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Understanding Your Blood Glucose

A blood glucose test measures how much glucose (a type of sugar) is in your blood. This worksheet will help you learn more about your blood glucose. It will also help you:

• See what you can do to improve your numbers if they are not normal• Talk with your doctor about your blood glucose levels• Keep track of your test results

What Is a Blood Glucose Test?

Blood glucose can be measured using various blood tests. One test uses a handheld glucose meter to measure the sugar level in a small drop of blood, usually from your finger. This type of test can be done at home or in a doctor’s office. Other tests draw a small amount of blood, usually from a vein in your arm, and send it to a lab to be tested.

Your doctor may want to check your glucose levels if he or she thinks you are at risk for diabetes.

The following 2 tests can be done with a small drop of blood from your finger, or a small amount of blood drawn from a vein in your arm.

• Random (also called casual) blood sugar test. Your doctor may order this testif you have symptoms of diabetes, or if your results on other tests have not beennormal. This test can be done at any time of day and does not require fasting.

• Fasting blood sugar test (FBS). Fasting means you don’t eat or drink anything(except water) for at least 8 hours before the test. The FBS is usually done firstthing in the morning before your first meal of the day.

The next 3 tests typically require a small amount of blood drawn from a vein in your arm.

• Hemoglobin A1C (or HbA1c or A1C). If you test your blood sugar at home,your results show your blood sugar at the moment of the test, but not for othertimes of the day. The A1C blood test gives you and your doctor a bigger picture

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of your blood sugar over time. It checks your average blood sugar level from all times of the day and night for the past 2–3 months. How can it do this? Blood glucose attaches to hemoglobin, the oxygen-carrying part of your blood. Hemoglobin cells last about 3 months. So by measuring the average blood sugar content of many hemoglobin cells, you and your doctor can see what your blood sugar has been on average. Your A1C is reported as a percentage that corresponds with an average blood sugar value. For example, an A1C of 6 tells you and your doctor that your average blood sugar over the past 2–3 months was 126.

• Estimated average glucose (or eAG). Like the A1C, the eAG allows you andyour doctor to see your average blood sugar over the past few months. YoureAG is reported in the same way as the readings on glucose meters. Thus aresult of 126 means your blood sugar averaged 126 over the past few months.

• Oral glucose tolerance test (or OGTT). The OGTT is also taken after overnightfasting. Your blood sugars are tested before and 2 hours after you drink a sugaryliquid.

What Is Blood Glucose?

Your blood glucose—also known as blood sugar—is a source of energy for nearly all cells in your body. Blood glucose is vital to your health. But levels that fall above or below the normal range on a regular basis may indicate health problems. Diabetes is the most common issue related to high blood sugar. There are several reasons why your blood glucose may be too high:

• Your pancreas is not making enough insulin.• The insulin in your body is not working properly.• Both of the above

High blood glucose levels may indicate you have diabetes. Your doctor will perform more tests to know for sure. High blood glucose levels may also be a sign of other conditions, such as:

• Swelling and inflammation of the pancreas (pancreatitis)

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• Overactive thyroid gland• Pancreatic cancer• Heart attack or stroke• Severe stress• Certain medicines

Your Plan for Healthy Blood Glucose Levels

If your blood glucose levels are not normal, then you will likely need to take steps to get them to healthy levels. The key thing to know about blood glucose is that you can improve your levels if they are not normal. In most cases, you can do this by making healthy changes. Talk with your doctor about changes you can make. You and your doctor can come up with a plan that’s right for you.

Some of the changes that might be part of your plan include:

• Limiting foods high in glucose or carbs. Foods high in glucose include mostsugary foods such as sweetened beverages, cookies, ice cream, candy, andother sweets. But there are many other non-sweet foods that can also raise yourblood sugar. The most common of these are foods made from simple carbs.These include white bread, white rice, pasta, and other processed foods. Simplecarbs break down into glucose very quickly, which can cause your blood glucoselevels to rise quickly. Be sure to check the nutrition facts label on prepared andpackaged foods to see how much sugar and carbohydrates they contain.

