriate for some people who have had diabetes for a shorter amount of time, for younger people, for those without heart disease and/or for those with type 2 diabetes treated with lifestyle or metformin only. A higher HbA1C goal, such as less than 8%, may be appropriate for people with a history of severe hypoglycemia, a limited life expectancy, advanced diabetes complications, other illnesses, or for whom a lower HbA1C goal is difficult to achieve. It’s important that people with diabetes discuss their target blood sugar goals with their health-care provider.
HbA1C levels should be checked between 2 to 4 times per year in people who have diabetes.
The fasting blood sugar, 2-hour post-meal blood sugar and HbA1C tests are important ways to diagnose prediabetes and diabetes, as well as indicate how well a person’s diabetes is being managed. If you think you have diabetes, it’s important to not try and diagnose yourself by doing a fingerstick with a home blood glucose meter. There are strict standards and procedures that laboratories use for diagnosing diabetes; therefore, you should get tested at your doctor’s office or at a laboratory.
It’s also important to talk with your doctor to make sure you understand a) how often you should have certain tests, such as a fasting blood glucose or HbA1C test; b) what your results mean; and c) what your blood sugar and HbA1C targets are.
If you have not been previously diagnosed with prediabetes or diabetes but your results are above “normal,” your doctor may recommend other tests and should discuss a plan of treatment with you. Treatment may include lifestyle changes, such as weight loss, a healthy eating plan and regular physical activity. You may need to start taking diabetes medications, including insulin. If you are diagnosed with diabetes, it’s recommended that you learn how to check your blood sugars with a meter so that you and your healthcare team can determine how your treatment plan is working for you.
En Español: ¿Qué es Un Nivel Normal de Azúcar en Sangre?
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