Type 2 diabetes is characterized by inefficient use of blood glucose by decreased production of insulin or ineffective insulin that is produced. Type 2 diabetes usually is controlled by diet and exercise or oral medications. Eventually, the pancreas gives out and insulin is added to your regimen to gain tighter control of your glucose levels. This is done to prevent complications with your eyes, kidneys and heart. Target glucose levels don't change whether you are diet controlled, using oral medications or have started insulin to control your glucose levels.
A.M. Fasting
Your target glucose level when you wake up in the morning is called "a.m. fasting." Before having breakfast, your blood glucose reading should be between 90 to 130 mg/dL or below 7.0 mmol/L, according to the National Diabetes Information Clearinghouse and the American College of Endocrinology. The American Association of Clinical Endocrinologists recommends a target glucose level below 140 mg/dL or 7.8 mmol/dL.
Pre-Meal Glucose
Glucose readings taken before the start of a meal need to be as low as possible to prevent large spikes in post-meal glucose readings. The higher your pre-meal glucose reading, the higher your post-meal glucose reading is going to be. This happens because your body thinks it is starving and needs additional glucose, so the carbohydrates and proteins you eat are readily converted into glucose to support your body. Pre-meal glucose levels should be below 130 or 140 mg/dL or 7.0 to 7.8 mmol/L as stated by the NDIC and AACE, respectively.
Post-Meal Glucose
Post-meal glucose reads are taken one to two hours from the start of your meal. Recommended glucose readings should be below 180 mg/dL or 10 mmol/dL as stated by both the NDIC and AACE. In 2001 and 2002, post-meal glucose readings were recommended to be kept below 150 mg/dL or 8.3 mmol/L. In 2005, the American College of Endocrinologists released a position statement recommending a glucose target below 140 mg/dL two hours after meals. Its position on pre-meal glucose levels is the same as that of the National Diabetes Information Clearinghouse.
Bedtime Glucose
Glucose levels before retiring for the night are recommended by ACE to be kept between 110 to 150 mg/dL or 6.1 to 8.3 mmol/dL.
Fasting Glucose
Any time your primary care physician asks you to have blood work done, you are to come in "fasting," or not having eaten since dinner. Target glucose reading in the fasting state for diabetics is less than 110 md/dL or 6.1 mmol/dL. This fasting level corresponds to maintaining a three-month average glucose reading or hemoglobin A1c below 6.5 percent. The national guidelines continue to state a target A1c reading of 7 percent, but all associations recognize the tighter glucose control you have, the closer your A1c is to normal levels, below 6 percent.
References
- National Diabetes Information Clearinghouse: What is Diabetes?
- "Diabetes Update: 2005 ACE Guidelines"; Susan Simmons Holcomb, PhD, ARNP, BC; 2005
- MayoClinic.com: Blood Sugar Testing: Why, When and How
- "American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control"; Etie S. Moghissi, MD, FACP, FACE and colleagues; 2009
