The key issue in managing your diabetes is, indeed, keeping your blood sugar levels in control; the commonly checked blood sugar levels are fasting (blood sugar level when you have had no food intake for eight hours), pre meals (just before major meals) and PP (post prandial or post meals -typically measured after two hours of finishing major meals).
The levels are checked either by laboratory tests or by glucometer testing at home or in clinic/hospital
The control of blood sugar is also checked indirectly by testing HbA1c level in blood, which correlates with average blood sugar levels over past 2-3 months; in fact, this is the gold standard for monitoring the control of blood sugar in diabetics n the long term, except in some conditions affecting the lifespan of blood cells
Following table summarizes the target levels for both blood sugars and HbA1c for good control of diabetes, as recommended by Indian (ICMR) and international guidelines such as ADA, AACE and IDF and summarizes FWI view in the end
|IDF guidelines||AACE guidelines||ADA guidelines||ICMR guidelines|
|Fasting/ preprandial/pre-meal glucose (mg/dL)||<110||<110||70-130||80-110|
|2-hours postprandial (PP)/postmeal (mg/dL)||<140||<140||<180 within 1-2 hours of beginning of the meal||120-140|
The target HbA1c levels stated in the table are not absolute, but have to be set depending on your age, number of years for which you have had diabetes, your co-existing illnesses and your risk of hypoglycemia (episodes of dangerously low blood sugar levels), which happen most commonly in patients treated with insulin and some oral medications, but nearly never happen with metformin, which is the first line drug and many other drugs
Striving of better control in early years of disease is especially important, since this not only lowers the risk of complications of diabetes itself but also has been shown to reduce risk of heart disease in diabetics, even if blood sugar control in later years of disease becomes less tightly controlled. To know more: read ‘How does good control of blood sugar help in diabetes?
Therefore, aim for HbA1c level less than 6.5%, if you got diabetes at a younger age and/or have no other serious diseases, discuss with your doctor!
For blood sugar levels checked by SMBG (Self Monitoring of Blood Glucose by glucometer), it is recommended that you chose an appropriate SMBG schedule, follow it and maintain diary of the levels, paired with the meal that you took and exercise you did in the same day; this way of monitoring helps both the doctor and the patient best !
Find out which is an appropriate SMBG schedule for you
Check out: Our references for diabetes mellitus