Diabetes Self-Management Blog

American Diabetes Association (ADA) guidelines advise “lowering A1C to below or around 7%” and postprandial (after-meal) glucose levels to 180 mg/dl or below. But new research shows that these glucose levels damage blood vessels, nerves, organs, and beta cells.

An article by diabetes blogger Jenny Ruhl analyzes at what blood glucose level organ damage starts. According to Ruhl, research shows that glucose can do harm at much lower levels than doctors had thought.

This news could be discouraging or even terrifying. If it’s hard to meet your current glucose goals, how will you reach tighter goals? Such news might make some people give up. But remember, a high postprandial or fasting reading won’t kill you. All we know is that higher numbers correlate with higher chances of complications. You have time to react.

In fact, we could choose to look at this as good news. We all know of people who developed complications despite “good control.” But complications are not inevitable; it’s just that so-called “good control” wasn’t really all that good.

First, the numbers. “Post-meal blood sugars of 140 mg/dl [milligrams per deciliter] and higher, and fasting blood sugars over 100 mg/dl [can] cause permanent organ damage and cause diabetes to progress,” Ruhl writes.

For nerve damage, University of Utah researchers studied people with painful sensory neuropathy, or nerve damage. They found that participants who did not have diabetes but who had impaired glucose tolerance on an oral glucose tolerance test, or OGTT, (meaning that their glucose levels rose to between 140 mg/dl and 200 mg/dl in response to drinking a glucose-rich drink) were much more likely to have a diabetic form of neuropathy than those with lower blood glucose levels.

The higher these OGTT numbers go, the more nerve damage is found, according to Johns Hopkins Hospital researchers. The OGTT gives a good idea of how high after-meal blood glucose levels are likely to be.

Glucose can also start killing beta cells at levels below 140. One study found that people with fasting blood glucose from 110–125 (within the official “prediabetic” range) had already lost up to 40% of their beta cell mass.

Italian researchers found that even with glucose levels in the supposedly “normal” range, beta cells started to fail. Ruhl says that researchers “found that with every small increase in the 2-hour glucose tolerance test result, there was a corresponding increase in…beta cell failure. The higher a person’s blood sugar rose within ‘normal’ range, the more beta cells were failing.”

Failing beta cells will lead to worsening diabetes, a truly vicious cycle. Slightly elevated glucose has also been shown to cause eye damage (“retinopathy”) and increased rates of heart disease, kidney damage, and stroke.

Where Does High Start?
Studies like the ones Ruhl quotes and others indicate that damage occurs with even slightly elevated blood glucose. But what can you do about that? Is it reasonable to try to keep glucose at normal levels all the time?

It seems for some people, that course would lead to frustration and burnout. In fact, ADA says that older, sicker people should have even less strict goals. How do you set reasonable goals for yourself?

Keeping normal numbers may require extraordinary effort. It may require very low carbohydrate intake. It may not be possible for you. If you’re taking insulin or drugs in the sulfonylurea or meglitinide classes, aiming too low can put you at risk of hypoglycemia (low blood glucose). The whole thing can make you crazy, because sometimes numbers will go up for no apparent reason.

As a result, most people set less-demanding goals for themselves. If they can keep their postprandial glucose under 180 and their fasting below 120, they’re OK, and the ADA agrees.

There’s nothing wrong with that. People can trade off how low they want their blood glucose against how much work they are willing to do and how many foods they’re willing to cut back or give up. They are adding to their risk, but, to me, quality of life is the most important thing.

Important note: Bringing blood glucose down by means of multiple drugs has NOT been shown to decrease complications much. Two huge studies, the ACCORD and ADVANCE trials showed this.

But people who manage to keep normal or near-normal numbers through healthy eating and living and intelligent use of medicines seem to live long, relatively healthy lives. They can even reverse type 2 or the complications of Type 1, even if they have spent years with elevated blood glucose before getting them under control. It’s almost never too late to get on track.

So my question is what are your target numbers? How high is too high for you? Does it make sense to aim for normal, non-diabetic levels, or is that just too demanding and unrealistic? If you had a newly diagnosed friend or relative, what would you tell him or her about glucose goals?

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Comments
  1. David: All I can relate to is my direct experience about how high is high. I have great discomfort about those folks arguing for numbers and averages that meet out of the factory brand new body working 110 per cent fine.

    Foer 30 years, I was all over, bad and rotting out. In last 5 years, my data shows that:

    once BG gets to 155 ( 6.9) and under - 6.4; the following happened:

    a) eyes cleaned up and no more hemorages on the retinas. Preciously bad.

    b) weight dropped, and need for large amounts of insulin boost dropped signifigantly.

    c) kidneys now stable and in good shape for a number of years and was on a 3 month watch upgraded to one a year.

    d) off the dam actos.

    As we are not steam engines that can go in for a complete rebuild periodically; our chemical plant ages and gets sloppy anad thus control is looser - wider swings and lower lows and liver grief. I do not see how we really get a older person back to the same numbers and swing of those numbers of a younger person and plant.

    Fingerprick caveman tools of 20% accuracy and 1 week unstable gronky cgms sensors technology are not sufficient to provide the window and control to run an older plant as if brand new.

    We still are in a search for the holy grail in medicine for the single vampire killing silver bullit - wooden stake rather than a a combined tuning stratagy of multiple hormones and meds; diet and exercise to fine tuning the body.

    We simply are not there yet.

    I truly wish folks promoting tigher numbers for diabetics whould have a more balanced open view of all the issues and not just use bossterism to push on things of questionable practical merit.

    Yes, this is an analog world and the larger the magnification, yes we can see all new worlds and issues but can we really absorb that now. The numbers on type 2 diabetics increase indicates we can barely get folks under 7.0 a1c never mind 5.0.

    Posted by jim snell |
  2. If 140 mg/dL or less at all times is necessary then high fat and low carb diets are a in the least highly desirable for diabetics and those on their way to diabetes. Also Diane Fennell’s article about high HDL being desirable supports that. I found in my case that eating a high fat diet including saturated fats(with the exception of trans-fats) improves HDL quite a bit without affecting LDL that much. Funny that the official doctrine is the opposite of this in spite of mounting evidence to the contrary.

    Posted by calgarydiabetic |
  3. calgarydiabetic adds more excellent valid comment.

    The fat in diet slows the digestion race as well and keeps spikes down.

    I agree.

