Confused about reasonable blood glucose levels targets.

By PRP Latest Reply 2010-07-16 14:36:54 -0500
Started 2010-07-16 11:29:16 -0500

I thought I had a good understanding of what I am supposed to do as a type 2. I was really feeling proud of myself after my first follow up A1C test results (went down from 6.4 to 5.4 in 3 months). But all that came crashing down after reading couple of books (from Dr. Bernstein) and reading couple of articles in the "Blood sugar 101" site ( The sites author seems to be very well balanced and well researched as she goes into a lot of published study papers to backup what she is saying. After that I am really depressed knowing that the goal is to get the blood sugar levels to "normal". The definition of that is as follows


13 replies

monkeymama 2010-07-16 13:12:42 -0500 Report

Hello there PRP! Everyone is correct here. There are standards that are set by The American Diabetes Association. Doctors than have to fall within these standards while they are developing their own standards for their diabetic patients. Each diabetics goals/levels may differ from the next. This is based on the doctors standards and the individuals diabetes plan. If your doctor is happy with your progress, than i would hold off. UNLESS, you starting seeing your BG numbers becoming to unstable, high, and inconsistant,that is when I would begin considering the Metformin. I am not trying to scare you on this but some people also get a not so friendly side effect from it. As a whole, you don't want to have to put anything more into your system unless you REALLY have to. Hang in there and keep up the GREAT working you are doing.

PRP 2010-07-16 13:59:55 -0500 Report

Thanks. I am a firm believer in "not putting anything that is not required in your body " philosophy. That's how I control my allergies and asthma. But I am also a big proponent of being pragmatic. And diabetes seems to be a different beast altogether. If the long term effect of taking medication and keeping a strict control on BG levels helps me to avoid a ton of complications it would be foolishness on my part to stick to philosophy and ignore the pragmatism. But there in lies the rub. Is it really true that not controlling the BG levels that strictly as prescribed above does definitely cause harm ? Does the side effects outweigh the benefits of that strict BG level control ? I cant seem to find a definitive answer to that.


PRP 2010-07-16 12:10:03 -0500 Report

I don't know what happened. The post got cut off it should continue to say was ——-
fasting less than 100
1 hr after food less than 120
2 hr after food less than 140
A1C in low 5s.

The information I gathered was that the goal is to acheive normal range as above. If diet and exercise does not do it, they recommend going on meds ranging from metformin , Jenuviaetc all the way to insulin. Now my question is should I start taking Metformin or am I being too much of a chicken Little on this? My doc did prescribe me Metformin but she is not pushing me to take that and seems to be happy with my progress.

Kirla 2010-07-16 12:40:25 -0500 Report

As long as my A1C stays below 6, my fasting blood sugar stays below 100 and my one-hour post meal numbers stay below 140-160 I don't plan on taking any meds. If and when my numbers go out of control, I've been thinking of maybe looking into insulin.

But for now, I just keep watching what I eat and try to stay a little active. I have read of lots of people who have been controlling with diet and exercise, some for 10 years or longer. I’m hoping with proper diet and exercise I will be able to maintain for the rest of my life without meds and or insulin.

Good Luck
PS. Dr. Bernstein from what I understand is a little bit extreme. A lot of people follow him and he has a lot of great advice but some of his beliefs may be a little hard to achive for most of us.

PRP 2010-07-16 13:48:53 -0500 Report

That right there is my dilemma. My A1C is @ 5.4 but my fasting sugars are around 110. They seem to vary depending on when I test. If I test @ 4:30 AM it is around 110. If I check around 6:00 AM they are around 100. I am guessing a dawn effect but that by itself is a whole another topic. My levels are seldom below 100. But most of my 2 hr after meal are around 120. I dont have a record of what my after 1hr numbers are. The fasting glucose numbers are the main reason for considering Metformin.


Kirla 2010-07-16 14:36:54 -0500 Report

Your A1C is great. 5.4 most people dream about. I read somewhere that numbers above 140-cause damage. As long as you stay below that you should be fine.

