A Guide for Persons with Diabetes on Controlling Blood Glucose

30 Aug 2025

A Guide for Persons with Diabetes on Controlling Blood Glucose Diabetes is a chronic health condition that affects how your body turns food into energ...

A Guide for Persons with Diabetes on Controlling Blood Glucose

Diabetes is a chronic health condition that affects how your body turns food into energy. Most of the food you eat is broken down into sugar (glucose) and released into your bloodstream. Your pancreas makes insulin, a hormone that acts like a key to let blood sugar into your body’s cells for use as energy. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make. This causes blood glucose levels to rise higher than normal.

Related reading: Managing Type 2 Diabetes A Complete Guide To Glucose Control

Controlling your blood glucose (also known as blood sugar) is essential for managing diabetes and preventing serious health complications. This guide will provide you with practical strategies and information to help you achieve optimal blood glucose control. Effective management is a continuous process, and understanding the interplay between diet, exercise, medication, and monitoring is crucial.

Understanding Blood Glucose Levels

Knowing your target blood glucose range is the first step in effectively managing diabetes. Work with your healthcare provider to determine the optimal range for you, as this can vary depending on the type of diabetes you have, your age, and any other existing health conditions.

Related reading: Mastering Type 2 Diabetes A Beginner S Guide To Blood Sugar Control

General Target Ranges:

  • Before Meals (Preprandial): 80-130 mg/dL
  • 1-2 Hours After Starting a Meal (Postprandial): Less than 180 mg/dL
  • A1C (Average Blood Sugar Over 2-3 Months): Less than 7% (as recommended by the American Diabetes Association for many non-pregnant adults). A1C goals need to be individualized

| Category | A1C (%) | Estimated Average Glucose (mg/dL) | |--------------------------------|---------|--------------------------------------| | Normal | <5.7 | <117 | | Prediabetes | 5.7-6.4 | 117-139 | | Diabetes Target Range (General) | <7.0 | <154 |

It's crucial to understand that these are general guidelines, and your individual target range may differ. Always consult with your healthcare provider to determine what’s right for you. They may recommend a different A1C target based on factors such as age, other medical conditions, and your ability to recognize and treat low blood sugar.

The Cornerstone: Diet and Nutrition

Diet plays a significant role in blood glucose control. Making informed food choices and understanding how different foods impact your blood sugar is essential.

Key Dietary Recommendations for Diabetes Management:

  1. Focus on Complex Carbohydrates:
    • What they are: These are slowly digested carbohydrates that provide a steady release of glucose into the bloodstream, preventing rapid spikes.
    • Examples: Whole grains (brown rice, quinoa, oats), legumes (beans, lentils), and non-starchy vegetables.
    • Why they matter: Unlike simple sugars, complex carbs offer sustained energy and are often rich in fiber.
  2. Limit Simple Sugars and Refined Carbs:
    • What they are: These are quickly digested carbohydrates that can cause a rapid increase in blood glucose levels.
    • Examples: White bread, sugary drinks (soda, juice), candy, and pastries.
    • Why they matter: These offer little nutritional value and can contribute to poor blood sugar control.
  3. Prioritize Fiber Intake:
    • What it is: Fiber is a type of carbohydrate that the body cannot digest.
    • Examples: Fruits, vegetables, whole grains, and legumes.
    • Why it matters: Fiber helps slow down the absorption of sugar, prevents constipation, and can even lower cholesterol levels. Aim for at least 25-30 grams of fiber per day.
  4. Choose Lean Proteins:
    • What they are: Proteins with lower fat content.
    • Examples: Poultry (skinless), fish, tofu, and lean cuts of beef.
    • Why they matter: Protein helps keep you feeling full and satisfied, preventing overeating. They have a minimal impact on blood sugar levels.
  5. Healthy Fats in Moderation:
    • What they are: Unsaturated fats that support heart health.
    • Examples: Avocados, nuts, seeds, and olive oil.
    • Why they matter: While important for overall health, fats can still impact blood sugar if consumed in excess.
  6. Portion Control:
    • What it is: Being mindful of how much food you're eating at each meal.
    • Why it matters: Even healthy foods can raise blood sugar if consumed in large quantities. Use smaller plates and bowls and measure portions when possible.
  7. Hydration is Key:
    • What it is: Drinking enough water throughout the day.
    • Examples: Water, unsweetened tea, and infused water.
    • Why it matters: Helps regulate blood sugar levels and prevent dehydration. Avoid sugary drinks as they contribute to rapid blood sugar spikes.
  8. The Plate Method: This is a visual tool to help you build balanced meals:
    • Half the plate: Non-starchy vegetables (broccoli, spinach, salad)
    • One quarter of the plate: Lean protein (chicken, fish, tofu)
    • One quarter of the plate: Complex carbohydrates (brown rice, quinoa, whole-wheat pasta)