    Posted by jim snell |
  4. One of my many diagnosed problems is Generalized Anxiety Disorder. Stress elevates my mg/dl close to 400, especially extreme stress. My daughter recently had surgery for cancer and my wife has been staying with her to help with the children. I didn’t feel like making a pot of coffee for one person so I used instant. The only instant we had was decaf. My morning finger-prick test dropped from 370 to 155! this has been holding true for almost a week now. It seems caffeine is one of my enemies. To hell with coffee!

    Posted by Steve Speare |
  5. I put in my vote to keep peak readings below 140 (7.8).

    Only a low carb. diet makes it easy enough to do (for me) and keep your blood sugar close to looking like a person without diabetes. The nice thing about this is that you can pretty much forget about fat intake (other than trans fat of course). You sort of live your life a couple hours at a time but you get very used to this (well most of the time :)

    It’s been several years since I started this approach and weight stays normal and complications (years in the making) have pretty much disappeared.
    (A1c from over 12 to just over 5)

    Did find it is important to know what your body is and how you need to approach your treatment… something too many doctors just don’t get — they seem to like the one size fits all approach.

    Posted by JohnC |
  6. Any insight on how to control early morning near normal (86) or low reading (62)at 3am and then 7 am reading at 149. Any hints on how to control this from happening?

    Posted by DanE |
  7. In response to DanE, what you are seeing is generally called “dawn phenomenon” and it is the result of the release of Cortisol at about 3 am. For me, it causes my blood sugar to rise between 6 am and 10 am. After that, it remains stable. But also in my case, even if I don’t eat a single bite, my blood sugar will rise from 80-90 to over 300 in those 4 hours. Obviously, I take insulin (I’m type 1) but my mother, who had Type 2, had the same problem. The analogs (Novalog and/or Humalog) work too fast to cover this, but a small dose of R works fairly well at preventing the blood sugar from rising. Discuss with your PCP.

    Posted by Lori Hamlin |
  8. Here’s my take on the whole BS (Blood Sugar) reading thing. If I maintain a decent food intake and exercise regularly, I really don’t care what my daily or even weekly ups and downs are. Sure, I’ll continue to test each day, but really the A1C pretty much tells the story. It is based on what’s been happening over a three month period. I have experienced the terror that the medical profession puts into the hearts and minds of diabetics, and the resulting discouragement that ensues, when they implore people to worry over their blood sugars readings several times a day. I believe that this is left over from concerns with Type I diabetics or insulin dependent Type II diabetics who really don’t have enough or any insulin and therefore have to adjust insulin to match carb intake and other things.

    I know that if I overeat, I’m likely going to have a high BS reading. Likewise, if I snack a lot at night, my morning BS is going to be higher than my average BS. So what?! It’s like saying that every breath you take or every glass of water may contain some carcinogenic substance. Yeah, we know that isn’t good, but should we stop breathing or stop drinking water? Some people get bent-out-of-shape about the particulars. Life is too short to waste so much time worrying about minutia. The answer is not to get all excited but to continually return to the moderate, balanced, lifestyle.

    I think that getting to and staying at 7.0 is a reasonable goal–for me. If I had my way, I’d drop most of the hair splitting experiments that deal with BS values. The article above shows clearly one thing. To be alive means that some sort of cell is going to die on a regular basis. Do we really have to nit-pick about a couple of decimal points on a A1C or a couple of points on a glucose reading. I personally, think not!!!!

    Posted by John Bell |
  9. I got interested on response from Lori. What is R?
    Thanks

    Posted by H Rios |
  10. IN LORI HAMLIN’S REMARKS, SHE STATED THAT ” A SMALL DOSE OF R WORKS FAIRLY WELL AT PREVENTING THE BLOOD SUGAR FROM RISING”. WHAT IS R?

    Posted by FRANK |
  11. “R” refers to “regular” insulin. This used to be the fastest acting kind, but now the analog insulins work much faster — too fast according to Lori.

    Posted by David Spero RN |
  12. I like John Bell’s response. Diabetes controls us every day and to not think about it all the time is great. I feel the doctors are trying to make more people diabetic with scare tactics. My husband’s now ex-doctor harped at him all the time - he is not diabetic - to the point when he went for his physical, the doctor only went on and on about diabetes and didn’t bother to do the physical so he knows nothing about the important things you find out from a good physical. Not the necessary blood tests and bodily tests. He gets a D- rating as a doctor.

    Posted by Ferne |
  13. I don’t know what i am suppose to do. Before I had M.V.A., my level was between 140 &v190. After my wreck it shot up to between 200 & 290. I was left a paraplegic and now am developing full blown C.R.P.S., and my levels are in the 300dredsl Sometimes in the 400 levels. Once it was 598. I take metformin, a shot in the belly every morning of some kind of long acting insulin, and finger pricks and shots four times a day. And my levels are still out of sight. I read about how you body crumbles and folds every time your levels get out of the norm, but i don’t know what to do about it. I am in a nursing home and have nurses handling my meds and the kitchen handles my meals. I don’t snack between meals. My doctor is a good doctor, but doesn’t act over concerned about this aspect of my medical problems. WHY is my type 2 out of control???? I am in constant pain from the crps, but can not go to a pain specialist. I am so afraid of the crps getting out of control and going beyond the point of possible remission. Any way, I didn’t mean to bother you guys. I apologise.

    Posted by Donald Roberts |
  14. In reference to the article on ‘How high is too high!’ I read an article in a publication, of which, I can’t remember the name, that BS for some people can be higher than the traditional guidelines and not be a negative for the individual. I believe is arelated to the size of a person, ie weight, age, etc. My BS usually run in the 180-240 range and my AiC is 8.5. I know it is still high on the charts, but is there any evidence that the article is correct?

    Posted by Larry |
  15. A good friend of mine is haveing extremely high level, she exercises eat a fairly good diet and takes meds but is still having high readings. What can she do to bring these down?

    Posted by Michelle |
  16. I am suffering through the same issue as DanE. (I am Type 1.) Sugar before sleeping in the night is fine. I even take ‘bed-night’ insulin - Mixtard 30 (earlier it was Mixtard 50) and if I wake up after 8-hrs, inevitably it’s high. If it’s 6-hrs, then it’s fine; means that I better take my morning dose of insulin quickly.

    I was under the impression that Mixtard has a 10-12 hr cycle. Besides it seems weird that when there’s no exercise (while sleeping) the absorption is fast. Or…it’s the ‘Dawn Phenomenon’ at work?

    I was following 180 as the PP level to aim for. 140 - boy, that’s going to be a tough one :-)

    So…what’s the max level for fasting - not 120?

