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This information was reviewed and approved by Dthia Kalkwarf (12/31/2013).

Diabetes is a disease in which the pancreas is unable to make insulin or the body is unable to use insulin or both. This leads to high blood sugar levels in the blood. Blood sugar is another way to say blood glucose. Your  body needs blood glucose for energy to be able to do work, including walking, breathing, and even thinking.

View Diabetes Blood Glucose Log Sheet

A diagnosis of diabetes can be made based on any of the following test results:

  • Hemoglobin A1C. An A1C of equal to or greater than 6.5%.

  • Fasting blood glucose test. A blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an 8-hour fast.

  • A random (taken at any time of day) blood glucose level of 200 mg/dL or more, along with the presence of diabetes symptoms, on 2 or more occasions.

  • Oral glucose tolerance test. A blood glucose level of 200 mg/dL or more,  2 hours after drinking a beverage containing 75 grams of glucose dissolved in water.

Gestational diabetes is diagnosed based on blood glucose levels measured during the oral glucose tolerance test, though the cutoffs for diagnosis are lower because glucose levels are normally lower during pregnancy.

The Hemoglobin A1c test tells the doctor and patient the average blood sugar level over the last 3 months.

A person without diabetes

A1c less than or equal to 5.6%


A1c 5.7 to 6.4%


A1C equal to or greater than 6.5%

Healthy level for a person with diabetes

A1c less than 7.0%


What Causes A1c Levels to be high?

High average blood sugars over the past 3 months may be from:

  • Weight gain
  • Too many carbohydrates from foods and drinks
  • Not getting enough exercise  
  • Not taking diabetes medicines as prescribed
  • Diabetes medicines need to be adjusted or changed
  • Illness
  • Stress
  • Addition of medications, i.e. prednisone


How Can My A1c Be Lowered to a Healthy Level?

  • Work with your health care team to achieve weight loss if that is a goal
  • Limit how many carbohydrates you eat and drink
  • Be physically active 30 – 60 minutes at least 5 days a week, such as brisk  walking
  • Take medications as prescribed by your doctor


Your A1c level should be drawn every 3 – 6 months to best understand your overall blood sugar control. Your diabetes educator(s) can help you to balance diet, encourage exercise, understand medications, and help you cope  with stress to improve your A1C level and manage your diabetes.

Things You Can Do to Control Your Diabetes

  • Maintain a healthy weight
  • Eat a balanced diet
  • Be active
  • Check your blood sugar
  • Take medication as directed
  • Get your eyes, feet, blood pressure, and cholesterol checked
  • Understand how to detect and fix high and low blood sugar


View 7 Steps for Better Living with Diabetes Infographic


Diabetes treatment revolves around a combination of lifestyle management and insulin.

Diabetes is usually first found in children, teenagers, or young adults. If you have diabetes, you must take insulin because your body no longer makes it. You also might need to take other types of diabetes medicines that work with insulin.

Type 2 diabetes is the most common form of diabetes, which occurs when the body builds up resistance to insulin. If the body can't keep up with the need for insulin, you may need diabetes medicines. Many choices are available. Your doctor might prescribe two or more medicines. 

Gestational diabetes is diabetes that occurs for the first time during pregnancy. The hormones of pregnancy or a shortage of insulin can cause gestational diabetes. Most women with gestational diabetes control it with meal planning and physical activity, but some women need insulin to reach their target blood glucose levels.


Methods of Administering Insulin

When you have diabetes, your body has trouble using insulin to move glucose into body cells for energy.  Insulin is vital for the body to survive, so some people with diabetes need to get the insulin through other means.

  • Taking injections. You'll give yourself shots using a needle and syringe. The syringe is a hollow tube with a plunger. You will put your dose of insulin into the tube. Some people use an insulin pen, which looks like a pen but has a needle for its point.
  • Using an insulin pump. An insulin pump is a small machine about the size of a cell phone, worn outside of your body on a belt or in a pocket or pouch. The pump connects to a small plastic tube and a very small needle. The needle is inserted under the skin and stays in for several days. Insulin is pumped from the machine through the tube into your body.
  • Using an insulin jet injector. The jet injector, which looks like a large pen, sends a fine spray of insulin through the skin with high-pressure air instead of a needle.

Possible side effects of insulin may include low blood glucose and weight gain.

Type 1 Diabetes

  • The body cannot make insulin
  • Requires insulin injection
  • Is not treated with oral diabetes medicines (pills)


Type 2 Diabetes

  • The body still makes insulin, but insulin is not working as well to let glucose into your body cells, or not enough insulin is being released
  • Treated with oral diabetes medications (pills)
  • Can progress to needing insulin

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