Diabetes Control: Does Tight Make Right?

Diabetes specialists, including those involved in the ACCORD study, continue to emphasize good control of glucose because hyperglycemia can devastate the heart, nerves, eyes and other organs. Exercise, diet, pills and insulin, as prescribed by a doctor, are all ways to control glucose.

"For now, any strategy that lowers glucose and is associated with a low risk of hypoglycemia and does not cause excessive weight gain should be considered appropriate," ACCORD researcher Byron J. Hoogwerf, M.D., wrote in the October 2008 issue of the Cleveland Clinic Journal of Medicine.

So what should your target glucose range be? Your doctor will set a goal based on many factors. For example, patients who are at increased risk for hypoglycemia or have hypoglycemia unawareness (difficulty sensing low blood sugar) may have a higher range than most. Others, such as women planning for pregnancy, may be advised to have especially strict control of their glucose.

Keeping that in mind, here are general ranges for diabetic glucose monitoring:

  • Before meals: 90 to 130 mg/dL (plasma)
  • One to two hours after the start of a meal: 180 mg/dL and lower (plasma)
  • Bedtime: 110 to 150 mg/dL

Ask your doctor what your glucose and glycohemoglobin A1C targets are, how often you should check your levels and how you can best achieve your goals.

Reviewed by Gary Pepper, M.D., FACP

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