Glucose Goals
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Tuesday, April 08, 2008 |
Q: "What is a good blood glucose reading?"
A: I'm glad you asked that question for several reasons. I hope you are asking what your target goals are, and not what is "good" or "bad." Those terms imply judgment of success and failure. The purpose of monitoring your glucose is to learn how your body responds to food, activity, medication, illness, or stress. Then you can use this information to take appropriate action and manage your diabetes successfully.
Your physician and diabetes educator should determine your individual target goals, as the goals may vary depending on your age, the presence of hypoglycemia unawareness, and certain medical conditions.
That said, the American Diabetes Association has established target goals for adults with diabetes. Note that the glucose is reported in mg/dL in the U.S. but some countries use mmol/L.
Also note that the glucose goals from the ADA are plasma equivalent. You need to know if your meter is whole blood or plasma calibrated. The older meters were whole blood calibrated, which is approximately 11% lower than the laboratory value while most of the newer meters are plasma calibrated (including FreeStyle® and Precision® Monitoring systems); plasma calibrated meters read closer to the actual laboratory value.
Below are target goals, taken from the American Diabetes Association's Clinical Practice Recommendations.
Pre-meal plasma glucose 70-130 mg/dL (3.9-7.2 mmol/L)
Peak post-meal plasma glucose <180 mg/dL (<10.0 mmol/L)
A1C (HbA1c) <7.0%
ADA key concepts regarding setting glucose goals:
- Goals should be individualized.
- Certain populations (children, pregnant women, and elderly) require special considerations.
- Less intensive glycemic goals may be indicated in patients with severe or frequent hypoglycemia,
- More intensive glycemic goals may further reduce microvascular complications at the cost of increasing hypoglycemia.
- While the A1C goal for patients in general is an A1C goal of <7%, the A1C goal for the individual patient is an A1C as close to normal (<6%) as possible without significant hypoglycemia.
- Postprandial (post-meal) glucose may be targeted if A1C goals are not met despite reaching preprandial glucose goals.
- The ADA further states that if the pre-meal glucose goals are within target but the A1C target is not met, then consider monitoring post-meal 1-2 hours after the start of the meal, with treatment aimed at reducing the average post-meal value <180 mg/dL which may lower the A1C. However, the effect of these approaches on the microvascular and macrovascular complications has not been studied.
ACE establishes different goals:
The American College of Endocrinology (ACE) held a Diabetes Mellitus Consensus Conference, August 20 - 21, 2001. The outcome of this ground breaking conference included new guidelines for pre and postprandial targets, as well as A1C levels.1 In addition to the new target levels, the ACE panel recommended that the standard name for the HbA1c test should be "A1C." You will note that these goals have not yet been adopted by the American Diabetes Association (ADA) and are lower than those recommended by the ADA.
| Fasting and pre-meal (plasma) | <110 mg/dL |
| 2-hour post- meal (plasma) | <140 mg/dL |
| A1C | <6.5 % |
1Based on Consensus Development Conference, Washington, DC, August 20 and 21, 2001.
Note regarding lower limits:
- If you are not taking any diabetes medication, you cannot get too low.
- Not all diabetes medication causes hypoglycemia.
- Be sure to confirm both your low and high glucose target goals with your healthcare team.
Related Questions
Converting mg/dL to mmol/L
Q:
"You refer to glucose measurements in mg/dL, but my country uses mmol/L.
How can I get the equivalent mmol/L?"
When to Call the Doctor
Q:
"I always read about target goals, but they don’t say when to call the
doctor. What is really too low or too high? Although I am often under 130
before meals, sometimes I’m not; yet I can’t imagine that I would call every
time I’m above 130."
Related Links
American Diabetes Association (ADA)
http://www.diabetes.org
American Association of Clinical Endocrinologists (AACE)
http://www.aace.com
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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