    Posted by Anuj |
  17. I have had diabetes now for almost 11yrs. i got it when i was pregnant with my son and never went away. i am now almost 47 yrs old. i am very hard on myself when comes to eating. i am only 137pds. not overweight at all(can afford to loose maybe 10) but never the less lately my blood sugars are high when i dont even eat bad things. the last test when i was at the doctor my Aic was 6.3 i know when i go in april it will be higher. why is this happening and especially when i didnt even eat high carbs or desserts. does your body change every 7yrs have anything to do with your insides changing in results to do with diabetes. please if you have any input let me know thanks signed frustrated diabetic

    Posted by michele |
  18. Michele, please ask your doctor if there might be some medical reason for your higher numbers, like an infection. Are you under some major stress? Also, are you getting your usual amount of activity?

    I have heard that you can make yourself crazy trying to keep numbers in the normal range. It might be better to have an A1c of 8.5% than to spend every waking minute worrying about what you ate and what your BS is now. However, if you can find a fairly simple, not too invasive way to get your numbers down, I think it’s worth it. This usually seems to be a low-carb way, although other diets have worked for some people.

    Posted by David Spero RN |
  19. I was soooooo happy to read the post by John Bell! I have been diagnosed a type 2 diabetic 3 years ago and I worry constantly, every minute of every day about my numbers. The stress has made me a different oerson then i was. i used to be fun and have a great sense of humor, now all i do is cry and worry! I have been doing research from books and on the Internet and listening to different doctors, not to mention numerous dietitians……..ugh! They all contradict each other. I recently decided to do what John has done. I’m sick of this ruling my life! I will continue to exercise and eat as healthy as I can…..maybe splurge a little bit on special occasions. We are all going to die some day of something. If I die because of diabetes……..then so be it!
    Thank You John!

    Posted by Tricia Vandemark |
  20. I’ve seen enough diabetics with amputations and missing eyes to take the “diabetes be damned!” attitude. If you don’t take care of your b.g. levels, parts of your body will start dying off. Some of the doctors out there are very ignorant of diabetes. My initial A1C was over 11. I’m getting ready to get my A1C in a couple of days. I’d be shocked if my number is not under 6.5. Despite only 3 months past my initial diagnosis, my low carb diet(30-50 grams/day) has kept me consistently below 140. I’ve even stopped taking Glyburide because it was causing too low b.g. levels at night. I’d recommend people ask their doctors to see an endocrinologist for further help to get their b.g. under control. My doc has very little faith that people can control their b.g. level thru diet and exercise. It doesn’t have to be a struggle. Yeah…it sucks I can’t overeat on desserts any more but…such is my new reality. Best wishes to everyone.

    Posted by Mark N. |
  21. GOSH WHERE DO I START? I HAVE BEEN D2 SINCE 2009. I HAVE NEVER HAD A NORMAL READING TIL I STARTED INSULIN 6 WEEKS AGO. WITHIN THESE YRS (2009-PRESENT) I HAVE GAINED AND LOST WT. FROM 135-210. RITE NOW I AM ON THE UP-ROAD TO WT. GAIN. WHEN I STARTED INSULIN I STARTED AT 10 UNITS, 30 DAYS I WAS UP TO 20. NOW I HAVE SWOLLEN FEET & LEGS FROM PRAVASTATIN. MY FEET & LEGS GO UP AND DOWN. INSULIN NOW AT 30 UNITS.
    I THINK THAT DIABETES IS AN ISSUE THAT SHOULD BE TREATED LIKE AN ADDICTION TO DRUGS OR ALCOHOL AND IN THE DIABETIC LIVES OF MANY BAD FOOD IS OUR ENEMY JUS LIKE DRUGS ARE TO A DRUG ADDICT AND ALCOHOLIC. THEREFORE, WE SHOULD HAVE OR SHOULD I SAY I WOULD LIKE TO HAVE A PLACE WHERE I CAN GO FOR REHAB FOR A FEW MONTHS JUS LIKE AN ALCOHOLIC OR DRUG ADDICT HAS TO GO FOR REHAB. WILL IT WORK? I THINK YES FOR ME IT WOULD.
    I KNOW THIS SOUNDS CRAZY BUT I/WE COULD DIE TOO. AND IT AINT SAFE FOR US TO BE DRIVING A CAR OR USING MACHINES WHEN OUR SUGARS ARE HIGH.
    IF I HAD THE MONEY TO BUILD OR MAKE/START A REHAB FOR DIABETICS THAT JUS CAN NOT GET A HANDLE ON THIS LIKE MYSELF I WOULD DO IT ASAP.
    PLEASE CAN SOME ONE GIVE ME FEED BACK ON THIS…
    I WOULD BE SO GREATFUL TO HEAR OTHERS OPINION.
    THANKS, MARY P.

    Posted by MARY P, COLORADO |
  22. I just began testing my blood in the mornings. I am Type 2, on Metformin once a day (500 mg) and my very first fasting test the number was 160. I have no idea if that is dangerously high or not. The nurse told me about low blood sugar levels, but not how to handle high ones. Also what is this Dawn Effect or Dawn Phenomenon and how do I handle it? I’m not a big eater and usually do not eat after 9:00 pm.

    Posted by Carol |
  23. Mary in Colorado — I don’t think there are any such retreat camps, at least not any that ordinary people could afford. Please try to find a diabetes support group in your area. If your doctor’s office doesn’t know of one, search online for “diabetes support groups Colorado.” Also, see my article, “Can Type 2 Diabetes Be Reversed“?

    Carol, you can get answers about the dawn phenomenon on our site by using the search function. A fasting glucose level of 160 is too high, but not “dangerously high” in the short term. You have time to fix this.

    You are also on a very low metformin dose. Ask your doctor about taking another tab at night.

    Posted by David Spero RN |
  24. I have been diagnosed as a type 2 diabetic and am taking 1000mg of metformin before breakfast and dinner. Testing upon rising I am averaging 112 - 125 and 2 hrs after each meal, I have been averaging 110 - 140. Are these numbers high for someone taking 1000mg of metformin twice a day?

    Posted by Pat |
  25. My dr just told me I am borderline diabetic, with a fasting glucose level of 100. I checked it again this morning before eating and it was 125. I am 38, weigh 138. I have not been sleeping well the last couple of months, maybe 4-5 hours per night, and am always wide awake at 3 am. Been busy and stressed and a bit of anxiety creeping in.

    Is 120 a high fasting level? I read on another sight that sometimes your levels can spike over night causing your body to become alert and making sleep difficult. Any suggestions? Am I just over thinking this?

