Understanding Diabetes
Your body uses glucose (sugar) as its primary energy source, and insulin lets that sugar into your cells. In diabetes, this system is disrupted, leading to high blood sugar levels that can damage your eyes, kidneys, nerves, and heart over time.
Managing these levels is difficult, especially when first starting, and our team of pharmacists are here to provide the tools and technology to make it easier.
Knowing Your Targets
For most adults, the general goal is to keep your A1C (a 3-month average of blood sugar) ≤ 7.0%. However, these targets are not one-size-fits-all.
- For older or frail adults, a more relaxed target is recommended (such as <8.0% or 8.5%) to prioritize safety and avoid dangerous blood sugar lows.
- For pediatric patients, the focus is on safety and early action rather than aggressive glucose lowering.
The days of solely relying on capillary blood glucose (the common finger-prick method) are evolving. New tools allow you to monitor your blood sugar in other ways that require less hands-on manipulation.
Continuous Glucose Monitors (CGM)
These involve a tiny sensor under the skin that measures sugar levels every few minutes. This is not measuring your blood glucose levels, but the levels in your interstitial fluid—the clear fluid that surrounds the cells under the skin.
While these devices are reliable and convenient, it is still a good idea to keep your glucometer handy when needed. Systems like Dexcom G7 and FreeStyle Libre 3 Plus sensors send data directly to your phone and can alert you if your sugar is dropping too low or rising too quickly, helping you stay on top of your targets.
Some Key Metrics to Look For
| Time In Range (TIR) | The goal for most people is to stay between 3.9 and 10.0 mmol/L for more than 70% of the day. |
| Glycemic Variability | Aim for a Coefficient of Variation (%CV) ≤ 36%. A lower percentage means your levels are more stable, significantly reducing the risk of hypoglycemia. |
Medications That Offer More Than Just Glucose Lowering
Modern diabetes management focuses on vascular protection. Your pharmacist may discuss medications that not only lower glucose, but also protect your heart and kidneys.
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Metformin
This is the foundational treatment for type 2 diabetes that helps reduce long-term complications. -
SGLT2 Inhibitors
(empagliflozin, dapagliflozin, canagliflozin)
These medications can reduce the risk of heart attack or stroke in high-risk patients. -
GLP-1 Agonists
(semaglutide injections, commonly known as Ozempic or Wegovy)
These medications can help manage weight and support target achievement to prevent complications. -
Statins
(rosuvastatin, atorvastatin, pravastatin)
These medications are indicated for most adults with diabetes over 40 to provide essential heart protection regardless of baseline cholesterol levels.
Sick Day Management
When you are sick, your blood sugar can rise even if you are not eating. Our pharmacists emphasize these important rules:
- Never stop your basal (long-acting) insulin, even if you cannot eat.
- Monitor more frequently by checking your sugars every 2–4 hours.
- Stay hydrated and aim for plenty of sugar-free fluids to prevent dehydration.
- If you are vomiting or dehydrated, you may need to temporarily pause certain medications to protect your kidneys. Always speak to your pharmacist about sick day management before making medication changes.
Our team of pharmacists is here to help you choose the right monitor, adjust your doses safely, and ensure your treatment plan fits your unique lifestyle. Come in and speak to us today for a consultation on how to take control of your diabetes.