Type 1 Diabetic told he should maintain blood sugar level between 80-120 at all times by Endo

Now I realize that we all should and would love to maintain a level of 80 - 120 blood sugar level, however I just don't think that is a realistic expectation for a type 1 Diabetic. I personally have been a type 1 for over 30 years and have carried a CGM for the last 2 years. I have my really good days where everything falls in place and other days where you would wonder if I was even trying. Not to mention colds, stress, unexpected activity or just the occasional miscalculation of carbs.
How many of you believe this is realistic or are even able to maintain this yourself. or do you think that maybe 60 - 160 would at least be a bit more realistic just want to make sure I am not the minority and if so I guess I just will have to try harder

No, you are not in the minority. I think we all have a wide variety of management. Some people try as hard as they can and still have wide outliers. Others seemingly easily stay within that range. Most of us are in the middle, but I'd say most of us couldn't maintain even the 60-160 all the time! But I'm wondering if the endo meant that as a target range - a goal, rather than something the person could accomplish on a regular basis? Aside from a goal there is also our target number that we correct to on our pumps. Mine is 110. If I'm high I do a correction based on my ISF that will hopefully return me to that number. Do I expect to always be at 110? I wish!

I think we are ALL different, some of us can manage fairly easily keeping our BG levels between 80-120 with somewhat of ease. Others no matter how hard they try, it doesn't happen. I think the important thing though is we ALL try to live as healthy as we can, and just do the absolute best you can keeping them numbers as low as you can. I certainly can't say I don't have days, where I get a spike to 200 eating something, but you keep those moments few and far between. Are you on a pump or MDI? Pumping has really made it a LOT easier for me to have more consistent numbers.

Hi Donald, I have 26 years with type 1. Since 2003 I began to take more control of my glucose to keep it as normal as possible but between 80 and 120 is not real for me. at 90 I need to drink some juice to raise it up, below 200 I am very confortable, over 200 I take care. Everybody is different and I am always surprises that my A1C is 6.5%. Now, to go to the gym I need to have it around 250, because my cardio drop it very fast.

Hi! This is a huge place for me.

I strive for a reading of 100, and am pretty good at it. But when I am not, my world crashes. I am beginning to think that safer (for me) is a bit wiser.

Sickness (referenced above and rare for me) is an entirely different issue--it is the day to day that is hard.

I just saw my endo (grrrr) today and am still processing it. My A1C was 5.7. Seems great, but I have had two devastating lows during A1C times. He is encouraging me to work for a higher number (!?!?!?!)

After 50 years, I am just confused.

Staying in a range of 80-120 all the time is the equivalent of having an A1c of about 5 and a standard deviation of about 10. I'd love to be able to do it - maybe in my next life when I don't have diabetes...

My Dexcom is set to alarm for lows at 65 and highs at 160. For me that is a reasonable and attainable range assuming that I am eating fewer than 100g of carbs per day and not going crazy with after-dinner treats. Do I stay in that range very often? No, but I could with better willpower.

I don’t think that even with perfect eating I could stay in a range of 80-120. In past years they used to call everyone with Type 1 “brittle.” That term is considered outdated now, but even with a pump and a CGMS, I can’t keep my BG in a range that small. My endo would never expect me to be able to do that. She is the first to admit that we don’t even know all of the factors that influence our blood sugar much less be able to control all of those factors.

Not very realistic, although an admirable goal. Keep in mind that a person without diabetes can have numbers outside that range. If those lucky folks with fully-functioning pancreases don't always stay within 80-120, you shouldn't beat yourself up about it.

Even on a strict Bernstein regiment, I cannot keep between 80 and 115. I have a pump, a cgm, I eat low carb less than 50 g per day. I test basal rates, exercise,ect, and although my blood sugar control has improved over the last four years, my A1C is 6.5, and not 4.2 -4.7 which is Bernstein's prescription. I am content in my achievements, and I am doing fairly well after 45 years of T1.

If you aim at that, you are much more likely to hit it than if you give up and aim at like 60-140 or 120-140 or some other range. I would want to know the exact context and how the endo would approach an "oops." To me, it's not that big of a deal but, at the same time, I will still get pretty wound up about fixing the oopses...

I have this incredible deal on a bridge for sale. The bridge works some days others not so much. However, if you buy it you may stand on the bank and yell at the bridge all day and see if you can improve operation.

No guarantees of course.

Actually brittle meant that small things could and would make big changes in Blood Sugar. Generally the longer you were a type 1 the more brittle you would become. Now this makes sense, since the longer you are type 1 the less natural insulin your body usually produces.

