This article aimed to provide guidelines for setting personalized blood sugar level targets. The main conclusion was that these targets should be flexible and adapted to patients characteristics.
Type 2 diabetes usually requires tight blood sugar control in order to prevent and minimize complications. If control is not achieved through lifestyle changes, oral medications or Insulin may be needed. Patients who are older or have associated diseases (heart disease, kidney disease etc.) usually have difficulty reaching blood sugar targets. Social status and financial issues also play a significant role.
Blood sugar control is assessed using the HbA1c test (or glycated hemoglobin test). This measures the average blood sugar level over a 3 months’ period.
This article reviewed data from recent large clinical trials on type 2 diabetes. The authors analyzed whether setting higher blood sugar targets would significantly increase the risk of complications. Prevention of retinopathy (eyesight problems) and nephropathy (kidney disease) required tight blood sugar control, especially in the early stages of diabetes. However, cardiovascular events (heart attack, stroke) were not significantly influenced by the degree of blood sugar control.
For younger patients with few other diseases, who are able to follow a strict treatment schedule, the authors recommend an HbA1c level of 6% or less. In patients who had diabetes for a long time, who are older, have other diseases or have difficulty with their treatment, the HbA1c target can be raised to around 8%.
Blood sugar goals need to take into consideration a set of patient characteristics. These include: age, presence of complications, disease duration, ability to understand and follow treatment, social and economic factors. Depending on these characteristics, personalized blood sugar targets can be set.
Published By :
Annals of internal medicine
Date :
Apr 19, 2011
My main problem is that I need to be around 17 or 18 before going to bed to carry me through the night.
You may want to communicate with the online diabetes community. Here is a link to a past blogpost on this group. Kathleen