Setting Blood Sugar Goals - Diabetes Type 2

Setting Blood Sugar Goals

Your blood sugar control can be tracked using several different measurements:

Fasting blood glucose is the measurement of blood sugar after you have not eaten for eight or more hours. Your morning glucose check at home can serve as your fasting glucose.

Two-hour "postprandial" glucose is measured two hours after a meal. Most doctors recommend a bedtime sugar check at home. For most people, the timing will be close to two hours after dinner.

Hemoglobin A1C is a useful laboratory blood test that helps to track long-term blood sugar levels. The test measures a type of red blood cell protein.

Red blood cells are continuously produced by the bone marrow. Each red blood cell remains in your bloodstream for several months before it is replaced. Episodes of high blood sugar can adjust the proteins within red blood cells to a unique type of protein. This type is called the A1C.

This adjustment is lasting. It's as if the red blood cell has been "tattooed" by high sugar levels. If you have high blood sugars through a large part of a two- to three-month period, you will have more cells with the A1C "tattoo." By checking your percentage of A1C, your doctor can get a good idea of your diabetes control in the last two to three months. However, your blood sugar levels in the two weeks before the test have the greatest effect on your A1C.

All of these tests are useful ways to monitor your diabetes. They also can show how well your treatment is working. In general, the closer to normal you are able to get each test, the better off you will be.

Respected groups of experts have set goals for optimum blood sugar control. Here's what they recommend:

	Fasting glucose goal	Two-hour/bedtime goal	Hemoglobin A1C goal
American Diabetes Association	80 to 120 mg/dl*	100 to 140 mg/dl*	In general, less than 7%. If you don’t have hypoglycemia problems (low sugars) at 7%, adjust your goal. Increase treatment until your A1C is as close to 6% as you can get without having hypoglycemia events.
American College of Endocrinology and American Association of Clinical Endocrinologists	Less than 110 mg/dl*	Less than 140 mg/dl*	In general, 6.5%. If you have hypoglycemia problems (low sugars) or medical problems in addition to diabetes, your doctor can choose a higher goal.

*Measurements are in milligrams per deciliter of blood. The numbers for fasting and two-hour glucose goals are for levels of "whole blood" glucose. This is the type measured by most home glucose monitor machines. A doctor's laboratory measures "plasma glucose." These numbers should be slightly higher than the numbers shown here.

For most people with type 2 diabetes, achieving these goals for "optimum" or "tight" blood sugar control takes effort. It often requires more than one medicine. As you set your personal goals, read about what is gained through tight blood-sugar control.

Last updated July 29, 2010

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