As a 37 year diabetic I would be considered very brittle. So for instance, if I dine on a few grams of carb, I can and do, expect a fairly wild rise in Blood Sugar. Likewise, if i take a small amount of insulin, I can bottom out quickly. In short I am a brittle diabetic.

Now you are 100% correct, it is an older term that is almost never used anymore. My doctor (an old hand) will sometimes say I am brittle, so I always inquire if he means Peanut Brittle and we have a good laugh. But yes I have been very 'brittle' for about 22 years. No never Peanut Brittle, LOL.

How's that rick? I'm not talking about yelling at a bridge. With diabetes, you have inputs (food, exercise, stress, phases of the moon...) and outputs (BG readings) and, if things are off, you can either just give up and yell at the bridge or you can think, "hmm, was something off, is there something I can fix next time" and perhaps slowly obtain data to obtain a different result. It's not always better but even a mistake can provide useful data about a ratio or rate that can allow you to make changes. I don't beat myself up if I run outside of what I'm aiming at but keep working at it. I don't work more than a person who's aiming at a different target but I get ok numbers and it probably helps that I'm aiming at a relatively small target.

I agree...I spent 20+ years with high BG and was considered none compliant and when I changed my target to a smaller target 70-120 my numbers dropped and my A1c has dropped into normal range for the past 6 years...My doctors also say I'm still none compliant, they think my numbers are wonderful but will not officially approve my methods. I know I can't really maintain blood sugars between 70-120 but the end result is that my BG is in range more than 85% of every day and this = A1c's in the low 5's , I'm still waiting for the Bete's complications, nothing alarming has shown it's face so far....;-)

I wonder if any of your Endo's other patients actually do this? I eat ~30g carb / day and correct if over 140. There are still plenty of mistakes I make and situations that can push me out of range. To keep things in perspective PWD I know outside of TuD seem to spend most of their time from 200-300.

I think that your endo was giving you the target range for what can be considered "normal"for those without diabetes. my range of "normal" is 70 to 140. With a cgm, relatively low carb (less than 90 grams a day); good exercise, expert temporary basals,and dual wave bolusses as nececessary, accurate carb conting, little stress and a sunny day in winter Ohio, I can get to it. Maybe. But not every day. Definitely not every day.

I agree with Acid:. It's not always better but even a mistake can provide useful data about a ratio or rate that can allow you to make changes. I don't beat myself up if I run outside of what I'm aiming at but keep working at it.

God bless,

Sam I am,Yes, most of the PWD that I personally know outside of TuD are type 2 and 200-300 is "normal" for about 70% of them, unfortunately. The others I know outside of TuD are type one children in excellent control ( 85-130), a few type one adults in excellent control. But most of my type two friends outside the DOC do not test frequently and have no idea. They wait until the 3 to 6 month a1c and " I let the doctor tell me what to do."

God Bless,

80-120 is an admirable goal, but something that is just not possible for me to do. You should ask your endo how to do it and see what he says. I would be very curious of his answer?

60-160 is somewhat achievable if I am doing amazing I may be able to do achieve this control for 2 days in a row. With current technology and standards I usually have at least 1 test (slightly) outside of this range a day.

This might not be the perfect or right answer to many...but maintaining some semblance of normal is very important to me. I have a pump, I use a CGMS, but I don't strive for completely unattainable goals. To me, trying to stay between 80-120 all the time would be unattainable if I want to continue the kind of life I have now. Traveling, doing things sporatic...living life. To keep a perfect 80-120 all the time would, to me, mean doing the same things everyday, taking out all variables of life...of living. I don't want poor control. However, I want to live my Life. I don't want to live Diabetes. FWIW my last A1C was 6.7 . Maybe too high to some, but for me...I'll take that, since I know the three months involved in the creation of that A1C was a heck of a lot of fun.

I think there is a difference between a "target" on your pump and where you try to keep your blood sugars most of the time. For many, a pump target of 70-120 mg/dl is quite reasonable, that is the range that your pump will use when calculating corrections. If you are in that range, then no correction. If you are higher or lower, the pump wizard will suggest a correction. But this doesn't mean that your blood sugar is always in that range, far from it.

On the other hand, there is a question (and a very individual one) of where you try to keep your blood sugar most of the time. I think many of us seek to have a blood sugar as close to normal while balancing the risks of hypos and the difficulty of that management. We are each very different and our choices reflect our own bodies and the priorities and choices we make in our lives.