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Safe blood sugar level and diabetes
Safe blood sugar level and diabetes -- Posted by Gumbo on 11-09-04 17:54
Safe blood sugar level and diabetes
Although other factors affect whether you develop complications from
diabetes, keeping blood sugar levels as close to normal as possible (tight
or strict blood sugar control) seems to help decrease your risk of
complications. In the Diabetes Control and Complications Trial (DCCT),
people with type 1 diabetes who kept their blood sugar levels between 70
milligrams per deciliter (mg/dL) and 120 mg/dL before meals and less than
180 mg/dL at bedtime had fewer complications from diabetes than people who
did not keep their blood sugar levels within this range.1 For people with
>type 2 diabetes, the United Kingdom Prospective Diabetes Study (UKPDS)
found a strong correlation between safe blood sugar range and reduction in
risk for complications.2
The American Diabetes Association (ADA) recommends that you keep your blood
sugar levels within:1
a.. 80 mg/dL to 120 mg/dL before meals and 100 mg/dL to 140 mg/dL at
bedtime when using a blood sample drawn from a vein (a whole-blood sample).
b.. 90 mg/dL to 130 mg/dL before meals and 110 mg/dL to 150 mg/dL at
bedtime when using a blood sample drawn from a fingertip (plasma blood
sample).
The ADA also recommends that a level of 6.5% or less be the hemoglobin A1c
(HbA1c) target level (6% is normal) for people who want to tightly control
their blood sugar levels.1 HbA1c is a measure of how well blood sugar levels
have remained within a safe range over the previous 2 to 3 months. If you
choose not to tightly control your blood sugar level, you can still reduce
your risk for complications from diabetes by keeping your HbA1c level close
to 6.5%. In the United Kingdom Prospective Diabetes Study (UKPDS) of people
with type 2 diabetes, there was a 35% decrease in the risk of eye, kidney,
and nerve problems for each percentage point decrease of HbA1c.2
A possible complication when you tightly control your blood sugar is more
frequent low blood sugar (hypoglycemia) episodes. Some people need to have
target blood sugar levels above either of these ranges because of the
dangers associated with low blood sugar. They should work with their doctor
to establish a target blood sugar range that is best for them. That range
should be the best level of control that they can achieve without placing
them at significant risk for hypoglycemia.
These people may include:3
a.. Children younger than age 2. Low blood sugar levels may harm brain
development in young children. The risk of very low blood sugar from tightly
controlling blood sugar levels is higher in these children because their
food intake and activity level varies from day to day. In addition, children
of this age are unable to describe the symptoms of low blood sugar when they
experience them.
b.. Children between the ages of 2 and 7. Low blood sugar levels may harm
brain development, which is not complete until the age of 7 years. If tight
control of blood sugar is used in this age group, it must be done with
extreme caution and must be monitored closely.
c.. Children before they have reached puberty. These children seem to be
protected from complications from diabetes. As a child grows older and can
recognize early symptoms of low blood sugar, his or her blood sugar level
range can be lowered closer to the safe range for adults.
d.. People who already have severe diseases, such as kidney failure, from
complications of diabetes. They may not benefit from such control of their
blood sugar level.
e.. Older adults who have atherosclerosis and are at risk for permanent
injury (a heart attack or stroke) from low blood sugar levels.
When a woman with diabetes is trying to become pregnant, her target blood
sugar level range should be a little different from the target range for
other people with diabetes. Her target range should be:4
a.. Between 70 mg/dL and 100 mg/dL before meals when a whole blood sample
is used and between 80 mg/dL and 110 mg/dL when a plasma blood sample is
used.
b.. Less than 140 mg/dL two hours after meals when a whole blood sample is
used and less than 155 mg/dL when a plasma blood sample is used.
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