What should my blood sugar range be? That's often one of the first things people diagnosed with diabetes want and need to know. They are often given an answer that compromises their life and health.
The American Diabetes Association (ADA) Complete Guide to Diabetes 3rd edition recommends "to keep blood glucose as close as possible to that of a person without diabetes" (page 153). We wholeheartedly agree with that. This should be the goal of every person with diabetes.
But then the ADA and other authorities depart from that goal when they recommend a range with an upper limit that is dangerously high. They recommend an A1C of 7% or under to “help avoid diabetes complications of the kidneys, eyes, feet, and nerves” (page 91).
(The A1C is a weighted average percentage of glycated hemoglobin, blood cells with glucose attached to them, over the past several months. It is a fair indicator of blood glucose levels over that time.)
Unfortunately, the recommended 7% is still too high. It is certainly not "as close as possible to that of a person without diabetes," which is about 5%.
Let's look at what an A1C of 7% represents in terms of everyday blood glucose levels. It indicates an average blood glucose level of 150 mg/dl (8.5 mmol/l). This average level may seem safe to the ADA, but studies by both the American Association of Clinical Endocrinologists (AACE) and the International Diabetes Federation (IDF) indicate that anything above 140 mg/dl (8 mmol/l) significantly raises the risk of heart attack.
Notice that this is the risk for a maximum glucose level, up to two hours after meals. The ADA's high of 150 mg/dl is a daily average. In other words, the ADA's actual recommended maximum is more like 180 mg/dl (10 mmol/l) -- far above the already significant risk of 140 mg/dl.
So a much safer maximum acceptable blood sugar level is not even the ADA's 150, according to the AACE and the IDF and other authorities, but 140 mg/dl. And neither 150 nor 140 should be the constant or the average blood sugar level. The average blood glucose level should be much lower, between 90 and 100 mg/dl (5 and 5.5 mmol/l), considerably lower than the ADA's recommended 150 mg/dl.
If the average glucose level can be maintained between 90 and 100 mg/dl, it should result in an A1C test result of less than 6%. That single percentage point between an AIC of 7% and one of 6% can be the difference between a relatively healthy life with diabetes and one with high risk of complications, heart attack, and stroke.
The American Diabetes Association (ADA) Complete Guide to Diabetes 3rd edition recommends "to keep blood glucose as close as possible to that of a person without diabetes" (page 153). We wholeheartedly agree with that. This should be the goal of every person with diabetes.
But then the ADA and other authorities depart from that goal when they recommend a range with an upper limit that is dangerously high. They recommend an A1C of 7% or under to “help avoid diabetes complications of the kidneys, eyes, feet, and nerves” (page 91).
(The A1C is a weighted average percentage of glycated hemoglobin, blood cells with glucose attached to them, over the past several months. It is a fair indicator of blood glucose levels over that time.)
Unfortunately, the recommended 7% is still too high. It is certainly not "as close as possible to that of a person without diabetes," which is about 5%.
Let's look at what an A1C of 7% represents in terms of everyday blood glucose levels. It indicates an average blood glucose level of 150 mg/dl (8.5 mmol/l). This average level may seem safe to the ADA, but studies by both the American Association of Clinical Endocrinologists (AACE) and the International Diabetes Federation (IDF) indicate that anything above 140 mg/dl (8 mmol/l) significantly raises the risk of heart attack.
Notice that this is the risk for a maximum glucose level, up to two hours after meals. The ADA's high of 150 mg/dl is a daily average. In other words, the ADA's actual recommended maximum is more like 180 mg/dl (10 mmol/l) -- far above the already significant risk of 140 mg/dl.
So a much safer maximum acceptable blood sugar level is not even the ADA's 150, according to the AACE and the IDF and other authorities, but 140 mg/dl. And neither 150 nor 140 should be the constant or the average blood sugar level. The average blood glucose level should be much lower, between 90 and 100 mg/dl (5 and 5.5 mmol/l), considerably lower than the ADA's recommended 150 mg/dl.
If the average glucose level can be maintained between 90 and 100 mg/dl, it should result in an A1C test result of less than 6%. That single percentage point between an AIC of 7% and one of 6% can be the difference between a relatively healthy life with diabetes and one with high risk of complications, heart attack, and stroke.
Source...