    Thanks

    Posted by Mandy |
  26. I am a type 1 diabetic and have been grossly unman-aged for about 6 years. I recently started taking care of myself and keeping my sugar under 200. But this morning I took 20 Lantus which is normal and 15 novolog to cover my high of 271 and breakfast, which was small bowl of Oatmeal with a handful of raisins and cinnamon. 2 hours later it rose to 302 and I wanted to exercise but I can’t due to my glucose levels. What should I do to lower it so I can continue to exercise? They say not to if its over 250.I’m a 5′9″ 200 Lbs.

    Posted by Christopher Sevillano |
  27. Pat and Mandy,

    Both of you have glucose numbers in the prediabetic range. There are a number of things you can do to bring them down. My favorites are exercise, vinegar, bitter melon, and cinnamon. Eating very little refined carbohydrate will also help.

    Christopher, your numbers are too high. I would talk with your doctor or a diabetes educator, or read more to find out how to bring them down. Exercise whenever you get the chance. You might want to change your diet — probably with less carbs.

    Posted by David Spero RN |
  28. I was diagnosed with type 2 about 7 weeks ago. My a1c was 8.5my fasting was 233. I have been trying to control numbers by diet and weight loss. Following ADA recommendations on diet. Finding that even so, my numbers are higher than should be. My average for past 30 days is 167. I am in normal range for weight(136). But im sure i could lose 10 lbsmore. Family hx of type 2(mother has it. ESRD and on dialysis) .so i know where it can lead if my levels dont go down. Had gestational diabetes 17 yrs ago. How long should i wait before starting with oral med?Also, my numbers are almost always high in the morning. Whether i have a late night snack or not. Anywhere from 140-200. How much can genetics factor in control of diabetes?Just want to do all I can without meds. Thank you.

    Posted by Leslie |
  29. People with diabetes should not be eating carbs. You want to manage your diabetes? Give them up. Period. I know life sucks and we want to be able to enjoy our addictions like the rest of normal society but the only real way to do that completely without risk is perfectly timed insulin injections to ideally make sure our blood sugar does not rise above 140mg/dl.

    I suppose people could use 180 mg/dl if they are type 1 since type 1 is so much harder to control.

    However eating oatmeal as a type 1 diabetic and letting one’s blood sugar spike into the 300’s is simply not acceptable. A person should be eating scrambled eggs cooked in olive, canola oil, or butter instead.

    Cholesterol will improve, blood sugar will go down, you will be healthier. The food guide pyramid and the ‘carbs are healthy’ mentality put out by the government is simply not applicable here.

    Posted by Derrick G |
  30. I went in to Doc’s office for pre surgery clearance which consisted of urine and ekg well as they were looking at ekg they checked urine and said we need to do a BS check and according to them level was 300 needless to say now on metformin 500mg once a day for first week and then twice a day from then on for now. They are letting me have surgery but afer that I know everything has to change. How hard is it?

    Posted by Robert Schneider |
  31. i had my sugar levels under control for about 2 year with the help of junuvia, diet and exercise, then they slowly started creeping up into the 150 180 levels in the morning. i was so discouraged so i took matters into my hands and went off all meds, this included crestor for colesterol and junuvia for sugar. not much happened. then i read an article about dairy and how it can affect your sugars and colesterol so badly. six weeks with hardly no dairy, fasting morning at 125. i feel better too. all the meds the doctors put you on seem to cause more problems than the original problem.

    Posted by joseph |
  32. DOCTOR TOLD ME I HAVE DIABETES BUT SINCE THEN I HAVE TESTED MY BLOOD SUGAR TWICE A DAY IT HAS NEVER GONE OVER 120 AND THAT IS AFTER I HAVE HAD LUNCH OR DINNER DURING THE DAY I TEST AND IT HAS BEEN READING IN THE 80′S NO MORE THAN 98 I AM JUST CONCERNED DO I REALLY HAVE DIABETES OR WAS IT A FLUKE READING PLEASE HELP WITH SOME ADVISE.

    Posted by monique |
  33. Robert,

    Don’t panic. You’re in the right place and there’s no rush. Look through this site, or ask to see a diabetes educator to get started. Get a book and check some other sites. It’s a serious challenge, but you can do it.

    Monique,

    Your numbers are not in the diabetic range or even the prediabetic range. I’d say keep up with what you’re doing and don’t worry. Maybe tell your doctor about your concerns.

    Joseph,

    Keep up the good work! It’s great that you got off meds and your glucose levels are better. Let’s get them down a bit more — 125 is still a bit too high. Have you checked your postprandial (after-meal) glucose levels?

    Posted by David Spero RN |
  34. Leslie,

    The ADA diet is not a good one for most people with diabetes. Too many carbs. Consider the diets in my article “‘Reversing’ Type 2 Diabetes: Can It Be Done?” on this site. Your morning blood glucose levels might be helped by metformin at night, or by vinegar at bedtime, but you should work with your doctor on that if possible.

    Posted by David Spero RN |
  35. I’ve been a type 1 for 3 years. I initially drove myself crazy worried about Blood Glucose. I was checking myself 20 plus times a day, constantly worries about my sugar dropping too low, and running out of strips before I could order more…which only increased my anxiety. I switched to low carb. I shoot for 20 or less carbs per meal. This has made my blood sugar more manageable…at the very least, I have less anxiety. I still wish my control was better than I have, something I will continue to work on. My biggest problem is cutting myself off at a good time in the evening…if my blood sugar is not at an ideal level before bedtime no amount of fast acting insulin will bring it normal…even if I get up every three hours. It will stay like that until I am up and moving. I know my doctor would want me to take a long acting insulin…which will only cause me anxiety (when I did take it, their prescribed dose of lantus made me see purple spots…I somehow had the presence of mind to check my BG…the meter only said “Low”) That experience kind of scared me. Novolog is predictable. 3 hrs after my dose it has done all it is going to do. I can relax. Worrying about hypoglycemia 24/7…putting that off as long as I can.

    Posted by Sean |
  36. “Keeping normal numbers may require extraordinary effort. It may require very low carbohydrate intake. It may not be possible for you.”

    I suggest you read the books by Furhman, Barnard, and “Seale, House, and Newman”. I am not saying it isn’t challenging but with the appropriate changes in lifestyle a greater degree of control of blood glucose is possible than many people would believe. Of course there will always be exceptional cases but Furhman’s book presents some specific cases of insulin-dependent people who had poorly controlled glucose for years who were able to get their sugar under control and drastically decrease their insulin in a matter of weeks by applying his recommendations. It isn’t easy, but it is relatively simple and the results are almost unbelievable.