Sample Meal Plan (Adaptable to Individual Needs):

| Meal | Example | |----------------|-----------------------------------------------------------------------------------------------------------| | Breakfast | Oatmeal with berries and a sprinkle of nuts | | Lunch | Grilled chicken salad with mixed greens, avocado, and a light vinaigrette dressing | | Dinner | Baked salmon with roasted broccoli and quinoa | | Snacks (Optional) | Apple slices with peanut butter, a handful of almonds, or Greek yogurt with berries |

Always work with a registered dietitian or certified diabetes educator to create a personalized meal plan that meets your individual needs and preferences. They can help you understand carbohydrate counting, glycemic index, and how to adjust your diet based on your medication and activity levels.

The Power of Exercise and Physical Activity

Regular physical activity is another critical component of blood glucose management. Exercise improves your body's sensitivity to insulin, which helps your cells use glucose more effectively.

Benefits of Exercise for Diabetes:

  • Lowers Blood Glucose Levels: During exercise, your muscles use glucose for energy, which helps lower blood sugar.
  • Improves Insulin Sensitivity: Regular exercise makes your body more responsive to insulin, reducing the amount of insulin needed.
  • Helps Manage Weight: Exercise helps burn calories and build muscle mass, which is essential for weight management.
  • Reduces Risk of Heart Disease and Stroke: Diabetes increases the risk of cardiovascular diseases, and exercise can help lower this risk.
  • Boosts Mood and Energy Levels: Exercise releases endorphins, which have mood-boosting effects.

Recommended Exercise Guidelines:

  • Aerobic Exercise: Aim for at least 150 minutes of moderate-intensity aerobic exercise per week. This could include brisk walking, cycling, swimming, or dancing.
    • Example: 30 minutes of brisk walking, 5 days a week.
  • Resistance Training: Include resistance training (weightlifting, bodyweight exercises) at least 2-3 times per week.
    • Example: Lifting weights, using resistance bands, or doing bodyweight exercises like squats and push-ups.
  • Flexibility and Balance Exercises: Incorporate exercises like yoga or tai chi to improve flexibility and balance.
  • Break Up Sedentary Time: Even short bursts of activity throughout the day can make a difference.
    • Example: Stand up and walk around for a few minutes every hour.

Important Considerations Before Exercising:

  • Check Blood Glucose Before and After Exercise: Monitor your blood sugar levels before, during, and after exercise to understand how your body responds.
  • Adjust Insulin or Food Intake: Depending on your blood sugar levels, you may need to adjust your insulin dose or eat a snack before exercising.
  • Stay Hydrated: Drink plenty of water before, during, and after exercise.
  • Wear Proper Footwear: Choose shoes that fit well and provide good support to prevent foot problems.
  • Carry a Medical ID: Wear a medical ID bracelet or necklace that indicates you have diabetes.

Precautions:

  • If your blood sugar is too high (over 250 mg/dL), avoid vigorous exercise until it's under better control.
  • If you take insulin or certain diabetes medications, be aware of the risk of hypoglycemia (low blood sugar) during and after exercise. Carry a quick source of carbohydrates (glucose tablets, juice) in case your blood sugar drops too low.

Consult with your healthcare provider before starting a new exercise program, especially if you have any other health conditions. They can help you create a safe and effective exercise plan that meets your individual needs.

