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Blood sugar, or blood glucose, is the main sugar found in your blood. It is your body’s primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps your cells take in glucose and use it for energy.

If your body does not make enough insulin or cannot use it well, glucose builds up in your blood. This can lead to high blood sugar, or hyperglylycemia, which can cause serious health problems, such as diabetes, heart disease, stroke, kidney disease, nerve damage, and eye problems.

Blood sugar levels

The blood sugar level, blood sugar concentration, blood glucose level, or glycemia, is the measure of glucose concentrated in the blood. The body tightly regulates blood glucose levels as a part of metabolic homeostasis. Glucose levels are usually lowest in the morning, before the first meal of the day, and rise after meals for an hour or two by a few millimoles. Blood sugar levels outside the normal range may be an indicator of a medical condition.

A persistently high level is referred to as hyperglycemia; low levels are referred to as hypoglycemia. Diabetes mellitus is characterized by persistent hyperglycemia from any of several causes, and is the most prominent disease related to failure of blood sugar regulation. There are different methods of testing and measuring blood sugar levels. The blood glucose target range for diabetics, according to the American Diabetes Association, should be 5.0–7.2 mmol/l (90–130 mg/dL) before meals, and less than 10 mmol/L (180 mg/dL) after meals (as measured by a blood glucose monitor).

Keeping track of your blood sugar is a key part of diabetes management. Whether those glucose levels are checked with a fingerstick meter or a continuous glucose monitor (CGM), it’s an important part of daily life with this condition, along with the future possibility of diabetes-related complications. But just what is considered “normal” when it comes to blood sugar levels? Diabetes is different for everyone, meaning that target goals will vary for each person and those goals will depend on many different factors.

While this is an area to consult with your doctor and diabetes care team about, the medical community has guidance on what certain people should strive for in blood glucose levels. The 2022 standards from the American Diabetes Association (ADA) are a set of guidelines followed by many professionals in the diabetes field. This chart details goals for specific groups of people with diabetes.

Group	Before meals (fasting)	After meals (post-prandial)	Other
Adults with type 1 diabetes	80–130 mg/dL	< 180 mg/dL (1 or 2 hours after)
Adults with type 2 diabetes	80–130mg/dL	< 180 mg/dL and (1 or 2 hours after)
Children with type 1 diabetes	90-130 mg/dL		90–150 mg/dL at bedtime/overnight
Pregnant people (T1D, gestational diabetes)	< 95 mg/dL	140 mg/dL (1 hour after)	120 mg/dL (2 hours after)
65 or older	80–180 mg/dL		80–200 mg/dL for those in poorer health, assisted living, end of life
Without diabetes	99 mg/dL or below	140 mg/dL or below

As with all aspects of diabetes management, these guidelines are used as a starting point by the medical community. One’s individual goals may vary, based on your personal needs. Make sure to consult with your doctor and diabetes care team to determine what may be best for you.

Low blood sugar

Low blood sugar (also called hypoglycemia) has many causes, including missing a meal, taking too much insulin, taking other diabetes medicines, exercising more than normal, and drinking alcohol. Blood sugar below 70 mg/dL is considered low. Signs of low blood sugar are different for everyone. Common symptoms include: shaking, sweating, nervousness or anxiety, irritability or confusion, dizziness, hunger. Know what your individual symptoms are so you can catch low blood sugar early and treat it.

If you think you may have low blood sugar, check it even if you don’t have symptoms. Low blood sugar can be dangerous and should be treated as soon as possible. The best way to treat low blood sugar is to eat or drink something that has about 15 grams of fast-acting carbohydrate, such as glucose tablets, juice, soda, or candy. Check your blood sugar again after 15 minutes and repeat the treatment if needed. Once your blood sugar is back to normal, eat a snack or meal to prevent it from dropping again.

High blood sugar

High blood sugar (also called hyperglycemia) occurs when your body does not have enough insulin or cannot use insulin properly. High blood sugar can be caused by eating too much, being sick or stressed, skipping or taking the wrong dose of diabetes medicine, or being less active than usual. High blood sugar can cause symptoms such as: increased thirst, frequent urination, blurred vision, fatigue, headache, nausea, or dry mouth. If left untreated, high blood sugar can lead to serious complications, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS).

These are medical emergencies that require immediate treatment. To prevent high blood sugar, you should follow your diabetes care plan, which includes checking your blood sugar regularly, taking your diabetes medicines as prescribed, eating healthy foods, and being physically active. You should also have a sick day plan and know what to do if your blood sugar is too high.

One of the ways to measure how well your diabetes is controlled is to do an A1C test. This is a blood test that shows your average blood sugar level over the past 2 to 3 months. The A1C test measures the percentage of hemoglobin, a protein in your red blood cells, that has glucose attached to it. The higher your blood sugar levels, the more hemoglobin with glucose attached.