How long have you been using your meter? Meters are known to be inaccurate. Some as much as 20%. I have used the Reli On meter from Wal-Mart and when my insurance made me use liberty, I had to switch to one of there’s. I got higher reading with the reli-on meter than with the liberty. Most companies give meters away for free. Maybe you should try getting a new one or try a different brand.

Anyway with an A1C of 5.4 and post meal numbers staying below 120. I wouldn’t be ready to jump on the meds right now. But you got to do what you feel you got to do. I think your doing great. But if taking the meds will make you feel better, than you need to discuss this with your doctor.

If it were me, I would wait awhile and maybe try a new or different brand of meter. Keep doing what your doing and maybe the fasting will start dropping. Who knows? Were all different and some of us may need more time than others.

Anyway you can always take the meds for a while and see if your fasting numbers drop. Then decide later if you still need them or not. This isn’t an exact science. It’s different for everyone.

I reread your post and see that the 120 was a 2-hour reading. Maybe you should find when you peak. It may give you more info to help you decide what to do.

To find your peak, you just eat a regular meal the way you always do. Then start to test at maybe 30 or 45 minutes after eating and then test every 10-15 minutes until your numbers drop. This should give you a pretty good idea when you peak after a meal. Just remember to keep track of the time along with your readings. I believe that most people will peak at about the 1-hour mark. I used to peak at 1-hour but the last time I checked, it changed to about 1 hour 10-15 minutes for me.


MAYS 2010-07-16 12:05:46 -0500 Report

Do not let everything that you read dictate your life to you, if you do you will be riding high on life after reading one book, and down in the dumps after reading the next one.
Your A1C test results were very good, most diabetics can only imagine those numbers, let alone achieve them.

Are you serious about being depressed now (?), this will add to your depression at first, then YOU will make it (the depression) go away, depression causes your glucose level to rise !

You were doing fine, it was working for you and it showed in your test results, here is a page from my manual of life, "Love Yourself and Do What is Right for You."


PRP 2010-07-16 12:32:28 -0500 Report

Don't get me wrong I am not depressed "depressed" . In fact I am really happy about my results and had started a thread just to announce my results. I guess I should have said that I am "puzzled" by my latest discovery. The fact that they say that you can prevent the degenerateness(is it even a word ?) of diabetes by a strict control of BG levels in the normal range implies if you don't diabetes will degenerate and lead to complications. That fact was the depressing part of the thought process. Am I causing more harm than good by not taking Metformin with my stubbornness of avoiding medication. If it is I would like change that.


Kirla 2010-07-16 11:53:08 -0500 Report

All we can do is try and get normal numbers.

I believe that a normal A1C is between 4 & 6. I have tried to get mine below 5.0 and so far the best I could do is 5.4. Even getting to 5.4, I had to cut all starchy carbs from my diet. It’s not easy to do. I recently gave up trying to get my A1C below 5.0. I am trying to add, some small amounts of carbs to my diet for better nutrition.

I believe normal fasting blood sugars and before meal numbers is between 70-90. I think the 1-hour after eating should be below 140. At least these make a good target to try and reach.

I used to try and keep my one-hour after eating blood sugar readings below 110. Lately I have added pancakes, waffles, ice cream and pasta to my diet and my numbers have gone up some. But most of the time they’re under 130 1 hour after eating.

Welcome to Diabetic Connect

Good luck

PRP 2010-07-16 12:39:52 -0500 Report

I realized that my post got cut off after I looked at it so I added the rest of it in another reply. I read your blog about "This is what I did" and had also left a comment. You were one of my inspirations to achieve lower A1C levels using diet and exercise. I try to incorporate what you explained in your blog. My recent A1C test shows that it is working. Thanks for the detailed explanation you provided to my question on your blog. That was very helpful and gave me lot of confidence in my efforts.


Harlen 2010-07-16 11:40:47 -0500 Report

lol boy do I know where your coming from lol
I like to keep mine 75 to 95 thats when I feel best and the Doc is happy with it .there is a thinf cald to much info lol
If your keeping it good dont chaige a thing lol
Best wishes

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