at what point are you "safe"?

By haoleboy Latest Reply 2014-03-07 14:33:00 -0600
Started 2014-03-03 23:16:38 -0600

as a type 2 my goal is to keep my blood glucose levels down to where I am not at risk of further damaging my body … I have spent the past two hours researching this online and am more confused now than when I started.
so can someone point me to a definitive answer?
what is the BGL at which damage occurs to the body?

21 replies

ICDA250 2014-03-07 14:20:22 -0600 Report

Once upon a time (in the 1990s in a land far far away) I was told that damage begins occurring when blood glucose is measured above 200. Of course your A-1c score can be converted to an average of what your blood glucose levels would be and this would probably be a more reliable indicator than any one blood glucose reading..
In my Certified Pharmacy technician coursework and my graduate studies in psychology there were research studies indicating that the blood glucose goals for individuals who were past middle age would not be as strict for the purposes of avoiding heart complications and strokes as the goals for younger diabetics…these studies did not focus on damage to the eyes or renal function.
So haoleboy you have asked a very good but complicated question and Mr. Spock would say we would need more data to really provide adequate answers.

theladyiscrazy 2014-03-06 07:56:59 -0600 Report

Great question. Yes, there are a LOT of contradictory information out there. I also see difference of opinions among the medical staff as well.

jigsaw 2014-03-06 06:52:08 -0600 Report

Quite frankly, I am not for or against any particular means, or professional direction to better health, generally speaking. Most of us are not professionally trained in the area of health, more specifically diabetes. Certainly, like many here, I am not qualified to recommend a diet, or best way to treat your diabetes.

I have found ways, that work for me, after many years of trial and error, and quite a few doctors, My experiences may be helpful to some, and not to others. I am not for or against Dr Bernstein, Dr. Atkins, or a host of others that offer information and concepts for those with diabetes. I think many of these concepts and approaches written by these doctors are helpful to some, but not as much to others, and possibly under certain circumstances, even harmful! The results you obtain are in part, greatly dependent on you, the individual involved and many variable parameters.

Whatever choices are made, I believe it's imperative to be monitored by ones own physicians, just in case a problem arises.

So, with this in mind, I thought I would share this interesting link, which you may find helpful. It really has little to do with my opinions, but I thought you might enjoy it.

MoeGig 2014-03-07 12:10:35 -0600 Report

Dr Bernstein's numbers are pretty low. I've had Type 1 since 1965 and have had no complications and keep my A1c in the 6's. If I try to aim below 6, I end up with too many hypoglycemic reactions. 6's has been a good compromise and have no complications yet.

jigsaw 2014-03-07 14:23:36 -0600 Report

I found it impossible to go much below 6. When I kept my carb levels at or below 30 grams, for any length of time, I just felt terrible. No complications here so far, and I'm feeling good. I guess it's really a matter of what works for a given individual.

haoleboy 2014-03-07 12:57:46 -0600 Report

I'm type 2 and have never gone hypo, and for what it's worth the highest I have ever tested is 185. feel I am a good candidate to go sub 5.0

jigsaw 2014-03-07 14:16:35 -0600 Report

If you can do it, with no sacrifice in nutrition, then go for it.
When I took my carb levels down to 25-30 grams, I felt lousy. My energy levels were so low, that a strong windy day could have blown me away to the next city. My A1c didn't change much either.

On the flip side, and after 20 years @ 6.0, I still feel good, and I can still out run my wife, so I think I'm fairly safe!

haoleboy 2014-03-06 11:12:27 -0600 Report

thanks …interesting article and good discussions that followed in the comments. thanks, certainly provided more food for thought. a long with 'everything in moderation' one of my guidelines is that 'the truth lies somewhere in the middle'.

haoleboy 2014-03-04 22:20:04 -0600 Report

thanks for the input. my reason for asking is that I am setting my health goals for the next three months. when first diagnosed my goal was to get under 7, then to get under 6 (which I have been for the past 6 months) so while prioritizing my goals (I have other health concerns) I started wondering how much benefit there would be in reducing my a1c to the low 5's (cost benefit analysis, if you will). As I mentioned I seemed to be getting contradictory info. I did come across Dr Bernstein's work and what he says makes sense to me and I am setting a sub 5.0 a1c as my long term goal and 5.6 for 3 months from now. will I succeed? perhaps, but if not I will be giving it a good try and be healthier for the effort.
(I am typing this with my 2 year old grandson sitting in my lap … one of my great motivators)

- Steve

Glucerna 2014-03-05 22:07:04 -0600 Report

I see so many positives in your approach Steve: you're aiming for excellent overall health with diabetes management as a part of your goal; you're proactively looking for ways you can continue to improve your health; it sounds like you're also looking for balance in your life and making sure you have time for fun and family; and you're willing to shake things up and try something different. Your grandson has a wonderful role model! ~Lynn @Glucerna

GabbyPA 2014-03-04 16:33:39 -0600 Report

What I have been taught is that anything above 140 (a non diabetic's most high reading) can cause damage to your body. However, I have also been taught that the roller coaster ride of swings between highs and lows can be very damaging as well, and keeping something consistent is important, maybe even more so than keeping it below 140. Now, I am not saying that keeping a consistent 200 is good. Please don't misunderstand me. Just that if you tend to hang out around 130 or something, that you can lower that, just don't drop like a rock if you can avoid it.

mary, the diabetes lady
mary, the diabetes lady 2014-03-04 15:29:25 -0600 Report

I love the way you are proactive about your diabetes! It's awesome that your goal is to keep your blood glucose levels at a number that does not do any further damage to your body. Being vigilant about keeping your numbers in a normal range may also serve to reverse some of the damage type 2 diabetes has already done to you. My husband had severe neuropathy in both his feet for 20 years and reversed it with low carb and exercise. It's been a thing of the past for the last 8 years!