• Eating complex carbohydrates. Complex carbs don’t break down into glucoseas quickly as simple carbs. Eating these types of carbs can help keep your bloodsugar levels lower and more stable. Complex carbs include whole grains, brownrice, and oatmeal. Other good choices are fresh fruits, vegetables, beans, andlegumes. These foods may also help keep you feeling full longer, which can helpwith weight loss.

• Exercise. Regular moderate to vigorous activity helps to lower your blood sugar.This is because as you exercise, your muscles use the glucose in your blood forenergy. Work up to getting 150 minutes of moderate-intensity aerobic activity aweek. Keep in mind it’s best to start slowly. If you haven’t been active in a while,

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start with just 10 minutes of activity and build from there. When you are ready, you can build up to more. Starting slowly can make it easier to change your habits. It can also keep you safe. Be sure to talk with your doctor before you change how active you are.

• Maintaining a healthy weight. Excess weight is a risk factor for diabetes.Excess fat on your body means there is excess fat around the organs that controlyour blood sugar, the liver and pancreas. You and your doctor can talk aboutwhat your weight goal should be and how this can boost your overall health. Youcan also talk about what steps you will take to work toward your goal.

• Taking medicine. For some people, getting regular exercise and eating healthyfoods may be enough to manage their glucose levels. But some people may alsoneed to take medicine. Your doctor may talk with you about taking medicine tohelp manage your glucose levels.

• Managing stress. Strong feelings of stress can raise blood glucose levels. It’simportant to take steps to manage the stress in your life in healthy ways. Youcould learn a relaxation skill. Take a class to help you understand your stresstriggers. Or simply take time to relax and do something you enjoy. Making sureyou get enough sleep can help, too.

With a few changes, you can help shift your blood glucose levels into the healthy range. These changes can help you improve your health and lower your risk for diabetes and other health conditions. Making even small changes may help you move your numbers to a more healthy level. Will you make changes to what you eat? Add more activity to your day? Most of the steps you can take are not big changes. They are small habits that you can work on changing over time.

Talking About Your Blood Glucose With Your Doctor

Take this worksheet with you when you visit your doctor. You can write your test results on this sheet, as well as what you and your doctor discuss. If you have a report from a biometric screening, be sure to take that with you as well. You should also bring a list of any medicines or supplements you take, both prescription and over-the-counter.

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Questions to Ask Your Doctor

What do my blood glucose results tell me? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

What are healthy blood glucose levels for me? And why? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

Should I have my blood glucose tested again? If so, which test should I have and why? When should I be tested again? Do I need to fast before my next test? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

Do I need additional tests? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

What changes can I make to help manage my blood glucose and improve my overall health? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

What medicine or treatment do I need, if any? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

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My Action Plan

I have talked with my doctor about taking these steps to improve my blood glucose:

1. 2. 3.

My Blood Glucose Record

Use these charts to record your test results and keep track of your numbers over time.

Blood glucose results:

Date of test ___________ Type of test: _________________________________ Glucose level ___________mg/dL A1C level ______%

Blood glucose results:

Date of test ___________ Type of test: _________________________________ Glucose level ___________mg/dL A1C level ______%

Blood glucose results:

Date of test ___________ Type of test: _________________________________ Glucose level ___________mg/dL A1C level ______%

This information is not intended to take the place of regular medical care or advice. Please check with your doctor before using this information or beginning any self-care program.

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Credits

Primary Author: Jason NielsenLast Clinical Reviewer: Leilani Fraley, RNLast Review and Approval: Leilani Fraley, RN, 05/25/2018

References

American Diabetes Association (n.d.). Blood glucose testing. Retrieved from http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/

American Diabetes Association (2018). Standards of medical care in diabetes.Retrieved from https://professional.diabetes.org/content-page/standards-medical-care-diabetes

Zamani-Alavijeh, F., Araban, M., Koohestani, H. R., & Karimy, M. (2018). The effectiveness of stress management training on blood glucose control in patients with type 2 diabetes. Diabetology & Metabolic Syndrome, 10, 39. doi: 10.1186/s13098-018-0342-5