Setting goals in an important tool in managing diabetes. Target blood glucose levels are one of them.
ADA suggests the following targets for the nonpregnant adults with Type 2 Diabetes. (border is mine)
I was dumbfounded when seeing these. What’s up with the A1C of 7%? I think that all of the ADA numbers are a bit too generous. I’ve always had my A1C target at close to 6%; it was 6.5% at diagnosis and the last one was 6.1%. I have never checked my postprandial or preprandial BG with the exception of a morning fasting; the latter was always around 100 and a few times even in the mid 90’s. My doctor says that my diabetes is under control. According to the ADA standards, my numbers are super normal.
But then ADA goes on saying that these target numbers can be individualized. In other words, not written in stone.
Diabetes Management website sheds more light on this. It explains that normal BG numbers are different for people without diabetes and for PWD (people with diabetes). However PWD should be shooting for the levels closer to those without diabetes. This is more protective against diabetes complications. Now this starts making sense. I am quite comfortable with this definition.
Group Health website, on the other hand, suggests a higher A1C target numbers for PWD whose BG numbers tend to run low. It recommends increasing A1C target up to 8%. Their rationale is that low BG numbers can increase risk for falls. I totally disagree with this; I think that higher A1C can increase risk for the diabetes complications that in turn can increase risk for falls just as well. It’s obvious, isn’t it? Peripheral neuropathy, nerve pain and foot drop are fine examples of the complications that carry higher risk for falls, as well as for developing even more complications. Count in hypo unawareness, another form of a neuropathy. So thanks but no thanks.
If my BG numbers ever happen to run low, I would manage this on a daily basis but without increasing the target levels. I would probably increase my carbs intake, ever so slightly, and then check the postprandial BG. Maybe consume more carbs before exercising, not a problem. I think that normal BG and/or A1C targets are safer in view of the possible future complications. Still would be shooting for around 6% of A1C.
And last but not least: Conversion
In Canada and UK, blood sugar is reported in millimoles/liter or mmol/L, while in the U.S., it’s mg/dL (milligram/deciliter). To convert Canadian or British numbers to American numbers, you multiply them by 18. Therefore, if someone reports their fasting BG as 6, you multiply that by 18 and get 108.
How do you manage your diabetes?