About Blood Sugar

The blood sugar basics

Do you know how to control your blood sugar? If you are one of the millions of Americans living with diabetes, learning the basics is a great first step to help you manage your condition.

There are two ways to monitor blood sugar:

  • Self-tests using a glucose meter that measures your blood sugar at a specific moment
  • The A1C test performed by your doctor, which shows your average blood sugar level over the past 2-3 months

For many people with diabetes, the American Association of Clinical Endocrinologists (AACE) recommends an A1C of 6.5 percent or less to help reduce the risk of serious long-term health problems. Nearly half of people with diabetes are not at an A1C of <6.5%. In addition to knowing your A1C, testing your blood sugar at home using a glucose meter will give you a more complete picture of your blood sugar control.

People with diabetes need to be aware of:

  • High blood sugar (hyperglycemia)
  • Low blood sugar (hypoglycemia)

If you are diagnosed with type 2 diabetes, it means that your healthcare provider has found your blood sugar to be too high. However, both high and low blood sugar can be serious for patients if they go untreated.

It’s important to monitor and control your blood sugar, and working with your diabetes healthcare team to set your A1C goal and blood sugar goals, as well as tracking your progress over time, is a great way to get started!

What is blood sugar and how does it work in the body?

  • Blood sugar, or blood glucose, is the body’s main source of energy
  • When you eat food, the body breaks down the sugars and starches into glucose, which then enters the bloodstream
  • Insulin, an important hormone produced in the pancreas, helps glucose move from the blood into most of the body’s cells, where it can be used for energy

What happens when blood sugar levels are too high or too low?

  • When blood sugar is too high, called hyperglycemia, people with diabetes may have symptoms such as frequent urination, increased thirst, fatigue or blurred vision. In severe cases, high blood sugar can require emergency treatment; therefore, it’s important to test your blood sugar right away if you think you are experiencing a high blood sugar episode. It’s also important to ask your diabetes healthcare team, how often you should test your blood sugar to keep track of your blood sugar control between office visits
  • When blood sugar drops too low, called hypoglycemia, people with diabetes may feel sweaty, dizzy, hungry and shaky. It’s important to recognize the signs and symptoms of low blood sugar right away and take steps to raise it to help reduce the risk of serious consequences

What are my blood sugar and A1C goals?

  • Talk with your diabetes healthcare team about setting your own blood sugar targets and developing a treatment plan to help you meet those targets
  • An A1C recommended for many people with diabetes is 6.5 percent or less to help reduce the risk of serious long-term health problems such as blindness, amputation, heart disease and stroke. A higher A1C may be appropriate for some people. Talk with your diabetes healthcare team about the right A1C goal for you
  • Following a well-balanced, healthy meal plan, staying physically active and taking your medication as prescribed are key components of controlling blood sugar successfully, and can help you meet your personal blood sugar goals
  • Diabetes is a progressive disease and sometimes changes in medication may be needed to help control your blood sugar. If your doctor decides it is time to change your medication, it may not mean you haven’t tried hard enough – many people need to adjust their treatment plan over time to help them reach their blood sugar goals

How are blood sugar and A1C levels tested?

  • Self-monitoring your blood sugar is an important aspect of controlling diabetes
  • A blood glucose meter measures your blood sugar at a specific moment and it is the most accurate and easy way to test blood sugar regularly
  • Having your A1C tested is a crucial step in understanding your blood sugar control – the A1C test reflects your average blood sugar levels over the past 2-3 months
  • The staff at your health care provider’s office or a lab usually performs the A1C test and the results are reported as a percentage
  • Blood sugar self-monitoring and A1C testing can give you a more complete picture of your blood sugar control and a good idea of how your diabetes treatment plan is working

How often should I check my blood sugar and A1C?

  • It’s important to check blood sugar regularly to make sure it is within range of your goals. Talk with your diabetes healthcare team to develop a schedule for regular, at-home blood sugar testing that works for you
  • According to AACE guidelines, patients at an A1C of 6.5 percent or less should have their A1C tested at least twice a year, while patients not at this goal should be tested at least four times a year
  • Keeping a log of your blood sugar results and your A1C test results is important and can help give you and your diabetes healthcare team a good picture of your body’s response to your diabetes care plan
  • It’s important to test your blood sugar right away if you experience symptoms of low or high blood sugar


Etie Moghissi, MD, FACP, FACE

Dr. Etie Moghissi is a clinical endocrinologist involved in patient care in private practice in Marina del Rey, California, as well as an associate clinical professor of medicine at the University of California, Los Angeles. She is Board Certified in Internal Medicine and Endocrinology and is a member of the board of trustees of the American Collage of Endocrinology.

As a clinical endocrinologist, I treat a number of people with type 2 diabetes and know that managing the disease can be a difficult undertaking. The initial diagnosis is often overwhelming and many patients do not realize that high blood sugar levels over time can lead to serious long-term complications.

That’s why I’m working on the Blood Sugar Basics: Get to Your Goals program to provide you with clear tools and missions that encourage you to know your A1C and talk to your diabetes healthcare team (including your primary care provider, endocrinologist, and/or diabetes educator) about setting and attaining your blood sugar goals.

By working with your diabetes healthcare team, you can develop an individualized treatment plan and learn more about how lifestyle changes, such as meal planning and physical activity, and medication, when prescribed, all play key roles in helping you reach your A1C goal and blood sugar goals. For more advice about type 2 diabetes management and the importance of teaming up with your doctor, click here.

I am very excited about Get to Your Goals and hope that you find it to be a helpful resource. I know how important it is for people with type 2 diabetes to work with their diabetes healthcare team to set personal goals and a plan for achieving them, and that’s exactly where you’ll start with the first mission of Get to Your Goals – Gather Intelligence.