The A1C test result is reported as a percentage. The higher the percentage, the higher your blood sugar levels have been. A normal A1C level is below 5.7 percent. A level of 5.7 to 6.4 percent means you have prediabetes, and a level of 6.5 percent or higher means you have diabetes. For most people with diabetes, the ADA recommends an A1C of less than 7 percent.

Your doctor may have a different goal for you, depending on your age, health, and other factors. You should have an A1C test at least twice a year, or more often if your doctor advises.

I hope this information helps you understand more about blood sugar and how it affects your health. Please remember that this is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your blood sugar or diabetes.

Foods that can help you lower and control your blood sugar levels

There are many foods that can help you lower and control your blood sugar levels. These foods have a low glycemic index (GI), which means they do not cause a rapid rise in blood glucose after you eat them. They also contain nutrients that can improve your insulin sensitivity and reduce inflammation. Some examples of foods that do not raise blood sugar and help control it are:

1.   Avocados: These fruits are rich in healthy fats and fiber, which can help you feel full and prevent overeating. Avocados also have a very low GI of 10–30.

2.   Fish with omega-3 fatty acids: These include salmon, trout, tuna, mackerel, and halibut. Omega-3 fatty acids can lower triglycerides, improve blood pressure, and reduce inflammation. Fish is also a good source of protein, which can help regulate your blood sugar levels.

3.   Garlic: This herb has been shown to lower fasting blood glucose and improve insulin sensitivity. Garlic also has anti-inflammatory and antibacterial properties. You can add more garlic to your meals or try a garlic spread as a substitute for butter or salad dressing.

4.   Sour cherries: These fruits contain anthocyanins, which are antioxidants that can protect against type 2 diabetes and obesity. Sour cherries also have a low GI of 22 and are lower in sugar than many other fruits.

5.   Vinegar: This condiment can help lower the post-meal blood sugar spike by slowing down the digestion of carbohydrates. Vinegar also has anti-glycemic and anti-obesity effects. You can use vinegar as a salad dressing or add it to soups, sauces, or marinades.

6.   Vegetables: Non-starchy vegetables, such as broccoli, spinach, kale, cauliflower, carrots, and tomatoes, are low in calories and carbohydrates, but high in fiber, vitamins, minerals, and phytochemicals. They can help fill you up, lower your blood sugar, and prevent oxidative stress. You can eat them raw, cooked, or in salads, soups, or stir-fries.

7.   Chia seeds: These seeds are high in fiber, protein, omega-3 fatty acids, and antioxidants. They can help lower blood sugar, cholesterol, and blood pressure. They also have a low GI of 1 and can absorb water and form a gel-like substance in your stomach, which can reduce your appetite and calorie intake. You can add chia seeds to smoothies, oatmeal, yogurt, or baked goods.

8.   Cacao: This is the raw form of chocolate, which contains flavonoids, magnesium, and polyphenols. These compounds can lower blood sugar, improve insulin sensitivity, and protect against cardiovascular disease. Cacao also has a low GI of 10–40 and can boost your mood and energy. You can use cacao powder or nibs to make hot chocolate, smoothies, or desserts.

9.   Berries: These include blueberries, strawberries, raspberries, and blackberries. They are rich in antioxidants, fiber, and vitamin C, which can lower blood sugar, inflammation, and oxidative stress. They also have a low GI of 25–50 and are lower in sugar than many other fruits. You can eat them fresh, frozen, or dried, or add them to smoothies, salads, or desserts.

10.               Nuts: These include almonds, walnuts, pistachios, and cashews. They are high in healthy fats, protein, fiber, and minerals, which can lower blood sugar, cholesterol, and blood pressure. They also have a low GI of 15–25 and can increase satiety and metabolism. You can eat them as a snack, or add them to salads, oatmeal, or baked goods.

11.               Whole grains: These include oats, barley, quinoa, buckwheat, and brown rice. They are high in fiber, protein, and phytochemicals, which can lower blood sugar, cholesterol, and inflammation. They also have a low to medium GI of 40–60 and can provide sustained energy and prevent hunger. You can eat them as breakfast cereals, or use them to make bread, pasta, or pilaf.

12.               Eggs: These are a complete source of protein, which can help regulate your blood sugar levels and preserve your muscle mass. Eggs also contain choline, which is important for brain and liver health. They have a very low GI of 0 and can keep you full for a long time. You can eat them boiled, scrambled, poached, or in omelets.

These are some of the foods that do not raise blood sugar and help control it. However, you should also pay attention to the portion size, cooking method, and combination of foods that you eat. For example, you should avoid adding too much sugar, salt, or fat to your foods, and balance your carbohydrate intake with protein and fat. You should also consult your doctor or dietitian for a personalized meal plan that suits your needs and preferences.