Managing diabetes is a collaborative process between you and your healthcare team. Whether you have been recently diagnosed or are refining your long-term care, asking the right questions ensures your treatment is tailored to your unique physiology and lifestyle.
The following guide breaks down the essential targets and the most critical questions to bring to your next appointment to maximize your health outcomes.
Before your appointment, it is helpful to understand the standard clinical benchmarks. However, keep in mind that “normal” for the general population may not be the safest “target” for you.
Blood Glucose (Daily Levels)
Normal: 4.0-6.0 mmol/L (fasting) and <8.0mmol/L two hours after a meal.
Prediabetes: Random glucose of 7.0-11.0 mmol/L.
Diabetes Diagnosis: Random glucose >11.0 mmol/L, or fasting glucose >7.0 mmol/L.
HbA1c (3-Month Average)
HbA1c measures your average blood sugar over the previous 8–12 weeks.
Normal: 20-41 mmol/mol (4.0-6.0%).
Prediabetes: 42-47 mmol/mol (6.0-6.5%).
Diabetes Diagnosis: 48 mmol/mol (>6.5%).
Standard targets aren’t always ideal. For example, in older adults or those with heart disease, a slightly higher range (e.g. 7.0-12.0 mmol/L) is often safer to prevent hypoglycaemia (low blood sugar), which can lead to dangerous falls or confusion.
What is my specific target range for daily glucose and HbA1c?
How often should I test my blood sugar, and is there a specific time (e.g., fasting vs. post-meal) that provides the most useful data for you?
What are my personal “red zone” numbers where I should seek emergency care?
Can you explain the “Dawn Phenomenon” and if it affects my morning readings?
Diabetes treatment is highly individualised. From oral medications like Metformin to GLP-1 agonists and insulin, you need to understand the “why” behind your prescription.
Why is this specific medication the best choice for my lifestyle?
What should I do if I miss a dose? Should I take it late or skip it?
What are the side effects (e.g., GI upset, weight changes), and will they fade over time?
If I am prescribed injectables and have a fear of needles, what support or alternative devices (like insulin pens or ports) are available?
Activity and food are just as powerful as medication. However, they can cause blood sugar to fluctuate unpredictably.
How should I adjust my medication or carbohydrate intake before a workout?
Are there specific foods that interact with my medications?
What are my “Sick Day Rules”? (When you are ill with a cold or flu, blood sugar often spikes even if you aren’t eating much).
How should I manage my glucose levels when traveling across time zones?
Diabetes affects the small blood vessels. Without management, this can lead to issues with the eyes (retinopathy), kidneys (nephropathy), and feet (neuropathy).
Kidneys: “What was my last uACR (urine albumin-to-creatinine ratio) and eGFR (kidney function) result? Should I be on an ACE inhibitor or SGLT2 inhibitor to protect my kidneys?”
Eyes: “When is my next dilated eye exam scheduled?”
Feet: “Can you perform a monofilament test today to check for nerve damage in my feet?”
Cardiovascular: “How are my blood pressure and cholesterol levels? People with diabetes have a higher cardiovascular risk; should I be on a statin?”
Inflammation from infections can make diabetes much harder to control.
Am I up to date on my Flu, COVID-19, and Pneumonia vaccines?
Should I receive the Hepatitis B series? (Recommended for many adults with diabetes as they are at higher risk for infection).
[ ] Review glucose logs/CGM data.
[ ] Confirm HbA1c target.
[ ] Check kidney (eGFR) and cholesterol (LDL) labs.
[ ] Physical foot inspection.
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