The American Heart Association recommends the following limits of added sugar (sugars not found in fruits and vegetables): no more than 100 calories per day (about 6 teaspoons or 24 grams of sugar) for most women and no more than 150 calories (about 9 teaspoons or 36 grams of sugar) for most men.

If you have diabetes:

Blood sugar targets can be individualized based on a variety of factors such as:

Duration of diabetes
Age/life expectancy
Conditions a person may have
Cardiovascular disease or diabetes complications
Hypoglycemia unawareness
Individual patient considerations

However, in general the American Diabetes Association suggests the following for most adults with diabetes who are not pregnant²:

Less than 7% (154 mg/dL)
Before a meal: 80 to 130 mg/dL
Two hours after the start of a meal: Less than 180 mg/dL

Consult your physician when determining your goals as targets may differ based on age health and whether more or less restrictive goals are appropriate for you.

A1C tests measure average blood sugar for the past 2-3 months and do not require drinking anything or fasting. Prediabetes and diabetes are determined based on the following:

A1C less than 5.7% (117 mg/dL) – normal

A1C between 5.7% and 6.5% (between 117 mg/dL and 140 mg/dL) – prediabetic

A1C 6.5% (140 mg/dL) or higher – diabetic

What is Diabetes and How Can it Affect My Health?

Diabetes is a disease that affects how your body converts sugar into energy. Type 1 diabetes is usually diagnosed in children, teens, and young adults. Thought to be caused by an autoimmune reaction, people with Type 1 diabetes cannot make their own insulin and will have to take it every day to survive. People with Type 2 diabetes can’t use insulin well and can’t keep their blood sugar at normal levels and is usually diagnosed in adults.

Diabetes can cause several other health complications, including ketoacidosis and ketones, neuropathy, skin complications, eye complications, foot complications, kidney disease, cardiovascular disease, high blood pressure, and stroke. Cardiovascular disease is twice as likely to occur in people with diabetes.⁴

Ketoacidosis and Ketones

Your body begins to burn fat for energy when your cells don't get the glucose they need for energy. If enough ketones build up, your blood becomes more acidic, and the high levels of ketones can actually poison your body.

Neuropathy

Researchers think that uncontrolled high blood sugar damages nerves and interferes with their ability to send signals over time. Neuropathy is more common in those who have had diabetes for several years. The most common neuropathy is peripheral neuropathy, which affects the nerves in the hands, feet, legs, and arms. Autonomic neuropathy affects the nerves that control the bladder, intestinal tract, and other organs. Other types of neuropathy include Charcot’s Joint, cranial, femoral, and focal neuropathy, compression mononeuropathy, thoracic/lumbar radiculopathy, and unilateral foot drop.

Skin Complications

Skin conditions can be one of the first indicators of diabetes. While anyone can get the following infections, diabetics are known to get bacterial infections (styes, boils, folliculitis, carbuncles, infections around the nails), fungal infections (moist, red areas surrounded by tiny blisters and scales), and itching (yeast infections, dry skin, or poor circulation) more easily.

Conditions specifically related to diabetes include: acanthosis nigricans (tan or brown raised areas on the sides of the neck, armpits, and groin), diabetic dermopathy, necrobiosis lipoidica diabeticorum, allergic reactions, diabetic blisters, eruptive xanthomatosis, digital sclerosis, and disseminated granuloma annulare.

Eye Complications

Glaucoma, cataracts, and diabetic retinopathy (nonproliferative and proliferative retinopathy and macular edema). Factors that influence your chances of retinopathy include blood sugar control, blood pressure levels, length of time you’ve had diabetes, and your genes.

Foot Complications

If you have peripheral neuropathy that affects your feet, you can experience tingling, burning or stinging, weakness in your feet, or even loss of feeling, which means you could injure yourself without knowing it. Establishing a foot care routine can help you avoid more serious complications later.

Wash, dry, and moisturize your feet thoroughly every day; wash and dry in between your toes but avoid moisturizing there.
Trim your toenails regularly, using an emery board/nail file to keep the edges smooth.
Look for sores, cuts, blisters, corns, or redness and let your doctor know if you find any.
Wear moisture wicking socks.
Wear shoes that fit well and always check them for sharp objects before putting them on.