Medication Management

For many people with diabetes, medication is an essential part of managing blood glucose levels. Medications work in various ways to lower blood sugar, including:

  • Insulin: Replaces the insulin that your body is not producing or using effectively.
  • Oral Medications: Enhance insulin sensitivity, stimulate insulin production, or reduce glucose absorption.
  • Injectable Medications (Non-Insulin): Help regulate blood sugar levels and can promote weight loss.

Types of Diabetes Medications:

  1. Insulin:
    • Rapid-acting insulin: Begins working within 15 minutes, peaks in about 1-2 hours, and lasts for 2-4 hours.
      • Examples: Lispro (Humalog), Aspart (NovoLog), Glulisine (Apidra).
    • Short-acting insulin: Starts working within 30 minutes to 1 hour, peaks in 2-3 hours, and lasts for 3-6 hours.
      • Example: Regular (Humulin R, Novolin R).
    • Intermediate-acting insulin: Begins working within 2-4 hours, peaks in 4-12 hours, and lasts for 12-18 hours.
      • Example: NPH (Humulin N, Novolin N).
    • Long-acting insulin: Starts working within a few hours and lasts for up to 24 hours.
      • Examples: Glargine (Lantus, Basaglar), Detemir (Levemir), Degludec (Tresiba).
  2. Oral Medications:
    • Metformin: Reduces glucose production in the liver and improves insulin sensitivity.
    • Sulfonylureas: Stimulate the pancreas to release more insulin.
    • DPP-4 Inhibitors: Help increase insulin release and decrease glucose production in the liver.
    • SGLT2 Inhibitors: Increase glucose excretion in the urine.
    • Thiazolidinediones (TZDs): Improve insulin sensitivity.
  3. Injectable Medications (Non-Insulin):
    • GLP-1 Receptor Agonists: Enhance insulin release, decrease glucose production, and promote weight loss.

Important Considerations for Medication Management:

  • Follow Your Healthcare Provider's Instructions: Take your medications as prescribed and at the correct times.
  • Monitor Blood Glucose Regularly: Check your blood sugar levels as directed by your healthcare provider to see how your medications are working.
  • Be Aware of Side Effects: Learn about the potential side effects of your medications and report any concerns to your healthcare provider.
  • Never Skip Doses or Change Your Dosage: Without consulting with your healthcare provider.
  • Store Medications Properly: Follow storage instructions provided by your pharmacist.

If you have any questions or concerns about your medications, don't hesitate to contact your healthcare provider or pharmacist. They can provide you with valuable information and support.

Regular Blood Glucose Monitoring

Monitoring your blood glucose levels is essential for understanding how your body responds to food, exercise, and medication. Regular monitoring helps you and your healthcare team make informed decisions about your diabetes management plan.

Methods of Monitoring Blood Glucose:

  1. Blood Glucose Meter (Glucometer):
    • How it works: You prick your finger with a lancet to obtain a small drop of blood, which you then place on a test strip inserted into the meter. The meter provides a blood glucose reading within seconds.
    • Benefits: Affordable, easy to use, and provides immediate results.
  2. Continuous Glucose Monitor (CGM):
    • How it works: A small sensor is inserted under the skin and measures glucose levels in the interstitial fluid (fluid surrounding cells) every few minutes. The sensor transmits data to a receiver or smartphone.
    • Benefits: Provides continuous, real-time glucose readings, identifies trends, and can alert you to highs and lows.
  3. A1C Test:
    • How it works: A blood test that measures your average blood glucose level over the past 2-3 months.
    • Benefits: Provides a long-term picture of your blood glucose control.

Frequency of Monitoring:

The frequency of blood glucose monitoring depends on several factors, including:

  • Type of Diabetes: People with type 1 diabetes typically need to monitor their blood glucose more frequently than people with type 2 diabetes.
  • Medication Regimen: If you take insulin, you may need to monitor your blood glucose several times a day.
  • Individual Goals: Your healthcare provider will determine the appropriate monitoring schedule based on your individual needs and goals.

