The Numbers Game


#1

I’ve heard so many differing opinions on what my goals for my BS to be. The Endo says 80-140. ADA says up to 180. Sometimes when I’m over 200, it doesn’t seem to be that high, so I don’t stress. I only start worry when I’m around the 275 mark or under 60.

What numbers do you consider to be too low or too high, and you start to correct? Are there in ranges that make you feel safe or are easier to manage?


#2

Those are great questions. I’ve heard the numbers 140 after an hour and 120 after two hours being acceptable. Should I be concerned about very short spikes? Mine tend to peak at 30 - 45 minutes and be a little lower by one hour. My doctor tells me that’s OK but I’ve read that swinging up and down can be more damaging than consistently higher levels. What do other people think? Also, didn’t Bernstein write that we should try to avoid more than a 30 point spike after meals whenever possible? Since my fasting level is between 85 - 95, going up to 140 usually makes me feel bad.


#3

I just really started trying to do tight control and my endo advised not going over 140 two hours after a meal. However, I usually don’t start feeling “high” until I’m around 275 and up.

Right now, if I am under 180 two hours after a meal, I am happy. Before a meal, I like to be under 100.


#4

I would pretty much agree with Katrina - I sort of have 160 post prandial and 100 preprandial as my goals.
It is very very hard for me not to get totally caught up in the numbers and let a high reading ruin my day. So, I try to just look at them as information and nothing more - they do not have to dictate how I feel.
I have a very unpredictable dawn phenomenon - never know when it’s going to kick in. I control it by drinking 12 ounces of water before bedtime so that I naturally get up about 2 a.m. to pee and then test so I can correct if I’m headed up.
On mornings when I haven’t caught it and wake up at 200, I used to use it as an excuse, saying “well, you did everything right yesterday and now you wake up high - let’s stop at Starbucks and get a big gooey cinnamon roll…” And then of course I’d be chasing a high around for the rest of the day.
Now, if I wake up at 200, I correct it and know that I’ll be in range by mid-morning and the rest of the day has a chance at going smoothly.


#5

It’s so hard to figure out numbers. I have goals, but I don’t know if they’re really reasonable. I know what I have to do to acheive them, but I don’t know if those lifestyle changes are ones I can live with. I think what makes it tricky is that if you pick ‘wrong’, you may not know for years. I’m not going to post my numbers - I’m prediabetic and that makes a big difference.


#6

I spent several months researching just this question and after reading an immense amount of journal research, I put what I found on my web site at http://www.phlaunt.com/diabetes

Check out the “Research connecting organ damage to blood sugars” page and you’ll see why the endo tells you to stay under 140 mg/dl. There is compelling evidence that staying above that level for sustained periods of time correlates with developing neuropathy. They are also finding people blood sugars over 140 mg/dl at 2 hours on a GTT developing retinopathy. So it’s a good idea to shoot for under 140 as much as possible.

If you have the kind of Type 1 where you get hypos even if you keep your carbs at a reasonable level a higher target might be necessary, but if that’s your case, it would still be worth trying to monkey around with carb intake and insulin ratios, timing, and changing insulins to see if you could get better control of the hypo problem. I realize not everyone can. But for those who can, it does look like staying under 140 mg/dl as much as possible should really lower the chances of complications.

Normal people appear to go up to 120 and then pretty much go right back down, BTW, based on studies with CGMS.

My targets for several years have been:
1 hour after eating 140 Maximum but I try to get lower
2 hours after eating 120 Maximum
3 hours after eating under 100

Ideally I try to get under 100 at 2 hours and in the 80s as much of the day as possible.

I don’t always make it to my targets, (understatement!) but just shooting for them is very helpful and has translated into an A1c that has bounced around between 5.7 and 5.5% for the last 3 years.


#7

My target for before meals is 4-7 mmol/l and for two hours after meals is 6-10 mmol/l. I preferably like to stay closer to 7-8 after meals if possible. If I try to aim for 5 or 6 I end up low by the next meal. My personal target for bedtime is 6-8 mmol/l although my endo recommends 5-6, but I like staying higher just because I’m scared of going low and would rather be a bit high all night (I tend to drop slightly anyway depending on how much activity I’ve had the day before).

Personally I don’t tend to be really concerned about highs (frustrated yes, concerned no) until they’re 13+, and I don’t tend to worry too much about lows (unless there’s a bunch in a row) unless they are below 3. Diabetes is so random and unpredictable sometimes that I have to remind myself not to get worked up over every reading, it’s the patterns that count more.

I would like to lower my targets, but every time I try I end up going low multiple times a day. I admire people who can stay in a really tight range and not go low! And then there are times like today after breakfast when I was 11.8 even though I eat the same thing (and measure it out) every morning. Frustrating!