    Posted by A. Russo |
  37. I have a 7 year old who was recently diagnosed as type 1 (bg when we went to the hospital over 800 and dka). We’ve lowered his carbs dramatically since coming home from the hospital 2 months ago which has resulted in much lower insulting dosages (honeymoon?) and him generally feeling better. My question is regarding ketones. Is it ok for him to have a trace of ketones? He eats lots of meat now. He also eats veggies but not as much as he does meat. I smell the acid smell on his breath fairly often. I know the endo doesn’t like that but there are other things the endo says that I don’t agree with (like eating margarine not butter and that birthday cake is fine as long as we cover it with insulin). Any advice? Do any of you on a low carb diet have ketones? Obviously, I want to make sure he’s able to grow and gain weight adequately.

    Posted by Lorraine |
  38. Hi! I have been a diabetic for over 7 years now and i am 17 years old.. I give up! I seriously cant do this anymore.. My sugar has never been stable and my average is 10.9.. I cant control it. I have been to many different doctors and no one can help me. I know that i am responsible for myself and the manangeing of this illness but i have no time or motivation. I was also on a pump for a year, wich only made this worse. I am not saying that i am innocent but i find it extremely hard to do everything at the right time when it is needed.. Please help me..

    Posted by Lia terblanche |
  39. I’m a little confused with the numbers. What is a good target range for fasting, immediately after eating, 2 hours after eating and bed time? I read that it’s good to have blood sugars when going to sleep around 140 for sugars levels not to be too low in the morning. Is this true or is each person different of how fast sugar levels drop?

    Posted by Sally |
  40. Hi Lorraine,

    The presence of ketones in your son’s urine is likely an indication that he’s not getting enough carbohydrate in his eating plan. When the body doesn’t get enough glucose from carbohydrate (food) sources, it starts to burn fat for energy. A by-product of this “fat burning” is ketones. It’s certainly understandable that you want to watch your son’s carb intake to help him manage his blood glucose levels. But carbohydrate is an essential nutrient and everyone, including children, needs some carbohydrate. Children need this nutrient for normal growth and development. Healthy carbohydrate foods, like fruits, whole grains, low-fat milk, and beans provide a whole host of other important nutrients, as well, that your son won’t get from eating mostly vegetables and meat. My suggestion is to meet with a dietitian who has experience working with children who have diabetes. He will review your son’s food intake and work with you and him to come up with a more balanced, but still healthy, eating plan. Perhaps the endocrinologist can recommend someone for you. You can also contact your local American Diabetes Association office for names of dietitians in your community.

    Posted by acampbell |
  41. Hi Lia,

    It sounds like you are really hurting and scared now. That’s understandable in your situation!

    But you’re not doing that badly for 17 years old. This is a really hard age to manage diabetes, because of hormones and because of all the craziness of being 17. Don’t panic. This will get easier.

    The best thing you could do is get some more help. Is there a Type 1 diabetes support group near you, or can you connect with one other person your age who is going through this? Perhaps a local diabetes clinic or your doctor can help you find someone, or you can advertise on the Internet. Perhaps your parents can be more helpful if you tell them what you need from them.

    Don’t be perfectionist about this. Have a goal of bringing your numbers down gradually. Be aware there will be many slipups, and a slip is not a disaster. There are probably things you could do better to manage your diabetes. But my priority
    for you is that you get some help and stop beating yourself up.

    David Spero RN

    Posted by David Spero RN |
  42. Hi Sally,

    Target numbers depend a lot on the individual. Ideally, fasting should be under 100 and two hours after meals should be below 140. But these goals may not be realistic for you — you kind of have to decide for yourself (OK to ask for help from doctor or diabetes educator, of course).

    Assuming you are Type 2, I don’t think there is any reason to run a glucose of 140 at bedtime. If you’re not using night time insulin, there’s no reason you should go low overnight.

    Posted by David Spero RN |
  43. Hi Lorraine,

    I think it’s OK for adults to run some ketones on a low-carb diet, but I’m not sure about kids. I asked our diabetes educator Amy Campbell to answer this, and I think she will soon.

    Posted by David Spero RN |
  44. OK i don’t have diabetes so my doctors says but today i feel really shaky so i check my blood sugar and it was 135 should i be concerned.

    Posted by patricia |
  45. Patricia,

    If your fasting (before you ate anything) glucose level was 135, you have reason to be concerned. If it was 135 after eating, that is not a problem. Check a fasting glucose level tomorrow morning.

    Posted by David Spero RN |
  46. Eating smaller meals, eliminating between meal snacks, eating a lite dinner early and no evening snacks at all
    helped me. I was 329 now average fasting bg is 90. I eat meat, eggs and vegetables with a little dairy, occasional berries, and a few nuts. I walk about 1/2 hour or 1 hour a day. Took 6 months and no meds.

    Posted by Kerry |
  47. I am a #2 diabetic and i am currently taking Januvia 100 mg once a day. After i eat a small meal, my sugar reads from the 106 to 175 range. My A1C was 6.9.I would like to get these levels lower, but i do not know what i should do.?I do not drink or smoke and my weight is ok @ 170 lbs.I guess i will cut out ALL breads, potatoes and pasta and see if that helps and Also no sugar.

    Posted by Michael |
  48. Michael, I agree with your plan. Just plan what you will eat instead of the grains and potatoes and sugars.

    Posted by David Spero RN |
  49. I have diabetes 2. My level is 6.6 if I eat fruit goes to 7. I cant eat fruit myself? I am not taking any medication.

    Posted by Marie |
  50. My A1c is 8.5 would like to get down to 7.0/6.9 need the help

    Posted by Olivia lashambae |
  51. My Glucose level was 200 I felt terrible so went to the ER . I was told this was ” not bad” 500 was the panic number
    Is this correct??

    Posted by LARRY VAN BUSKIRK |
  52. Hoping someone can give me some insight. Sorry for the long post.

    A little over three months ago I got sick on vacation. The doctor drew blood and as a side note told me my A1C was 7.0. I now know this was probably due to a serious tooth infection I had for about 5 months as well as dropping off a low carb diet and eating 600++ carbs a day for the next week or so while on vacation…and I’m not talking 600++ of “good” carbs. Being overweight and having type 2 in the family I took this as a wake up call and jumped in head first to get things where they should be. Three months and lots of research and testing later I am at a good place based on diet alone. I have been healthy low carb (more chicken/pork/fish over red meat) and lost about 30lbs (20 or so more to go). My feeling is if I eventually need med’s or an official diagnosis I want to hold off as long as possible so I am motivated to continue to do the right thing. Using an at home A1C test I have steadily dropped to 5.8% (I double test to confirm “accuracy”). My before dinner BG is about 85 and 1 and 2hr after dinner is never more than 120 and usually in the 90’s…granted I don’t eat more than 25-100 “healthy” (green) carbs per day.