In addition to a good foot care routine, it’s important to not walk around barefoot or soak your feet and to stop smoking.

Kidney Disease

Not everyone with diabetes will develop kidney disease, but blood sugar is one of the factors that influences the chances for developing kidney disease. The high sugar levels from diabetes can make the kidneys filter too much blood, damaging the kidneys and eventually causing them to fail. Taking control of your blood sugar and blood pressure are important steps to preventing and managing kidney disease.

Establish healthy lifestyle and diet habits – exercise regularly, eat less salt, avoid alcohol and tobacco, lose some weight, take medications as directed by your healthcare provider, and follow any other medical advice they provide.

Cardiovascular Disease, High Blood Pressure, and Stroke

The number one cause of death in people living with diabetes is cardiovascular disease (CVD). Heart disease is twice as likely in people with diabetes than those without it. Managing blood pressure can help decrease risk for diabetes. The harder your heart has to work, the more at risk you are for diabetes and heart disease. Strokes are 1.5 times more likely to happen in people living with diabetes compared to those who don't have diabetes. Proper diet, exercise, and diabetes management can help reduce the risk of CVD and its complications. Visit KnowDiabetesbyHeart to learn more.

For more information about potential health complications from diabetes, consult your healthcare provider.

What Happens When My Blood Sugar Levels Aren’t Normal?

While diabetes is generally the cause of spikes and dips in blood sugar, you do not have to have diabetes to experience high or low blood sugar.

High blood sugar (hyperglycemia) Symptoms

If your blood sugar level is too high, you may experience:

Increased thirst
Frequent urination
Fatigue
Nausea and vomiting
Shortness of breath
Stomach pain
Fruity breath odor
A very dry mouth
A rapid heartbeat

What can cause increased blood sugar?

An increased or high blood sugar is referred to as hyperglycemia.

Too much food, like a meal or snack with more carbohydrates than usual
Dehydration
Not being active
Not enough insulin or oral diabetes medication
Side effects from other mediations, such as steroids or anti-psychotic medications
Released hormones due to illness, stress, menstrual periods, or short-term pain

Low blood sugar (hypoglycemia) Symptoms

If blood sugar levels become too low, signs and symptoms can include:

An irregular or fast heartbeat
Fatigue
Pale skin
Shakiness
Anxiety
Sweating
Hunger
Irritability
Tingling or numbness of the lips, tongue, or cheek

What can cause decreased blood sugar?

Not enough food, like a meal or snack with fewer carbohydrates than usual, or missing a meal or snack
Alcohol, especially on an empty stomach
Too much insulin or oral diabetes medication
Side effects from other medications
More physical activity or exercise than usual

Seek a doctor's help immediately if:

You have what might be hypoglycemia symptoms and you don't have diabetes
You have diabetes and hypoglycemia isn't responding to treatment, such as drinking juice or regular soft drinks, eating candy, or taking glucose tablets

How can I Maintain My Target Blood Sugar Levels?

While different individuals may have specific management and treatment plans, most individuals would benefit from building and following:

A Healthy Meal Plan
- Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt
- Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta
- Fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese
- Drink water
- Plating – ½ the plate with fruits and vegetables, ¼ with a lean protein (beans, chicken, turkey without the skin), and ¼ with a whole grain (brown rice or whole wheat pasta)
A Workout Plan
Blood Sugar Testing Schedule
Self-Care Routines

Consult your healthcare provider if you have concerns about your blood sugar. Your healthcare provider should be able to help you determine what your blood sugar targets should be and how to reach them.

This blog post is for informational purposes only. It is not intended to diagnose or treat any conditions or illnesses or act as a substitute for professional medical advice.

U.S. National Library of Medicine, Medline Plus. Blood Sugar
American Diabetes Association. The Big Picture: Checking Your Blood Glucose.
American Diabetes Association. Understanding A1C: Diagnosis
American Diabetes Association. Diabetes: Complications.
Mayo Clinic. Hyperglycemia in diabetes: Overview
Mayo Clinic. Hypoglycemia: Overview

Heart Health Part 2: Blood Sugar

Heart Health Part 2: Blood Sugar

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