Learning From Our Mistakes

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There’s often no better way to learn something than to make a mistake. We did that in the most recent issue of Diabetes Self-Management magazine.

In the article “Diabetes Basics: Managing Your Blood Glucose Ups and Downs,” which appears in the January/February 2009 issue, a table within the article mistakenly said the American Diabetes Association’s recommended goal for blood glucose levels before meals is 90-130 mg/dl. (The text of the article, however, got the numbers right.)

In fact, since the beginning of 2008, the ADA’s recommended goal for blood glucose levels before meals has been 70-130 mg/dl. The error was pointed out by three diabetes educators and was no doubt noticed by others.

Once this error was brought to our attention, we decided to have a look at why the ADA made this change from 90 to 70 mg/dl in the 2008 recommendations. As stated in the ADA’s “Standards of Medical Care in Diabetes — 2008,” “The listed blood glucose goals are levels that appear to correlate with achievement of an A1C of less than 7%.”

Interestingly, the goal of an A1C level of less than 7% has been in place since at least 2002. So it seems that the recommended before-meal blood glucose levels are just now catching up to the A1C goal, perhaps due to improved methods for “translating” blood glucose levels into A1C levels. (See “What’s Your eAG? You’ll Know Soon…”) Incidentally, the ADA still recommends treating for hypoglycemia when blood glucose is below 70 mg/dl.

What difference have the new ADA premeal blood glucose and A1C level recommendations made in your diabetes control efforts?

Also, what mistakes have you learned from as you work to control your diabetes? Let us know your experiences by leaving a comment.

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