What Glucose levels mean and what i should be aiming for

Andy2 said:

I have been advised to test my blood sugar level. however I don't really understand what the numbers mean as there seem to be different levels wherever I look.

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Take a look at this page and see if it answers your questions???

https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

Hi and welcome Andy
Firstly where are you (country) and why have you been advised to check your blood sugar levels?

Andy2 said:

I am in the UK and was advised to check glucose levels as my HbA1C was 45.

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OK so you are pre-diabetic.. assuming that's a 45 mmol/m HbA1c

Ideally you want your bloods to be between 4 and 8 mmol/l (which is what the meter should show you)
very ideally between 4 and 6 mmol/l which would put your pre diabetes into remission.

When you have your next HbA1c below 40 mmol/m would be good.

Are you quite sure your hba1c was 45?

xfieldok said:

Are you quite sure your hba1c was 45?

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It’s how we are given the results, not 6.2 or whatever

Where do you live, UK?

Andy2 said:

Yes it was 45 and the year before it was 50. That is on the HbA1c test.

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Don't worry about the confusion. We all get confused to start with. lol.

Here in the UK,
HbA1c is measured in mmol/mol which gives numbers like your 45 and sometimes up to over 100, with below 42 being normal, and 42-47 being pre-diabetic, and over 48 being diabetic. This is an average reading over the last 2-3 months.

However, when we do our finger prick testing with a home meter, we get a snapshot of what our blood glucose is at that time.
This is measured (in the UK) as mmol/l and gives numbers that could be anywhere from 4 upwards, with 'normal' blood glucose being, as @bulkbiker says, between 4 and 7.

This graphic shows how the different measures line up
(the % figure is how America measures HbA1c, and how the UK used to measure it several years ago. Sometimes you still get old school doctors in the UK giving HBA1c in % but that shouldn't have been used officially for years now)

Andy2 said:

Hi thanks for the diagram. however now I find that the figures written down for me on the booklet that I fill in when testing are as follows: 4-8 Fasting, 4-8 Pre food, 6-12 post food. nothing on what it should be before bed. So these numbers don't match thos you have described. so I don't know if I'm in trouble or not. So I don't really know what to do.

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That is because, in the post I made above, I was quoting the official levels that people get diagnosed with.
Diagnosis is different from daily target levels, and each of us has to make a personal choice about where we want to aim.
'normal' (below 7 will give you the best chance of avoiding long term diabetic complications caused by raised insulin resistance and raised blood glucose)
the target levels listed in your booklet are higher than that, because the NHS usually gives higher targets. They assume that type 2 diabetics won't be motivated, or able, to reduce their blood glucose (could be either option), so they set looser targets. This may, in time lead to a progression of Type 2 diabetes, so many ppl here on the forum aim lower.

You need to take a deep breath, test often enough to work out what is actually happening to your blood glucose before food and 2 hours after the start of your meal, and then decide what target you personally are willing to aim for. Then adjust your diet to reach that target, or accept medication to help you to get there as well.

T2 Diabetes is a condition where the individual, their choices, actions, food and lifestyle, are the biggest factor in controlling it.
So it is mainly up to you to make the decisions and act on them.

The more information you gather (plenty of info in the posts above, and all over the forum, and on all the links you will find on the Diabetes.co.uk main website and on Dietdoctor.com and Jason Fung's website and blog, and all over the internet) for you to make informed choices.

Vegetarianism shouldn't be a problem: Sugar and Starch are going to be a problem.
If you can bear to stop eating sugar you should do so (glucose is less bad than fructose*; 1 sucrose= 1 glucose + 1 fructose, but Fibre is your friend)

T2Ds should definitely look into the benefits of cutting starch: severely reducing carbohydrate intake -cf Keto diet. It might be hard to get carbohydrate right down as a vegetarian but it's the starch that really matters and there's a huge difference between 200g/day and 100g/d
Your doctor might encourage you to keep eating carbs -do your own reading. There might be times when you need carbs -especially if you are taking medication- but I'm completely convinced that starch and sugar are unhealthy as part of your regular diet -your body is generally good at dealing with them in moderation but they are not beneficial and diabetes is your body failing to deal with them. (I eat them anyway because I'm addicted -I'd try much harder not to if I was T2).

Exercise also has a massive impact on BG levels.
Even a short walk after meals can help a lot
Fitness is also incredibly important
Intense exercise can impact your BG levels for days (and not necessarily in ways you would expect).

Adrenaline pushes BG up and weird things happen around waking up time (varies by person as well as many lifestyle factors).
Cortisol also increases BG -stress affects you.

If the doctor says you are "pre-diabetic" I'd treat that as being diabetic and work hard to get it back down.

* This may seem odd since Glucose directly increases your blood sugar level and Fructose does not but Fructose wrecks your liver and sets you producing fat around your organs which is almost certainly at the heart of your problems -both are problematic though and T1Ds prioritise the other way around.

NB the HbA1C number and the finger prick number are totally different units

Your booklet guide numbers are fine but it's better to be at the lower end of those ranges but 6.4 shouldn't be a concern.

The diagram above is to show you what HbA1C means and if you get below 31/5% you don't need to worry about it (unless you're having hypoglycemia episodes but that's a different thing). HbA1C is a measure of your average BG levels over 3 months (weighted to more recent values) so it will be higher than your 'resting' BG level since it includes all those post-meal figures (assuming you eat carbs/starch).


If you are eating starch&sugar you probably go over 8mmol/L within an hour of eating and might not come down for a long time. Your 45 HbA1C likely means you are coming down reasonably quickly still but that will get worse if you don't address it.

The more you exercise the less you need to worry about diet

Also take a look at the benefits of fasting -amazing things happen if you don't eat for 3 days or so (especially if you exercise moderately to burn off the glycogen stores early).
Youtube has lots of videos on this stuff (of varying quality but it's a very digestible source of info).


In the UK the NHS should be giving you all the blood glucose testing strips you want so I recommend testing as often as you feel comfortable with (and keep records).