    Now the question which I can’t seem to find an answer. After three good months I decided I needed to test myself. I had a big bagel for breakfast. My 1hr was 175 and my 2hr was 146. A few hours later back to 85. I’m thinking that was ok so I wanted to do another test. Last weekend I ate a staple of my old diet (when I was not low carb dieting), about 3/4 of a bag of hard pretzels (250+ carbs in 30 minutes). 2 hrs later 280…2 more hours…214…2 more hours (and dinner)126…2 more hours…71 (as low as I’ve ever been). I occasionally use my wife as my control subject but I don’t want to put her through eating that many carbs. The question is…can a non-diabetic person deal with that many carbs that quickly? What are your thoughts? Also…why did I drop so low 8 hours later (no booze involved)? Any help would be GREATLY appreciated!!!!!

    Posted by Andrew |
  53. Olivia, You can and should get that A1C down. Try reading my article on reversing Type 2 diabetes by clicking here.

    Larry, a glucose of 200 over a long period is enough to make you feel pretty bad, but not ER bad. Something else must have been going on. If you’ve not been diagnosed with diabetes, you might want to be checked out.

    Andrew, you’re at a point where your diabetes is completely controlled as long as you don’t tax your system with refined carbs. Yes, a non-diabetic person could handle those pretzels, but you can’t. Maybe some day you will be able to, but perhaps not. The reason sugar dropped so low is probably that your phase 2 insulin response was still in overdrive when the pretzels were gone. This is classically what happens with refined carbs and why they should be avoided by anyone with diabetes or at risk for it.

    Posted by David Spero RN |
  54. David…thank you for your answer. I was hoping to hear even a “normal” person could overdose on refined carbs and go that high but in the back of my mind I knew otherwise. I’m creating a “poison” list of items that just are not worth eating and pretzels has zoomed right to the top of the list. I also appreciate your information about the 71 reading. I read a study regarding 1st and 2nd phase response and it seems my 1st phase is not up to snuff. Hopefully if I stay on track that will improve with time. Thank you again!!!

    Posted by Andrew |
  55. Andrew,

    Quantities are important too. You probably have enough phase I response to handle one pretzel. Just not a whole bag. But for long-term recovery, avoiding them completely is probably best.

    Posted by David Spero RN |
  56. David…you are dead on with your prediction. I reviewed my testing/food log and about 7 weeks ago after having some stomach issues which I thought may have been due to my low carb diet (they were not…I was taking WAY too many probiotics…LOL). I ate a few hard pretzels and a bag of “healthy” microwave popcorn thinking that may help the problem. I estimated it at about 150 carbs. My 2hr # was 126.

    Pretzels will stay on the poison list. As much as I love them I would rather have the occasional peach or bagel than a bunch of pretzels. It has become clear that living with diabetes is all about making choices. Choices on what to eat, what to drink, supplementation, and exercise. I am just trying to find my balance so I may live as “normal” a life as possible. I’ve treated my body badly for 46 years and it deserves a break.

    I really appreciate your help and the information you provide/blog. The most frustrating part of the last few months is the difficulty in finding reliable and consistent information regarding options to deal with this head on without having to have DIABETIC stamped on my medical record and ending up on the drug path. I am not going to go on a long tirade about the medical establishment and diabetes…but I could. I don’t know if I can say this but I just downloaded your book and I’m really looking forward to reading it. Again, and I can’t say it enough…THANK YOU!!!

    Posted by Andrew |
  57. I eat whatever I want, pretty much whenever I want to. Carbs or whatever. Pizza, bread, bagels, pretzels, chips, cookies, onion rings - all in moderation. I do NOT pig out on them, but I don’t deny myself either. I am a nutritionist’s nightmare. Had Diabetes for 14 years now. I take Humulin U-500 insulin 2x a day, and I’m in my 40’s. I refuse to use a pump. My last 2 A1Cs were 5.9 and 6.1, which is right where my doc wants them. I’ve also lost 75 pounds in the last year. I exercise daily. I have cut my insulin intake by 75% over the last 2 years. My highest readings tend to be about 180 after meals, which they usually don’t get that high, but I also get hypoglycemic fairly often, which is being addressed by my continuing reduction in insulin. I don’t graze or snack much….I tend to stick to my 2 meals per day. I refuse to be miserable about what to eat or not eat, and I refuse to inconvenience myself counting carbs or whatever forever. I do test my BG 4 or more times per day. Food that’s “bad” for you tastes too good to go without, in my opinion. I mean, we COULD all survive on a tasteless green paste made from vegetable products (mashed peas and kale?), truth to be told. We could call it Soylent Green, but it wouldn’t be made from people! Sounds delicious. Well, maybe to some. But that’s just me and the choices I make. I’m certainly not telling anyone to do things the way I do. To each their own. I am under medical care and see my doc 4x per year with complete labs. We work closely together in the management of this, even though I don’t necessarily eat like a medical professional would recommend. Seeing a good doc is very important.

    Posted by Johnny Onions |
  58. Johnny,

    It’s great that your numbers are so good, you are losing a lot of weight, exercising and using less insulin. It seems your body is starting to “heal”. I think diet and exercise are the largest component for most people in managing Type 2.

    Let me ask you this question: If you could go back before you were diagnosed and your doctor said, “Hey, we caught this early. You need to exercise and lose weight, limit your pretzels, chips, pizza, french fries and baked potatoes etc… to a small amount a couple of times a month and eliminate soda and sugary drinks and a few other things. On the other hand you can eat all the pork, chicken, fish, red meat, eggs, bacon, sausage, cheese, salads, avocados, green veggies, and even nuts, fruit and berries in some moderation. You can even continue to drink most beers, wines, bourbon, scotch, and other booze etc… in moderation (in fact they lower your BG). If you do this you won’t have to give yourself a shot twice a day (or more), and you won’t need other drugs…hopefully for a long time. Plus you can keep your feet and your eyesight (among other things).”

    Would you have made the changes?

    I gotta admit I probably wouldn’t have listened…especially about the exercise which I hate and still don’t do. BUT…I am needle phobic and the thought of injecting myself twice a day for life scares the @#$$ out of me a heck of a lot more than giving up or minimizing my consumption of a few foods. Strangely, I’m OK with pricking my finger 4 times a day. :)

    I arrived at the conclusion 3 years ago that the food I was eating was bad for me and was literately killing me. My weight skyrocketed and I was having stomach issues which I’ve never had no matter what I ate. Additionally, I was having other problems which are now mostly gone. On Jan 1 2011 I made the decision to eliminate all fast food, all soda, and french fries. I dropped 20lbs in 6 months with no other changes and still ate all the other @#$@# except those items. I could probably go to the doctor and get a prescription for Metformin and go back to eating all the @#$@# I ate before…but why? The @##% food caused other problems beyond just increased BG.

