“Have you been feeling unusually tired, thirsty and brain fogged without knowing why. What if your body is signaling you that your blood sugar levels are out of balance?”
We frequently overlook basic indicators and mistake them for a tough day at work or stress when, in reality, our blood sugar levels are all over the place. The concentration of glucose or sugar in blood, which serves as the primary energy source, is known as blood sugar or blood glucose. When this concentration of blood glucose is disrupted, it leads to serious complications. Increased blood sugar (hyperglycemia) can cause damage to heart, kidneys, nerves and eyes. Low blood sugar levels (hypogylcemia) can cause dizziness, disorientation and even seizures, if left untreated.
A1C/HbA1C Test
The most common indicator to understand your blood sugar levels is the A1C test or HbA1c. The haemoglobin A1c test, also referred as glycated haemoglobin, glycosylated haemoglobin, HbA1c, or just A1c, is used to measure blood sugar levels of an individual. The test is expressed in percentage and shows average blood sugar levels for 90 days. Since haemoglobin’s main function is to transport oxygen from the lungs to every cell in the body, it becomes glycated, or coated, with glucose from the bloodstream. As blood glucose levels rise, more glucose binds to the haemoglobin protein, causing more glycated haemoglobin and a higher A1c level. This is why the A1c test measures the haemoglobin levels in the bloodstream at the time of testing, which is why it is used as an indicator of blood sugar control.
According to the American Diabetes Association (ADA), individuals whose blood sugar levels are stable and under control should have their HbA1c checked twice a year, and for those who are not under control or who are on medication adjustments should have it checked every three months.
The A1C test can be used to detect or identify:
Diabetes type 2: When you have type 2 diabetes, your body either produces insufficient insulin to transfer blood sugar from your circulation into your cells or your cells cease reacting to insulin, which causes your blood glucose levels to become too high.
Pre-diabetes: When your blood glucose levels are higher than usual but not high enough to be classified as diabetes, you are said to have prediabetes.
Interpretation of Results
The following percentages are frequently used to diagnose diabetes or prediabetes:
A1C below 5.7% is normal.
A1C between 5.7% and 6.4% indicates prediabetes.
A1C 6.5% or more indicates diabetes
A1C testing for diabetes and prediabetes is advised by the Centres for Disease Control (CDC) if:
You are over 45 years:
- You should retake the exam every three years if your findings are normal.
- You will often need to be checked every one to two years if your results indicate that you have prediabetes. Find out from your doctor how frequently you should get tested.
- An A1C test should be performed at least twice a year if your findings indicate that you have diabetes in order to track your condition and treatment.
You are under 45 and likely to develop diabetes because:
- You are overweight or obese.
- Your sibling or parent has type 2 diabetes.
- Have elevated blood pressure or cholesterol levels.
- suffer from heart disease or a stroke.
- engage in physical activity less than 3 times a week
- Had diabetes throughout pregnancy (gestational diabetes) or have given birth to a child weighing more than nine pounds.
- suffer from PCOS, or polycystic ovarian syndrome.
- Identify as American Indian, Alaska Native, Hispanic or Latino, or African American, increased risk of diabetes is also present in some Asian Americans and Pacific Islanders.
Advancements in Glucose monitoring: Non invasive Options
Although finger-prick glucometers have long been the preferred technique, non-invasive technology are now making at-home glucose monitoring more convenient and easier. To name a few, Abbott’s Freestyle Libre (https://www.freestyle.abbott/in-en/home.html)is a sensor-based continuous glucose monitor (CGM) that offers real-time glucose readings for up to 14 days with a rapid scan. It is put to the back of the upper arm. The Dexcom G6/G7 (https://www.dexcom.com/compare-g6-and-g7)is a continuous glucose monitoring device that transmits data to your smartwatch or phone. Finger pricks are not required.
Exercise Recommendations based on A1C Levels
A1C levels can be effectively managed by implementing lifestyle changes, of which regular exercise and the focused physiotherapeutic interventions are essential for enhancing insulin sensitivity and blood glucose regulation in general. Let us talk of recommended guidelines for exercise in various A1C level category individuals.