General Guidelines for Blood Glucose Monitoring:

  • Before Meals: To see how your blood sugar is before you eat.
  • 1-2 Hours After Starting a Meal: To see how your body responds to food.
  • Before Exercise: To ensure your blood sugar is in a safe range.
  • Before Bed: To prevent overnight hypoglycemia.
  • When You Suspect Hypoglycemia or Hyperglycemia: If you experience symptoms of low or high blood sugar.
  • When You Are Sick: Illness can affect blood sugar levels.

Keeping a Log:

  • Record Blood Glucose Readings: Keep a record of your blood glucose readings, along with the date, time, and any relevant information (food, exercise, medication).
  • Identify Trends: Look for patterns in your blood glucose readings to identify factors that affect your blood sugar.
  • Share Your Log with Your Healthcare Provider: Bring your blood glucose log to your appointments so your healthcare provider can review your progress and make any necessary adjustments to your diabetes management plan.

Addressing Hypoglycemia (Low Blood Sugar)

Hypoglycemia occurs when blood glucose levels drop too low (typically below 70 mg/dL). It's a common complication of diabetes treatment, especially for people who take insulin or certain oral medications.

Causes of Hypoglycemia:

  • Taking Too Much Insulin:
  • Skipping Meals or Eating Too Little:
  • Exercising Without Adequate Carbohydrate Intake:
  • Drinking Alcohol:
  • Certain Medications:

Symptoms of Hypoglycemia:

  • Shakiness:
  • Sweating:
  • Dizziness:
  • Confusion:
  • Irritability:
  • Hunger:
  • Headache:
  • Blurred Vision:
  • Rapid Heartbeat:
  • Loss of Consciousness (Severe Hypoglycemia):

The 15-15 Rule for Treating Hypoglycemia:

  1. Check Blood Glucose: If possible, check your blood glucose level to confirm that it is low.
  2. Eat or Drink 15 Grams of Quick-Acting Carbohydrates: Examples include:
    • Glucose Tablets:
    • 4 Ounces of Juice or Regular Soda:
    • 1 Tablespoon of Honey or Sugar:
    • Hard Candies (Check Label for Carb Content):
  3. Wait 15 Minutes: Allow the carbohydrates to raise your blood glucose level.
  4. Recheck Blood Glucose: After 15 minutes, recheck your blood glucose level.
  5. Repeat if Necessary: If your blood glucose is still below 70 mg/dL, repeat steps 2-4 until your blood sugar is within the target range.
  6. Eat a Meal or Snack: Once your blood glucose is back in the target range, eat a meal or snack to prevent another drop.

If You Are Unable to Treat Yourself:

  • Glucagon Injection: If you are unable to eat or drink, someone can give you a glucagon injection. Glucagon is a hormone that raises blood glucose levels quickly.
    • Emergency Situations: Glucagon is primarily reserved for serious cases when the person is passed out, unconscious or has seizures.
  • Call for Emergency Help: If glucagon is not available or if you do not respond to glucagon, call for emergency medical assistance.

Prevention of Hypoglycemia:

  • Monitor Blood Glucose Regularly: To identify patterns and prevent lows.
  • Adjust Insulin or Medication Doses: As needed, in consultation with your healthcare provider.
  • Eat Regular Meals and Snacks: And avoid skipping meals.
  • Carry a Source of Quick-Acting Carbohydrates: With you at all times.
  • Educate Family and Friends: About the signs and symptoms of hypoglycemia and how to treat it.

Hypoglycemia can be dangerous if left untreated. It's important to recognize the symptoms and take prompt action to raise your blood glucose levels.

Managing Hyperglycemia (High Blood Sugar)

Hyperglycemia occurs when blood glucose levels are too high (typically above 180 mg/dL after a meal or consistently above your target range).

