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Understanding Diabetes

What is diabetes? 

Diabetes is a condition where your blood glucose (sugar) levels are abnormally high.

Glucose comes from the food we eat and is also produced by our liver. Glucose is the main source of energy for the body’s cells and is transported through the bloodstream.

Glucose needs to enter the cells to be used and when that happens, blood glucose levels go back to normal.  Insulin, a hormone produced by our body, serves as a key to let glucose into our cells.

In diabetes, your body either doesn’t make enough insulin, and/or doesn’t use insulin well (i.e. insulin resistance). When this happens, your blood glucose level increases since glucose cannot enter the cells in our body. This then leads to diabetes. 

Complications of poorly controlled diabetes 

Poorly controlled diabetes increases your risk of serious complications such as heart disease, stroke, eye or nerve damage, and kidney failure. 

You can keep your blood sugar levels under control by managing your lifestyle (healthy diet with portion control and regular exercise) as well as taking your prescribed medications. This will help to reduce your risk of developing diabetes-related complications. 

Monitoring of Diabetes

Monitoring of diabetes is important for good control to reduce risk of developing complications. Monitoring should be done using a combination of blood glucose levels and HbA1c measurements.

Blood Glucose Level

  • Your blood glucose level reading tells you the current level of glucose in your blood (e.g. after a meal).

  • Monitoring can be performed using finger pricks, or flash glucose monitors.

  • In general, the ideal blood glucose levels are:

    • Before meals: 4 - 7 mmol/L

    • 2 hours after meals: <10 mmol/L

HbA1c

  • HbA1c reflects the average blood glucose level over 3 months. It is used to track diabetes control over a longer period of time.

  • In general, the ideal HbA1c level for most individuals with diabetes is <7%

Hypoglycemia prevention & management 

Hypoglycemia or low blood glucose levels (<4mmol/L) can happen for various reasons: 

  • Having a poor appetite or skipping meals

  • Taking excess diabetes medications or insulin

  • Unplanned exercise or alcohol 

Symptoms of hypoglycemia include hunger, cold sweat, dizziness, blurred vision, feeling “shaky” or feeling weak or tired. 

If you experience symptoms of hypoglycemia, do the following:

  1. Check your blood sugar levels if you are able to.

  2. If your sugar levels are low (below 4mmol/L), take 1/2 a glass of sweetened beverage (e.g. regular soft drink, fruit juice), 1 tablespoon of honey or sugar, or 6-7 jelly beans.

  3. Recheck your blood sugar levels in about 15 minutes. In the meantime, inform someone (e.g. friend or family member) about your condition.

  4. If your blood sugar levels are still low after 15 minutes, take another 1/2 a glass of sweetened beverage or 6-7 jelly beans and seek medical attention immediately.

  5. Once your blood sugar levels are back to normal (above 4mmol/L), consume a slower-acting carbohydrate such as 1 piece of fruit or 1 slice of bread.

Tips to prevent hypoglycemia

  • Do not skip or delay your meals 

  • Take your medications at the right time and at the prescribed dose 

  • Check your blood sugar levels regularly