The haemoglobin A1C test, also referred to as A1C or HbA1c test, provides an average of a person’s blood glucose levels over the 3 months prior to having the test. An A1C level below 5.7% is normal for someone without diabetes, whilst a level between 5.7% and 6.4% is indicative of pre-diabetes. Diabetes is diagnosed when the A1C level is greater than 6.5%. People with diabetes should aim to keep their A1C levels below 7% to delay the complications of diabetes1.
A hormone formed by beta cells in the pancreas; amylin regulates the timing of glucose release into the bloodstream after eating by slowing the emptying of the stomach.
In a pancreas, the continuous supply of insulin is referred to as the basal (or background) rate. For people with diabetes, the basal rate can be mimicked by long-acting insulin injections on MDI or an ongoing supply of short-acting insulin from an insulin pump.
Bolus insulin is the extra insulin a pancreas would produce in response to glucose consumed in a meal or snack. For a person managing their diabetes using MDI, a short-acting insulin injection is taken before consuming food to act like bolus insulin. For a person on insulin pump therapy, more short-acting insulin (in addition to the amount being given to mimic basal insulin) is administered around mealtimes.
Before starting to use continuous glucose monitoring, it is important to learn the difference between Blood Glucose (BG) and Sensor Glucose (SG) readings - the two key measurements used to monitor your glucose levels. View our short educational video to help you understand (and explain) the difference between the readings. Learn more
Continuous Glucose Monitoring or CGM, is a glucose monitoring tool which uses a sensor that is placed below your skin to continuously measure the amount of glucose in your interstitial fluid (this is the fluid that surrounds all of the cells in your body). Learn more.
The dawn phenomenon refers to a surge of hormones during the early morning. For people without diabetes, insulin responses adjust for this surge. However, people with diabetes do not have this required insulin response, which leads to an increase of the glucose levels.
Excessive blood glucose. Fasting hyperglycaemia is blood glucose above a desirable level after a person has fasted for at least 8 hours. Postprandial hyperglycaemia is blood glucose above a desirable level 1 to 2 hours after a person has eaten.
This therapy mimics the functions of a normal pancreas more closely and replaces the need for frequent injections (e.g. Multiple Daily Injections) by delivering precise doses of rapid-acting insulin. Learn more.
Interstitial fluid is the fluid that surrounds the cells of your tissue below your skin, and usually glucose moves from your blood vessels and capillaries first and then into your interstitial fluid.
Your sensor glucose (SG) readings are taken from your interstitial fluid, and not from your blood, (whereas finger stick readings measure blood glucose)
Excess ketones develop when there is too little insulin in the blood stream and too much glucose. Having excess ketones is a medical emergency and requires urgent medical care.
A spring-loaded device used to prick the skin with a small needle to obtain a drop of blood for blood glucose monitoring. If you have trouble getting an adequate drop of blood, diabetes educators suggest washing your hands with warm water, hanging your hand down by your side, or shaking your hand vigorously like a thermometer before lancing your finger. Each of these techniques can increase the blood supply to your fingertips. After puncturing your finger, gently “milk” it from the knuckle to the fingertip to promote bleeding.
This occurs when an injection site is overused and refers to the build-up of fat deposits under the skin around these sites. The danger is that insulin injected in these locations may be less effective as it is harder for the body to absorb it. To avoid lipohypertrophy, it is important to rotate your injection sites regularly. Learn more about the best way to choose or rotate your sites.
mmol/L (millimoles per litre) and mg/dl (milligrams per decilitre) are units of measurement which indicate the amount of glucose in your blood.
An MDI regimen consists of a minimum of four injections per day. The regimen includes one injection of long-acting insulin ( usually in the evening) and an injection of rapid or short-acting insulin before each meal.
Retinopathy is damage caused to the small blood vessels at the back of the eye, from (uncontrolled) high blood glucose.
Given 98% of serious vision loss - due to diabetes complications - can be prevented with regular eye examinations and treatment, it is important that you have an eye examination at least every two years (or more if directed by your doctor).4
Type 1 diabetes is an autoimmune condition where the body’s immune system has “attacked” the cells in the pancreas that product insulin.; there is no prevention and no cure (to date).
As for Type 2 diabetes, there is no single cause but several well-established risk factors. Many of these factors cannot be changed – such as family history, your ethnicity and where you were born. As for prevention, only up to 58% of Type 2 can be prevented (or delayed) by exercise and healthy eating.
