“Always bear in mind that your own resolution to succeed is more important than any other.” — Abraham Lincoln
High blood glucose is the defining characteristic of diabetes: It’s what leads to a diagnosis of diabetes, and it’s what can lead to long-term diabetes complications if sustained over time. Consequently, the medicines prescribed to treat diabetes lower blood glucose in one way or another. Exercise, too, usually lowers blood glucose, which is one of the reasons it’s an important part of a diabetes treatment regimen. But too-low blood glucose, or hypoglycemia, is no good, either, since it can cause you to lose consciousness.
Food raises blood glucose level, and certain other things can, too, such as illness and other forms of physical or mental stress. The challenge of managing diabetes, therefore, is to balance all of the things that can raise blood glucose (including the diabetes itself) with those that can lower it, so that your blood glucose level stays within a fairly narrow range. Staying in this range will not only help to prevent complications, but it will enable you to feel your best, both mentally and physically.
So what is that range, and how do you stay there?
Blood glucose targets
Both the American Diabetes Association (ADA) and the American College of Endocrinology (ACE) have published recommendations regarding target blood glucose ranges. The ADA recommends aiming for a blood glucose level between 70 and 130 mg/dl before meals and a level lower than 180 mg/dl two hours after the start of meals. The ACE recommends a goal of blood glucose lower than 110 mg/dl before meals and lower than 140 mg/dl two hours after the start of meals. (See “Blood Glucose Targets” for more information.)
While somewhat different, both of these sets of recommendations are based on research showing the level of blood glucose control needed to prevent long-term diabetes complications (such as nerve damage, kidney disease, and eye disease), while avoiding the short-term complication of hypoglycemia.
These recommendations are intended to guide the treatment of diabetes for most nonpregnant adults with diabetes, but they may not be right for every individual. Your health-care provider should discuss with you the blood glucose target range that is right for you. If you are elderly or have certain other medical conditions besides diabetes, you may be advised to keep your blood glucose level in a higher range to avoid hypoglycemia. Women who are pregnant or are contemplating becoming pregnant are usually advised to follow ADA or ACE guidelines to maintain lower blood glucose levels than adults who are not pregnant.
Staying in range
Your health-care provider will work with you to develop a plan to keep your blood glucose level within the desired range.