Guidelines for exercise for individuals with low A1C levels (Hypoglycemia)
Individuals with low A1C levels (Hypoglycemia) may suffer blood sugar dips during or after activity, or they may experience reactive hypoglycemia. The following guidelines needs to be administered following the 15-minute Rule:
- Make sure your blood glucose is at least 100 mg/dL before beginning any workout.
- If levels are low, eat a modest snack that is high in carbohydrates (15–30g).
- Steer clear of intense or continuous fasting exercises.
- Keep a quick-acting carbohydrates on hand, such as juice or glucose pills.
- Prioritize moderate intensity aerobic exercises, such as cycling or walking.
- Start with short duration (20–30 min) as per tolerance.
- Keep an eye out for delayed hypoglycemia both during and after exercise.
- Ensure adequate rest periods after every 15 minute and only restart after glucose levels are maintained.
- If hypogylcemia persistently interferes with physical activity, consult your concerned physician.
Guidelines for exercise for individuals with normal A1C levels
For maintaining good health and preventing diabetes:
- Participating in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise each week, spread out across 10 minutes or longer.
- Strength training for all main muscle groups should be done 2-3 days per week.
- Incorporate balance and flexibility training, particularly for older individuals.
- Be consistent and try to avoid being sedentary by getting up every 30 to 60 minutes.
Guidelines for exercise for individuals with Prediabetic A1C levels:
Exercise is an effective preventative measure for people who are at high risk of acquiring Type 2 diabetes.
- ≥150 minutes per week of moderate-intensity aerobic exercise is the target.
- Strengthening two to three days a week can help increase insulin sensitivity.
- There may be benefits to interval training, which involves moderate to intense bursts.
- For the best effects, combine dietary adjustments with exercise.
- Promote regular physical activity (e.g., standing at desks, walking after meals).
Guidelines for exercise for individuals with Diabetic A1C levels:
Exercise lowers complications and improves insulin sensitivity and blood sugar regulation.
Guidelines according to The American Diabetes Association & American college of Sports Medicine:
- Moderate-intensity aerobic exercise for 150 minutes per week, spaced out across at least 3 days, with no more than 2 days rest in between.
- 2-3 non-consecutive days per week for resistance exercise.
- Those with Type 1 diabetes: Check for either hyperglycemia or hypoglycemia. Before, during, and after an activity, regulate insulin and carbohydrate intake.
- Don’t exercise if your blood sugar is more than 300 mg/dL when you’re ketogenic.
- Exercises for flexibility and balance should be incorporated, particularly for elderly or neuropathy patients.
- Start slowly and work your way up; exercise prescription led by a Physiotherapist are best.
Precautions and considerations during Physical Activity
It’s critical to understand the difference between hyperglycemia, which results from inadequate glucose regulation, and hypoglycemia, which is brought on by consuming excessive amounts of insulin or medications that drop blood sugar. Exercise should not be done if blood glucose levels are greater than 250 mg/dl or less than 100 mg/dl. If you have active diabetic retinopathy, you should avoid intense activities like jogging or stepping. Limiting weight-bearing exercise is indicated by significant peripheral neuropathy. Patients who struggle with thermoregulation should stay away from strenuous exercise and pay close attention to drinking enough water. Blood glucose levels may be impacted by dehydration (e.g., 500ml of fluid ingested two hours prior to exercise). Exercise is generally advised to cause a suitable warm-up and cool-down time for diabetic individuals. Five to ten minutes of low-intensity aerobic exercise should make up a warm-up.
Embracing movement for Better Health
Regulating A1C levels doesn’t always necessitate significant adjustments; simple, consistent efforts yield the greatest results. Including regular exercise in daily life, whether it be strength training, yoga, walking, or functional movement routines, can help stabilize blood sugar levels, support weight control, and greatly improve insulin sensitivity. An effective therapy tool that not only aids in controlling A1C but also enhances general physical well-being is created when these exercises are carefully designed with an emphasis on posture, joint mobility, and endurance. This method turns daily movement into a significant health strategy when combined with affordable, non-invasive glucose monitoring tools and routine A1C testing. In the end, your A1C score is a reflection of your lifestyle rather than merely your blood sugar, and you can confidently and clearly take control of it by moving consistently and purposefully.
