This information is specifically for patients with diabetes under the care of a doctor at Cannon Medical Clinic.
You have been given a standing order lab requisition for HbA1C levels to monitor your diabetes control. A standing order means that you can go to the lab every 3 months and they will take your blood to do this lab test without you having to show a lab requisition every time. This standing order expires after a year and you will need to request a new one from Dr. Rossiter. Please make sure that you have your lab test done before your next scheduled diabetic appointment with Dr. Rossiter. You should schedule follow up appointments and lab tests specifically for your diabetes every 3 months. Of course you are welcome to schedule appointments more often than every 3 months if you have other concerns.
As a person with diabetes you will also have a more detailed appointment regarding your diabetes once a year with more extensive blood testing at this time.
Annual Influenza vaccination is recommended and provided free of charge.
Pneumococcal vaccination with Pneumo-vax 23 is recommended and provided free of charge.
You should have a diabetic eye exam every 1-2 years or as indicated. This can be performed by your optometrist. Please give them my name so that they can send me a consultation report.
Alternately the eye exam can be performed by an ophthalmologist (eye surgeon), I will be happy to write a referral for you.
Blood sugar targets
Target for most people with diabetes:
| A1C** | Fasting blood glucose (sugar)/ blood sugar before meals (mmol/L) | Blood sugar two hours after eating (mmol/L) |
| 7.0 % or less | 4.0 to 7.0 | 5.0 to 10.0 (5.0 – 8.0 if A1C** targets not being met) |
Signs & symptoms of low blood sugar
Keeping blood glucose (sugar) levels in a healthy range can be challenging.
When the amount of sugar in your blood has dropped below your target range (less than 4 mmol/L), it is called low blood sugar (hypoglycemia).
If your blood sugar has dropped, you may feel:
- shaky, light-headed, nauseated
- nervous, irritable, anxious
- confused, unable to concentrate
- hungry
- an increase in heart rate
- sweaty, headachy
- weak, drowsy
- numbness or tingling on your tongue or lips
Symptoms of very low blood sugar (less than 2.8 mmol/L) are more severe and can make you:
- confused and disoriented
- lose consciousness
- have a seizure
Causes of low blood sugar
Low blood sugar may be caused by:
- more physical activity than usual
- not eating on time
- eating less than you should have
- taking too much medication
- drinking alcohol
Treatment of low blood sugar
If you’re experiencing the signs of a low blood sugar level, check your blood sugar immediately. Low blood sugar can happen quickly, so it’s important to treat it right away. You may need help from another person if your blood sugar is extremely low.
If you don’t have your meter with you, treat the symptoms anyway. It’s better to be safe!
First, eat or drink a fast-acting carbohydrate (15 grams).
Good options include:
- 15 grams of glucose in the form of glucose tablets
- 15 millilitres (one tablespoon) or three packets of sugar dissolved in water
- 150 millilitres (2⁄3 cup) of juice or regular soft drink
- Six LifeSavers® (one = 2.5 grams of carbohydrate)
- 15 millilitres (one tablespoon) of honey (do not use for children less than one year old)
Next, wait 15 minutes & re-check your level.
If your blood sugar is still low, repeat these steps until your blood sugar is above 4 mmol/L.
If your blood sugar is above 4 mmol/L and your next meal is within an hour, no further action is needed.
If blood sugar is above 4 mmol/L and your next meal is over one hour away—or you will be physically active—eat a snack, such as half of a sandwich or some cheese and crackers (something with 15 grams of carbohydrate and a protein source).
If you need to drive, wait 40 minutes after treating a low blood sugar before getting behind the wheel.
To avoid low blood sugar again, think about why your blood sugar went low and make the necessary changes.
Medications that should be paused while you are sick:
- Diabetic Sick Day Medication Hold List (SADMANS)
Other resources
The Ozempic® App – App Store
The Ozempic® App – Google Play
Low Carb Diet Sheet for Type 2 Diabetes (Dr. David Unwin)
Diabetes Canada
Safe Driving with Diabetes
Cannon Medical Clinic 