    This weekend I smoked ribs, sausage and a pork shoulder…I did such a good job with seasoning (no sugars) I didn’t need BBQ sauce other than a vinegar/hot sauce blend for the chopped pork. For the most part I don’t feel like I’m giving up anything and I do not count carbs. I simply watch (and know) what I’m eating and pay attention to how it affects my BG and my weight loss goals. I eat a massive Cobb salad with blue cheese dressing for lunch multiple times a week. I have eaten out many times in the last 3.5 months, steak houses, seafood, I went all out at a wedding (including a little desert) and even Thai food. I am simply careful of what I eat and make choices to eat sides like grilled asparagus rather than fries. No big deal…I still had the ribeye and the mussels in wine and garlic (just no bread to soak up the sauce). Let me think…needle in my gut so I can eat the fries and some pie for desert or grilled asparagus and a cappuccino for desert. Thank you but I’ll skip the needle appetizer. :)

    I’ve been at this 3.5 months and my A1C has dropped from 7.0 to 5.4(Saturday). I’ve dropped 30lbs in that time. I hope to get to around 5.0 and drop another 25lbs (or a little more). I may be forced to start exercising to get there. :) YES…I miss some of the foods…but if I keep doing what I’m doing and lose the rest of the weight I should be able to add some things back in limited quantities on occasion…as long as my #’s stay on track and I don’t gain weight.

    In the last few months I’ve done an incredible amount of research (literally hundreds of hours), I’ve talked with Type 2 friends, I found that 2 of 4 of my grandparents were Type 2 and 2 of 4 had heat disease (among other serious problems). What I’ve determined is there are different paths to deal with T2. My best case goal is to “cure” it where I can eat almost anything in moderation. I’ll call it a managed cure since I won’t go back to eating all the @#$@# foods again. I mean really…who need to eat a package of Oreo’s, Doritos, or pretzels in one sitting let alone a large pizza or a burger, hot dog and jumbo fries? It sickens me just to think of it. My worst case goal is to simply hold off needing drugs for as long as possible and I am terrified I will need to give myself insulin shots.

    I do envy some of the foods you eat but I won’t medicate myself just so I can eat them. I hope you keep getting better and needing less insulin. I wonder if you would still need insulin if you minimized the intake of some of those “bad” foods?
    Good Luck Johnny!!!

    Posted by Andrew |
  59. i was diagnosed with type 2 about 5 years ago.
    i take metformine 2 x 500mg twice a day. i monitor twice a day morning just before breakfast and just before bed. i use a bayer contour meter. my reading’s are of the scale the highest has been so hi the mater alarm goes of and just reads high..
    readings as follows
    for a week period.
    28.9 mmol
    25.4 ” ”
    23.6 ” ”
    27.7 ” ”
    23.4 ” ”
    19.9 ” ”
    21.4 ” ”
    25.5 ” ”
    30.6 ” ”
    29.7 ” ”
    19.8 ” ”
    19.6 ” ”
    20.6 ” ”
    19.8 ” ”
    20.1 ” ”
    25.2 ” ”
    24.5 ” ”
    32.2 ” ”
    28.1 ” ”
    22.5 ” ”
    28.4 ” ”
    21.9 ” ”
    24.2 ” ”
    you get the idea.. i suffer with shoulder pain and tingling in my finger tips on the right side, also spots seem to take for ever to clear up. i have found silver plasters help. and just lately my gums have started oozing puss, and i am very into dental care brushing mouth washes ect..
    during the day i can suddenly feel sleepy for an hour or so. it seems im falling to bits day by day
    Question: what do you think medication i should be on to bring sugars down, i have changed my diet i dont drink any more … saying that when i used to drink i felt better the next day and my sugar levels would be in the 14 to 16 range mmol
    please advise any suggestions would help

    Posted by john pocock |
  60. Hi John,

    As you suggest, these numbers are way too high. (For those who don’t know, you convert a reading in mmol/l to the American mg/dl by multiplying by 18. So a reading of 20 mmol/l = 360 mg/dl, a bad number to have for a fasting blood glucose.)

    In my opinion, you should follow this up with your doctor immediately. There could be something wrong with your meter or the way you are doing the test. If the meter is giving good information, you should be on a different medication, possibly insulin.

    You say you have “changed your diet,” but perhaps you could do a lot more in that direction, especially reducing carbohydrates. Please get help. Make this your top priority.

    Posted by David Spero RN |
  61. Lorraine (and others)-

    Your post touched on something I have dealt with, with my 22 month old T1D angel. My husband and I differed on our desires to treat our son… I wanted low carb, control, strict, mostly whole foods (60 carbs or less/day) while the hubby wanted to do 150/day but he never fully explained why. So, at first (since I do meals) we were doing the low carb thing for 3 months… And, for those three months our son never grew, never grew taller or gained an ounce, lost 2 lbs in fact. He also lacked the energy and enthusiasm he used to have. His spirit started to wilt. He would have those trace ketones and I would see him actually lose muscle mass (I stare at this little guy often) when he had ketones. But… the numbers would be good. Hum…

    Then I decided to listen to my husband, who is a brilliant man in many other capacities, and did 120 - 150 carbs. I hate when he’s right, well, not so much that, but I dislike being wrong. Our son immediately grew… taller, bigger, but most importantly grew back the spirit he used to have. You want to know when he has the best numbers..? When he sees his grandma, when he goes to the park and runs, when he exercises and when he has a day where he laughs A LOT with his two brothers. I kid you not I have tracked it and the days he laughs the most and moves and plays and eats are the days he has the best numbers.

    I am still in the learning process with this and his numbers are all over the place and I get very frustrated with that damn finger prick that takes too much f-ing blood to begin with, but my two cents are make your child laugh, make him smile, make her move, make her live well, play well, learn well. We have a very very important role as parents of T1D kids because we have to train them to care for themselves and live their lives well and well means HAPPY and healthy. His numbers may be higher with dad’s approach, but he’s growing in amazingly positive ways.

    Natalie Z
    ps. I will be pushing the low carb thing once he becomes a man just not while he’s growing.

    Posted by Natalie Zey |
  62. Natalie,

    Thank you for sharing this beautiful and instructive story. Wishing your family long and happy life!

    Posted by David Spero RN |
  63. I am 71 and now weigh 175 lb at 6′ 0″.

