(CMR) Managing diabetes can be very challenging and usually takes commitment to seeing changes in your health. Home blood sugar testing is essential for managing your blood sugar daily, but it does not provide a full picture of what's happening over an extended period.
Doctors may occasionally administer a blood test that measures your average blood sugar level over the past two to three months, called the A1C test or the hemoglobin A1C test.
The A1C test provides another lens on how well your type 2 diabetes management plan is working and how it might be modified to control the condition better, Everyday Health explained. The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of glycated hemoglobin.
An A1C level below 5.7 percent is considered normal, while an A1C between 5.7 and 6.4 percent signals prediabetes, America Diabetes Association stated. Type 2 diabetes is diagnosed when the A1C is at or over 6.5 percent.
Diabetes can be a challenging condition to manage, but Everyday Health suggests making these changes to help improve your day-to-day blood sugar management and lower your A1C:
1. Start an Exercise Plan You Enjoy and Do It Regularly
Find something you enjoy doing that gets your body moving — take your dog for a walk, play a sport with a friend, or ride a stationary bike indoors or a regular bike outdoors.
A good goal is to get 150 minutes of moderate exercise per week, recommends Jordana Turkel, a registered dietitian and certified diabetes educator at Park Avenue Endocrinology and Nutrition in New York City. This is also what the ADA recommends. Different types of exercise (both strength training or resistance training and aerobic exercise) can lower your A1C by making the body more sensitive to insulin, Turkel says. She encourages her patients not to go more than two days in a row without exercising and to aim for two days of strength training.
If you monitor your blood sugar daily, check it before and after exercise. As the Joslin Diabetes Center at Harvard Medical School explains, exercise can cause your blood sugar to rise as more is released from the liver, and blood sugar to fall due to increased insulin sensitivity. Fluctuations in your blood sugar levels can result if you aren't careful. This is particularly important if you are on insulin or another diabetes medication that causes insulin secretion.
2. Eat a Balanced Diet With Proper Portion Sizes
It's best to check with a certified diabetes care and education specialist or a registered dietitian-nutritionist to determine what a balanced diet and appropriate portions mean for you. But a great rule of thumb is to visualize your plate for every meal and aim to fill one-half of it with veggies, one-quarter with protein, and one-quarter with whole grains, says Turkel. If you like fruit, limit your portions to a small cup, eaten with a little protein or lean fat to help you digest the fruit carbohydrates in a manner that is less likely to spike your blood sugar level.
Also, avoid processed foods as much as possible, and say no to sugary sodas and fruit juice, which are high in carbs and calories, and thus can lead to spikes in blood sugar and contribute to weight gain, according to the ADA.
3. Stick to a Regular Schedule, So You Can More Easily Follow Your Healthy Diet and Lifestyle
The ADA points out that skipping meals, letting too much time pass between meals, or eating too often can cause your blood sugar levels to fall and rise too much. This is especially true if you are taking insulin or certain diabetes drugs. Your doctor can help you determine the best meal schedule for your lifestyle.
4. Follow the Diabetes Treatment Plan Your Healthcare Team Recommends
Diabetes treatment is very individualized, with factors including how long you've lived with the disease, your socioeconomic status, and any other conditions you're living with playing a role in the best treatment approach for you.
Your healthcare team will help you determine the steps you need to take to manage diabetes successfully. Always talk to your doctor before making any changes, such as starting a very-low-carbohydrate diet or beginning a new exercise regimen, especially before making any medication or insulin changes.
5. Check Your Blood Sugar Levels as Your Doctor Has Directed
Work with your doctor to determine if and how often you should check your blood sugar. You may be tempted to pick up an A1C home testing kit, but Dowdell does not recommend doing that. As he mentions, day-to-day fluctuations in your blood sugar can be masked by an A1C result that is at your goal level.
Instead, if you have a personal continuous glucose monitor, such as a Dexcom G6 or a Freestyle Libre (or can get one from your healthcare provider), Dowdell recommends checking your “time in range” to see if you are at the optimal level. For many people, that is 70 to 180 milligrams per deciliter (mg/dL) (3.9 to 10 mmol/L), according to ADA guidelines. Having your A1C checked by your healthcare provider every three to six months is sufficient, he adds.
Understanding your A1C levels is an integral part of your overall diabetes management. Don't hesitate to ask your doctor if you have any questions about your A1C levels or what they mean.