Today’s Prompt: OBVIOUS. Target blood glucose levels for Type 2 Diabetes

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)
BG targets by ADA with border
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.

The Daily Prompt: OBVIOUS

How do you manage your diabetes?

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This entry was posted in A1C, complications, Daily Prompt, diabetes, diabetes management, neuropathy and tagged , , , , , , , . Bookmark the permalink.

4 Responses to Today’s Prompt: OBVIOUS. Target blood glucose levels for Type 2 Diabetes

  1. Excellent medical information- thank you

    Liked by 1 person

  2. You’re quite welcome, and thanks for taking the time to comment!

    Like

  3. Rick Phillips says:

    There is also a new US standard for 7.5 for people over 70. This is suggested for people who may be harmed by being in group situations like nursing facilities or who live alone. I support this standard since the issue of lows can be far worse than the long term effects of higher blood sugar.

    Liked by 1 person

    • I understand your position, Rick. Now, regarding diabetes management in the nursing facilities, let me tell you this. I can assure you that they check blood sugar 4 times a day. Fasting, twice after meals, and at bedtime. Will also pass a snack of graham crackers with milk at bedtime. 2 squares of graham crackers + 1 cup milk = 2 carbs.

      Like

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