Tight control means keeping glucose levels as close to a nondiabetic's glucose level as possible. Tight control isn't for everyone -- it can increase your risk of hypoglycemia and weight gain. According to the American Diabetes Association, if you're practicing tight control, your blood sugar level will be between 70 and 130 mg/dL before eating and below 180 mg/dL within two hours after eating; your A1C level will be at 7 or below.
Benefits of Tight Control
Preventing hyperglycemia, or high glucose levels, will lower your risk of developing the serious complications of diabetes, which include blindness, nerve damage, kidney failure and heart disease. According to the ADA, people who practice tight control have a much better chance of preventing these problems or delaying the progression of these health issues. Treatment is different for tight control and might involve changing your dose and timing of insulin injections, testing your glucose level more often, and paying closer attention to diet and exercise habits.
Intensive Therapy
Living with tight control isn't easy. Two different methods are used for intensive insulin therapy. The first requires an insulin pump, which releases a constant dose of regular insulin into your bloodstream. You can increase the dose when you eat, or you might need an injection of a different type of insulin, usually fast-acting. The other method is a multiple-injection method, which requires you to take more than three injections daily -- before meals and at bedtime. Both techniques require you to carefully monitor your blood sugar multiple times a day.
Risks of Tight Control
With tight control, you're keeping your glucose levels as low as you safely can -- but you run the risk of glucose levels dropping too low and causing hypoglycemia. If you exercise more than you normally do, or don't eat at regular intervals, you might start to feel hungry, irritable, shaky or anxious. Fortunately, you can easily treat low blood sugar by eating 15 g of carbohydrates. Tight control means more of the glucose in your bloodstream is transported into your cells. Glucose not used right away for energy is stored as fat, so people practicing tight control might gain weight.
Is Tight Control Right For You?
Tight control is a commitment that doesn't suit everyone's lifestyle. It's not appropriate for children or older adults, and it's not recommended if you're already prone to low blood sugar. According to a 2005 report by the National Institutes of Health, tight control can reduce the risk of heart disease and stroke by 50 percent in type 1 diabetics, but a 2011 study concluded that tight control might actually harm type 2 diabetics who already have heart disease. Talk to your doctor to determine if tight control is right for your individual needs.
References
- American Diabetes Association: Tight Diabetes Control
- MayoClinic.com: Intensive Insulin Therapy -- Acheiving Tight Blood Sugar Control
- National Institutes of Health: Tight Glucose Control Cuts Heart Disease by Half in Type 1 Diabetes
- U.S. Department of Health and Human Services: Tight Blood Sugar Control May Put Some Diabetics at Risk
