Reply
(anon)
Total Posts: 0

New Ranges from Endo

So, my endo just gave me these ranges as a guide:

Fasting 90-130
Before Lunch/Dinner 150 or less
2 hours after meals 180 or less
Bedtime 120 - 150

I'm lada type 1, so I didn't know what 'category' to post them in, maybe this is more specific to folks on insulin. they seem high? i told her what I've read on here; where everyone says 140 or below 2 hrs ppl. She said everyone goes up after eating and 180 2 hrs ppl is fine.
Frequent Responder
cactus8
Total Posts: 1,181
Registered on: ‎11-07-2009

New Ranges from Endo

sarahbee (6/12/2010)
So, my endo just gave me these ranges as a guide:

Fasting 90-130
Before Lunch/Dinner 150 or less
2 hours after meals 180 or less
Bedtime 120 - 150


LizzyLou has compiled this listing and saved it in the archives, you can access the whole post by clicking HERE

RECOMMENDED BLOOD GLUCOSE GOALS
ADA:........A1C..<7.0......Fasting....90-130....PP*...<180
JOSLIN:....A1C..<7.0.....Fasting....90-130....PP*...<160
AACE:......A1C..<6.5......Fasting......110.......PP*...<140
NON-D:....A1C..4.0-6.0....Fasting....70-100....PP**.70-140...**Non-diabetic

*ADA: "Post-prandial glucose measurements should be made 1�2 hours after the
beginning of the meal, generally peak levels in patients with diabetes."

ADA = American Diabetes Assn. Joslin = Joslin Diabetes Center AACE= American
Association Of Clinical Endocrinologists Non-diabetic= ranges compiled from goals
of all agencies.
Super Advisor
powerwalker2
Total Posts: 5,530
Registered on: ‎11-02-2009

New Ranges from Endo

sarahbee (6/12/2010)
So, my endo just gave me these ranges as a guide:
Fasting 90-130
Before Lunch/Dinner 150 or less
2 hours after meals 180 or less
Bedtime 120 - 150
I'm lada type 1, so I didn't know what 'category' to post them in, maybe this is more specific to folks on insulin. they seem high? i told her what I've read on here; where everyone says 140 or below 2 hrs ppl. She said everyone goes up after eating and 180 2 hrs ppl is fine.

I think you have to know what to do with your post-meal level (whatever it may be) in order to get it back down to your acceptable pre-meal, bedtime, and fasting levels. If you're using exercise to help get those levels down, need to know how much it takes, and what is achievable in boosting your metabolic rate and lowering your blood sugar to target goal range. I prefer narrower fasting and bedtime ranges, and lower pre-meal target level than what you listed that the doc gave you, because if I don't get those down lower with my post-meal exercise, my fasting levels are not going to be where I want them.
Nancy ~ T2 since '98 ~ 16 yrs ~ D&E 11yrs ~ treadmill, elliptical, bike 15-20 minutes 3x/day (including evening), dumbbells/resistance training, small portions heart-healthy high-fiber/low-fat fuel/carb-counting, 500mg Glucophage XR x4, 2.5mg Glucotrol XL x6, 6000IU Vit. D/day ~ RHR 53 ~ A1cs mainly between 5.9-6.9 av. 6.5
Trusted Contributor
morrisolder
Total Posts: 10,700
Registered on: ‎11-28-2009

New Ranges from Endo

sarahbee (6/12/2010)
So, my endo just gave me these ranges as a guide:

Fasting 90-130
Before Lunch/Dinner 150 or less
2 hours after meals 180 or less
Bedtime 120 - 150

I'm lada type 1, so I didn't know what 'category' to post them in, maybe this is more specific to folks on insulin. they seem high? i told her what I've read on here; where everyone says 140 or below 2 hrs ppl. She said everyone goes up after eating and 180 2 hrs ppl is fine.
At the same time normal is ~80 for fasting and <120 peak after eating. Many of us here would like to be as close to normal as we can, even if medical authorities believe we may not be able to achieve that and therefore set goals that are higher than normal for people with diabetes to strive to meet. I think the idea so that to set the goal as normal would discourage many people who fail to achieve that, so that more ::realistic:: goals are proposed. Note however that the ADA qualifies it's ,180 recommendation at 2 hours, saying that closer to normal is a better goal whenever it can be achieved without the risk of hypoglycemia.

Ther eis a history of lowering the numbers that define diabetes, and while it is hard to know for sure, aiming for normal numbers seems like good insurance if it can be ahcieved...
Morris

Diagnosed Type 2, with an A1c of 11.4 in 2003; averaging a 5.0 A1c since then with diet, exercise and Glipizide XL + meds for blood pressure and cholesterol. 
A bit dated, but scroll down on this page if you want to know more ...


Valued Contributor
ajsammycat
Total Posts: 985
Registered on: ‎10-31-2009

New Ranges from Endo

Sarah,

So, my endo just gave me these ranges as a guide:

Fasting 90-130
Before Lunch/Dinner 150 or less
2 hours after meals 180 or less
Bedtime 120 - 150

I'm lada type 1, so I didn't know what 'category' to post them in, maybe this is more specific to folks on insulin. they seem high? i told her what I've read on here; where everyone says 140 or below 2 hrs ppl. She said everyone goes up after eating and 180 2 hrs ppl is fine.


The ranges the doctor gave you are fairly standard. As others have pointed out, they are pretty much the ranges worked out by the American Diabetes Association, the Joslin Diabetes Center, and the American Association of Clinical Endocrinology. Having said that, there are some considerations that are specific to type 1s/LADAs.

I forget whether you are on insulin or not, and am writing this under the assumption that you are injecting both long-acting and rapid acting insulins. Otherwise, until you start taking insulin, you could follow the advice for type 2s, which is to try to aim even closer to normal.

While some may tell you to aim your bgs lower, the danger of aiming closer to non-diabetic numbers is that you increase the probability you will have hypoglycemic incidents (i.e. low blood sugars). The one thing the Diabetes Complications and Control Trial (DCCT, 1993) showed is the 300% increase in the number of low blood sugars, even when the person has substantial support from doctors, CDEs, and others. If you are particularly insulin sensitive, you may find it necessary to aim higher. The goal of bg management for type 1s is to try to keep bgs as close to normal as SAFELY possible -- and that means not only having bgs will help you avoid complications 20-30 years down the road, but also having bgs that ensure you will be around in another 20 yeas!

I would argue that while those numbers are a decent starting place, the bg guidelines you follow should be individualized just for you. For instance, I have been having problems with after breakfast and after lunch low bgs (e.g. in a 90 day timeframe, I had 100 lows). I have been working with a dietitian to readjust my insulin and I have to work on my brain to accept after breakfast bgs of >160 if I'm going to exercise and around 150 if I'm not exercising. It's something I need to do, or I'm fighting bgs in the 50s and 60s for hours, but it's not something everyone needs to do. Like I said, everyone's bg goals ought to be individualized, especially for those of us on insulin.

This is a perfectly acceptable topic to bring up with other type 1s, though it's also fine to discuss it here!

Angela