According to Dr. Bernstein (who believes that people with diabetes are entitled to normal blood sugars) a normal blood sugar is 83 to 85. Anything above that can be problematic. His range for Ha1c is 4.2 to 4.5. Now that may just be a bit difficult to achieve but just working at getting it down may be enough to prevent the debilitating effects of diabetes.

I love Dr. B's answer to the question: What do you do when you pass a bakery and the delicious smell of fresh baked breads and pastries come waifing over you? To which Dr. B replies: "I thank God I am alive." Good answer.

We all have issues. Many people are allergic to certain foods. One that is now almost commonplace is the allergy that children have to peanuts…anything with or about peanuts can send them into anaphylactic shock and possibly death. Peanuts! Who'd a believed? But it's very true.

So these precious children carry an Epi-pen with them 24/7. They can't be without that pen because they never know when someone will come near them with a peanut or even peanut breath!

We need to know that having type 2 diabetes really stinks however, it is also very much within our control. Getting blood sugars to be as close to normal using diet and exercise is one of the ways to be in control of your diabetes instead of it controlling you. :)

ICDA250 2014-03-07 14:31:50 -0600 Report

I know that both for myself and several other diabetics I know that we begin to suffer symptoms similar o hypoglycemia when ever our blood sugar levels go much below 120. My cousin who was diabetic and recently passed away told me the day that he died he was feeling woozy and his blood sugar was at 90. After he passed out I tested his blood sugar and it was below 45… the EMTs were unable to resuscitate him and I had been able to get him to eat prior to this episode. It seems one needs to be very careful when aiming for sugars that are too low or too high. I will have to look at the work of Dr. Bernstein but he appears to give out goals that may in fact be very detrimental according to what several of my internists and endocrinologists have suggested.

Glucerna 2014-03-04 12:49:15 -0600 Report

The American Diabetes Association suggests target BG levels of 70-130 before meals and <180 after meals for most nonpregnant adults, but notes that blood glucose targets are individualized based on: duration of diabetes, age/life expectancy, comorbid conditions, known CVD or advanced microvascular complications, harmful effects of diabetes such as damage to the eyes, heart, blood vessels, nervous system, teeth and gums, feet and skin, or kidneys. Perhaps you can talk with your doctor and get her input based on your individual situation? ~Lynn @Glucerna

jigsaw 2014-03-04 07:58:38 -0600 Report

Great question, with a some what lengthy and complex answer.
There are many variables that come into play.
For example:
1. How long does your BG stay high?
2. How high does your BG go?
3. How frequently does your BG go high?
4. What is your physical condition and health status in general?
All of these factors play a role in the answer to your question, and differ with every individual. There are also different opinions within the medical community, to add to the confusion!

I do my best to keep my blood glucose within the range of 90 to 110 as much as possible. Of course I experience some spikes when I consume carbs. The type of carbs and quantity determine the extent of my spikes, or increased BG levels. I try not to go beyond a BG level of 140, when I consume a meal. I could probably keep my BG increases lower, but then I would probably eliminate or cut back some important food groups in my case. This in turn could lead to nutritional deficiencies over the long haul. Also, I watch to make sure my BG becomes normal within ( approximately 2 hours, give or take ) after a meal.

My A1c has remained in and around 6.0 for the entire 20 years that I've had diabetes. Although an A1c of 7.0 or less, seems to be a common criteria, many endocrinologists recommend staying below 6.5, as of most recently. I prefer to play it safe and stay below 6.5 if possible. A concern of my doctors is to not go to low with ones A1c, especially when taking certain medications. That would increase the possibilities of BG lows or hypos. Hypos can do quite a bit of damage, depending on how extreme! They can also cause damage to the brain. I definitely do my best to avoid them.

A BG level of 180 is considered to be the kidney threshold. Apparently, that is the point where small capillaries in the kidneys can begin to get damaged.

This is information that I have absorbed over my 20 years of dealing with primary care physicians, endos, dieticians and diabetic educators.

Shawn Grant
Shawn Grant 2014-03-06 18:01:28 -0600 Report

Have you developed any complications with diabetes? I am recently diagnosed and fairly young. I don't want my health to go south 20 years from now, so just curious.

jigsaw 2014-03-06 19:47:47 -0600 Report

Shawn, I'm glad you asked! I have not experienced any complications from diabetes. Even after 20 years of living with diabetes, I still feel quite healthy. No physical limitations to speak of, with the exception of being 20 years older. I admit, I do take it a bit easier then I did in my younger days, but that's the only difference.

Glucerna 2014-03-04 12:43:18 -0600 Report

jigsaw, I think you mentioned something really important when you said that you 'could probably keep my BG increases lower, but then I would probably eliminate or cut back some important food groups.' I think it's important to maintain good BG management within an overall healthy diet. It's easy to forget about fiber, vitamins, minerals, phytochemicals when we focus only on BG numbers. ~Lynn @Glucerna

mjhorgan 2014-03-04 06:10:08 -0600 Report

The goal is to keep the average BG low enough to keep you A1C below 7.0. The landmark DCCT study proved that people with A1C's below 7.0 significantly reduce or prevent any complications. My A1C has been around 6 for many, many year now. That is not to say I don't get BG over 250 every so often. So, what this means is that if you have a BG over say 200 damage does not just occur. Even BG over 200 is not very. So, ask you DR about the A1C and use that as your goal. You t this by keeping your BG low enough.

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