    I was diagnosed as D2 about 3 years ago with fasting glucose ranging from 130 to 155 over six months. I went to diabetic education and they wanted me to eat far more carbs than I thought wise. Instead, I went on a reduced calorie diet (pretty easy on low carbs) and lost about 30 pounds. Gained about 10 of them back over several months, but am pretty stable now. I do go “off the wagon” on diet occassionally at a nice restaurant and suffer guilt afterwards, but it hasn’t really affected my morning fasting glucose.

    My excercise consists of walking several miles every day…sometimes as far as 7 miles but usually more like 3.

    My doctor reluctantly put me on 1000 mg of metformin after evening meal. I heard that it can’t hurt, and it’s cheap. Haven’t convinced my doc, but he continues to renew my scrip for it.

    Here is my question: It seems nearly impossible for me to get my fasting glucose under 110 or so. I do not test my PP glucose regularly but it is usually around 130 when I do.

    However, my A1c is reliably 5.1. Is the 5.1 more important than fasting glucose?

    Posted by Jasper2 |
  64. Hi Jasper,

    I think anyone with an A1C of 5.1 at age 71 has better things to worry about than diabetes. You might be able to lower the fasting glucose by taking the metformin at bedtime instead of after dinner, or with a spoonful of vinegar at bedtime. But you have a very healthy lifestyle and excellent postprandial numbers. You’re OK.

    Posted by David Spero RN |
  65. had a low insulin level of 1.1, glucose 88 and A1c 5.7, I know this means pre diabetic. I have been checking my sugars fasting anywhere from 80 -100 non fasting 140- 166. I have been having spells of feeling shaky, blurred vision, fatigue with high and low sugars any advice please

    Posted by Beverly Bailey |
  66. Beverly,

    You should see a doctor about this — 1.1 is a very low insulin level. I’m impressed that your blood glucose levels aren’t higher than they are. But the symptoms sound very much like diabetes and should be addressed.

    Posted by David Spero RN |
  67. If I could convince any overweight/obese/diabetic/prediabetic . . . to do anything, it would be to NOT delay starting on Metformin when insulin resistance rears its ugly head. (Especially) in combination with a low carb diet and exercise (especially resistance training), it has been proven to ward off diabetes, help you to lose weight, and to dramatically lower blood sugar levels. It also has anti-cancer qualities, raises HDL, and is a product derived from plants known to treat diabetic symptoms since the middle ages. The side effects are mild and fleeting for most people, unless one is an alcoholic/has kidney problems.

    I only wish I had not had the attitude that I didn’t want to “go on a pill” 7 years ago when my MD told me I was pre diabetic. I actually agonized over it, and denied the situation for years, until DN in my feet woke me up, and viagra stopped working.

    Now, everything is under control, and the burning in my feet has almost completely subside, my ED is greatly improving, and I am feeling better than I have in years.

    I thank God for the folks that brought Metformin to us. I believe it is literally adding may healthy years to my life. If, after my weight loss, diet, exercise can return me to completely normal numbers, I will STAY on it.

    Good luck to every one.

    Posted by Gary |
  68. BTW, Andrew and Jaspar? You guys f’ing ROCK! I still have about 20 lbs to go, and can’t quite believe that my LC diet is going to get me there without starving, but THE SCALES DON’T LIE!

    Posted by Gary |
  69. My age is sixty four years . I observed that though I am not diabetic still my fasting blood sugar level is higher than pp blood sugar level. Please provide reasons behind this p-henomenon

    Posted by Pradeep Dasgupta |
  70. The more doctors I see the more confused I become. When first diagnosed as type ii, I was told to keep morning BS to 180 or under. The diabetes school she sent me to told me to keep it below 150. I later saw an endocrinologist who told me to keep in between 80 and 120. Two hours after meals it should be under 200. If not, shoot Humalog.

    My A1C is 7%

    This is medical science?

    Posted by Wayne |
  71. On the diabetes sites I read I have seen no mention of the connection between allergies and high blood glucose levels. Allergies cause stress (DUH!) which results in the release of cortisol, the stress hormone. Cortisol causes an increase in glucose, a necessary weapon in the fight against stress/inflammation. No problem if the allergy is contained right away, but long term allergies (chronic high cortisol) result in several problems; high blood pressure and high glucose being only two.
    I tested at 6.8 on an a1c in Jan and was told that this confirmed diabetes. The doc wanted to put me on metformin. I refused, saying that I would prefer we treated my allergies first to see what happens. The doc reluctantly agreed. (Had never even considered allergies as a cause for high glucose.) When the allergies were treated the decrease in glucose was IMMEDIATE! No more high fasting glucose and within about 6 weeks my a1c was at 5.2.

    Cortisol, as important as it is in the “fight or flight” scenario can cause (or is directly related to) high glucose, high blood pressure, aromatase exhibition (resulting in low testosterone/high estrogen and the complications of such), microalbuminurea, neuropathy (which can be misidentified as diabetic related), high cholesterol, and the list goes on. Oh, yes, also poor weight management!

    No, not everyone’s high glucose is because of allergies. But you don’t know unless you test. Each symptom can be treated by a separate medicine. Or, you can find out what the cause is and treat that! Then ALL of tour problems might be resolved.

    Specialists too often have tunnel vision and only recognize factors that fall withing their specialty. Learn to read; learn to think; and take charge of your own health! The life you save may be your own!

    Posted by James Crabtree |
  72. I am on a pump. My A1C is 5.5 I take 28 units of insulin/day, but my evening and morning BG readings have slowly crept up. Evening -125-140, AM 140s -160s. This bothers me a lot, since I faithfully count carbs and measure portion sizes. My ophthalmologist says have two little bleed in my right retina. Now my doctor wants me too cut back on daily insulin - says I am overdosing. I am scared to do so, considering the retina bleeds and the high evening and AM readings. Any suggestions?

    Posted by Sue Policicchio |
  73. I had an epidural this afternoon and when I got home
    about 8pm my sugar had gotten up to 401 and at
    10pm it went down to 360. I gave myself 80 units of
    Lantus total between 8pm and 10pm.

    My question can I go to sleep with 360?? Is it safe or
    should I wait until the number goes down to 300??

    I am not giving myself anymore Lantus (80 is my max)

    Please advise what I should do.

    Thank you.

    Ruth

    Posted by ruth gold |
  74. Today I had a deep joint injection at 10 am. and my sugar was 121 when I went in I had 2eggs and toast for lunch at 2:30pm
    I tested again at 4pm it was at 491 what happened? It’s now 8:45. And it 475.

    Posted by PJ |

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