Causes of Hyperglycemia:

  • Eating Too Many Carbohydrates:
  • Skipping or Missing Medication Doses:
  • Illness or Infection:
  • Stress:
  • Inactivity:

Symptoms of Hyperglycemia:

  • Frequent Urination:
  • Excessive Thirst:
  • Blurred Vision:
  • Fatigue:
  • Headache:
  • Slow-Healing Sores or Cuts:

Strategies for Lowering High Blood Sugar:

  1. Check Blood Glucose: Confirm that your blood glucose is elevated.
  2. Take Corrective Action:
    • Insulin: If you take insulin, administer a correction dose as directed by your healthcare provider.
    • Exercise: Engage in moderate-intensity exercise, such as walking, to help lower blood sugar.
  3. Drink Plenty of Water: To help flush out excess glucose.
  4. Review Your Meal Plan: Assess your recent food intake to identify any dietary factors that may have contributed to the high blood sugar.
  5. Monitor Blood Glucose Regularly: Check your blood glucose more frequently until it returns to the target range.

When to Seek Medical Attention:

  • If Blood Glucose Remains High: Despite taking corrective action.
  • If You Develop Symptoms of Diabetic Ketoacidosis (DKA): DKA is a serious complication of diabetes that can occur when blood glucose levels are very high. Symptoms include nausea, vomiting, abdominal pain, fruity-smelling breath, and difficulty breathing.
  • If You Are Unable to Keep Down Fluids: Or if you have any other concerns.

Preventing Hyperglycemia:

  • Follow Your Diabetes Management Plan: Including diet, exercise, and medication.
  • Monitor Blood Glucose Regularly: And adjust your treatment plan as needed.
  • Stay Hydrated:
  • Manage Stress:
  • Get Regular Checkups: With your healthcare provider.

Uncontrolled hyperglycemia can lead to serious health complications. It's important to take steps to manage high blood sugar and prevent it from becoming a chronic problem.

Complications of Poor Blood Glucose Control

Persistent high blood glucose levels can lead to a range of serious health complications affecting nearly every part of the body, including:

  • Cardiovascular Disease: Increased risk of heart attack, stroke, and peripheral artery disease.
  • Neuropathy (Nerve Damage): Numbness, tingling, and pain in the hands and feet.
  • Nephropathy (Kidney Damage): Can lead to kidney failure and the need for dialysis or kidney transplant.
  • Retinopathy (Eye Damage): Can lead to blindness.
  • Foot Problems: Increased risk of infections, ulcers, and amputations.
  • Skin Conditions: Increased risk of bacterial and fungal infections.
  • Hearing Impairment:
  • Alzheimer's Disease:

Minimizing the Risk of Complications:

  • Achieve and Maintain Target Blood Glucose Levels:
  • Control Blood Pressure and Cholesterol:
  • Quit Smoking:
  • Get Regular Eye and Foot Exams:
  • Maintain a Healthy Weight:

The Role of Your Healthcare Team

Managing diabetes effectively requires a collaborative approach with your healthcare team. This team may include:

Related reading: The Complete Guide To Understanding And Improving Your A1C Blood Sugar

  • Endocrinologist: A doctor who specializes in diabetes.
  • Primary Care Physician: Your general practitioner.
  • Certified Diabetes Educator (CDE): A healthcare professional who provides education and support on diabetes self-management.
  • Registered Dietitian (RD): A nutrition expert who can help you develop a personalized meal plan.
  • Pharmacist: A healthcare professional who can answer questions about your medications.
  • Other Specialists: Such as podiatrists, ophthalmologists, and cardiologists, as needed.

How Your Healthcare Team Can Help:

  • Diagnosis and Management Plan: Providing a diagnosis and developing a personalized diabetes management plan.
  • Education and Support: Providing education and support on all aspects of diabetes management.
  • Medication Management: Prescribing and managing your medications.
  • Blood Glucose Monitoring: Reviewing your blood glucose logs and making recommendations for adjustments.
  • Screening for Complications: Performing regular screenings for diabetes-related complications.
  • Referrals to Specialists: Referring you to specialists as needed.

Being an Active Member of Your Healthcare Team:

  • Attend Appointments Regularly: And be prepared to ask questions.
  • Share Information: About your blood glucose levels, medications, diet, and exercise.
  • Follow Recommendations: And work together to achieve your goals.
  • Communicate Concerns: And report any changes in your health status.

Effective diabetes management is a lifelong journey that requires knowledge, commitment, and support. By understanding the principles outlined in this guide and working closely with your healthcare team, you can take control of your blood glucose levels and live a healthy, fulfilling life with diabetes.