Sugar Matters
October 12, 2010
What are your target numbers anyway?

Despite discussing this at various times, many patients seem to forget what their target numbers are in regard to their diabetes. If you are fortunate enough to have a glucose meter at home, you will have many more numbers to track what is going on, as compared to if you have a hemoglobin A1C every few months only. But something is better than nothing, so I encourage you to please do what you can, and overall the more information that you can muster, the better it is for you and your doctor/nurse.{{more}}

I will also place the caveat that while these are general guideline numbers, it will not be the same for everybody. There are some higher or lower targets depending on special situations. For instance, pregnant women have LOWER target numbers than non-pregnant women, but older people who have risks for falling may have a higher target number to keep them safe. Your doctor will determine what your target should be, based on general medical guidelines AND your specific situation in life (including your age, other illnesses you may have, special circumstances like pregnancy, etc). That said, here are the general targets for which you should aim:

Fasting blood sugars-these should be less than 120mg/dL(6.6 Mmol/dl) on waking. Now for the NORMAL population without diabetes, the normal value is less than 99mg/dL (less than 5.5 MMol/dl) on waking after at least an 8 hour fast. For people WITH DIABETES, however, (excluding pregnant women) we do relax this a bit in order to minimize the chances of waking up with a low blood sugar.

Random sugars throughout the day, or after a meal: for people with diabetes, this should ideally be no higher than 180mg/dL (10mMol/dl). By “random” I mean anytime during the day that is not fasting. So if you wander over to your neighbour for some afternoon tea and happen to check your sugars there, that would be a “random” blood sugar. Some of you may be quite shocked by this number, thinking it’s too low. “Don’t blood sugars go up after you eat?” You may ask. Well yes, but if your medication is doing its job properly (and you are watching what you eat as you should) then your blood sugars should not be much higher than 180mg/dL (10mMol/dl) at anytime during the day ideally.

Both those values I talked about there for fasting and random blood sugars are closely related to the A1C test that you have every few months. The A1C test tells you an average of your blood sugars for the past 3 months, meaning EVERY fasting blood sugar and EVERY random blood sugar level throughout the day for the past 90 days. Your target A1C is 7% or less. This number should be almost tattooed on your brain!!!! Why 7%? Because at this level or less, you stand a generally lower risk of developing complications from diabetes, whereas the higher you go above 7% the more likely you are to suffer serious problems, like strokes, blindness, kidney failure, etc.

I hope this week’s column answers some of your questions. We will continue on next week with more testing information.

Until then, stay safe and healthy Vincies!

Anita Ramsetty, MD [email protected]
Medical Director Endocrine Care Group
Tel: 843-798-4227