The blood glucose levels for a person without diabetes range between 4.0-7.8mmol/L (72-140mg/dl). To determine your target blood glucose levels, your doctor will consider your age, diabetes type, duration and severity, pregnancy status, the presence of any diabetes complications, types of medications you are taking and your overall health condition. In general, the target blood glucose levels are:
|Diabetes Type||Target blood glucose levels|
|Type 1 diabetes2||
4-6mmol/L (72-106mg/dl) before eating
4-8mmol/L (72-145mg/dl) 2 hours after starting a meal
|Type 2 diabetes3||
6-8mmol/L (106-145mg/dl) before eating
6-10mmol/L (106-180mg/dl) 2 hours after starting a meal
For people with Type 2 diabetes who are not taking insulin or sulphonylurea medication, a normal blood glucose level can be aimed for2.
|Risk of Hypoglycaemia (Type 1 and Type 2)||If insulin or certain medications are used, people with diabetes who are at risk of hypoglycaemia should aim for blood glucose levels of less than 4mmol/L (72mg/dl). Your doctor should inform you if this applies to you.|
The frequency of checking your blood glucose levels depends on your diabetes type and treatment plan. Your doctor will advise how often you should check your levels, but in general:
• Type 1 diabetes: You might be recommended to check your levels 4-8 times per day. This includes before eating, before and after exercise, before bed, and perhaps during the night. More frequent testing might be required if you are unwell, change your routine or commence a new medication.
• Type 2 diabetes: If you use insulin to manage your Type 2 diabetes, you might be recommended to check your levels at least 2 times per day. This testing is done before meals and occasionally before bed. If you manage your Type 2 diabetes with medication or diet and exercise, you may require less frequent testing.
Exercise done at the same time, duration and intensity on a daily basis will ensure the most predictable blood glucose responses. No one day is ever the same, but doing exercise consistently will give the greatest opportunity for stable blood sugars. Remember, though, that other factors such as stress, illness or foods eaten that day will still have an effect. Learn more about eating and exercising.
You cannot reverse your diabetes, but you can control it. Losing weight can put pre-diabetes or Type 2 diabetes into remission. However, aging, weight regain and the natural progression of the condition can bring it back.
Currently, there is no cure for diabetes. However, diabetes can be successfully managed. It is important to eat healthy, exercise and take your insulin or medication to remain healthy and control your blood glucose, blood pressure and cholesterol. It’s also important to be tested for diabetes complications, to treat issues early on.
Not necessarily. Sometimes people with Type 2 diabetes can manage their diabetes with diet and exercise or oral medication. If Type 2 diabetes is treated early enough with good glucose control, the pancreas is more capable of producing insulin for a longer time. However, for somebody who has Type 2 diabetes for 15 or more years insulin will typically be required via injections or insulin pump therapy.
After a diagnosis with Type 2 diabetes or prediabetes, weight loss is particularly important to increase insulin sensitivity. This allows the body’s cells to more effectively use the body’s insulin. Losing 4.5-9kg can improve blood sugar, blood pressure, and cholesterol levels. Losing weight may also mean you can take less medication or smaller doses.
The purpose of insulin is to signal to the body’s cell that they need to take insulin in from the blood. Glucose is then used as energy. To prevent weight gain, follow a healthy diet and exercise to use up energy.
Adults with diabetes can drink alcohol and should follow guidelines recommended to the general population: an average of 1 standard drink a day for women and no more than 2 for men. Having more than three drinks per day can lead to glucose control challenges, however. While alcoholic drinks are made from grains or fruits (i.e. sources of carbohydrates), alcohol cannot be converted into glucose and does not require insulin in order to be converted into energy. People who are on blood glucose-lowering medication or insulin should eat some food whilst drinking alcohol to avoid hypoglycaemia. People with Type 1 diabetes should regularly check their blood glucose levels to avoid hypoglycaemia occurring a number of hours after drinking. Learn more.
Carbohydrates are required for energy and essential nutrients. Fruit is a healthy source of carbohydrates, as well as vegetables, whole grains and legumes.
It is common for women to experience hormone fluctuations before their period, which affects glucose levels. Increased oestrogen can cause increased sensitivity to insulin, leading to hypoglycaemia. Progesterone can have the opposite effect. Within the first few days of a cycle, glucose levels should return to normal. Knowing how your levels fluctuate monthly can assist you to devise a management plan.
Menopause can also cause your glucose levels to fluctuate. During perimenopause a woman who takes insulin may experience hypoglycaemia due to decreasing progesterone levels.
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- Centers for Disease Control and Prevention “A1c Distribution Among Adults with Diagnosed Diabetes, United States, 1988–1994 to 1999–2006” Learn more
- American Diabetes Association “Checking your blood glucose levels” Learn more
- NHMRC, Blood Glucose Control in Type 2 Diabetes. 2009.
- Diabetes & Your Eyes – Diabetes Australia Revised 2010, Learn more