Hi all,
Blood sugar target for diabetics, it is really a controversial issue that a lot of physicians and diabetics experts have different opinions about it.
A lot of diabetics know that waking up with 120 BS reading is great (if you can do it) and below 180 BS after meals is marvelous and having A1C = 6.1 or so is great work done (My Endo told me so)
Well let's think again and see what is going on around us regarding the blood sugar targets.
ADA (American Diabetes association) blood sugar target for adults with type 1 or 2 is 80 - 130 fasting and less than 180 two hours after eating. while ADA recommends that A1C less than 7 is good control.
Dr. Richard Bernstein, the famous Diabetics physician and author of the book Diabetes Solution, says that the BS target for adults diabetics should be between around 83 or between 80 to 90 either fasting or after food; while Dr. Bernstein also recommends that A1C should be between 4.2 to 4.9 which is as normal as non diabetics as possible.
Dr Bernstein mentioned in his book that a lot of his patients were able to keep their A1C level at 4.2 using low carbohydrate diet along with exercise and right medication.
As a matter of fact Dr. Bernstein is almost 79 years old now and he got type 1 diabetes since he was 12 years old and he keeps the BS target numbers in the normal range that he advocates.
Dr. Bernstein considered, in his book, that the ADA blood sugar target recommendations mentioned above - as out of control.
Jenny Ruhl, the author of Blood sugar 101 book and diet 101 the truth about low carb diets book; says that Doctors consider normal fasting BS for non diabetic should be between 70 to 100 while there is a lot of studies proved that people who wake up with BS above 92 most likely to be diagnosed diabetes over the next decade!!
Jenny also said, regardless of what non diabetics eat; most of them have BS reading around 100 after eating.
Jenny said that there is an Atherosclerosis Risk in Communities study tracked 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease. for 15 years.
It found no association between fasting blood sugar and risk of heart disease, but A1c was a different story. The table below summarizes the correlation of baseline A1c with the risk of developing cardiovascular disease.
5%: 0.96 (0.74-1.24)
5% to < 5.5%: 1.00 (reference)
5.5% to < 6%: 1.23 (1.07-1.41)
6% to < 6.5%: 1.78 (1.48-2.15)
= 6.5%: 1.95 (1.53-2.48)
As you can see; if your A1C is 6.5 you are almost 100% more prone to get heart disease compared to a person who has A1C of 5 to 5.5
As Jenny said it right: it isn't whether you have diabetes that decides your risk, it's whether you have abnormal blood sugars, and the more abnormal, the more the risk. But "abnormal" blood sugars are those that doctors now treat as normal!
So; I say here that you really need to redefine your blood sugar target or another word your normal blood sugar target.
In my opinion; we, as diabetics, need to try as hard as possible to get ourselves in the normal zone of blood sugar whether in fasting, post meal and A1C, another way to say that is try to achieve the numbers of non diabetics non insulin resistant to avoid complications and / or risk of getting diagnosed with heart diseases.
Beware that the numbers that your Dr. tells you it is normal (something like below 180 after meals) - it is not - please consider the above normal range because actually it is your efforts that needed here, it is your eyes, heart, kidneys, foot that you want to protect.
The best thing that you may want to do to yourself as diabetic is, at least, to stop your BS to get over 140 after meals.
Dr. Rob Thompson says in his great book of Low starch Diabetes solution that Doctors differ in their recommendations to their patients.
You will notice some Drs. want to keep some bothersome symptoms like frequent urination, thirst. etc.. away from their patients - While some other Drs. care a lot to reduce your numbers as close as to normal. These Drs usually do not give you instructions but they teach you how to do that yourself, they improve your inner compass of controlling your disease.
You need to know that diabetes, in specific, requires a lot of hour to hour management and this kind of unstoppable management depends mainly on you, not on your Dr., because of the followings:
So if you know all the above and you are kind of convinced of it; let us agree that you need to readjust your BS target again and here I will tell you what I believe Blood Sugar targets should be based on many trusted books and researches published over the net - as follows:
Blood sugar target for diabetics, it is really a controversial issue that a lot of physicians and diabetics experts have different opinions about it.
A lot of diabetics know that waking up with 120 BS reading is great (if you can do it) and below 180 BS after meals is marvelous and having A1C = 6.1 or so is great work done (My Endo told me so)
Well let's think again and see what is going on around us regarding the blood sugar targets.
ADA (American Diabetes association) blood sugar target for adults with type 1 or 2 is 80 - 130 fasting and less than 180 two hours after eating. while ADA recommends that A1C less than 7 is good control.
Dr. Richard Bernstein, the famous Diabetics physician and author of the book Diabetes Solution, says that the BS target for adults diabetics should be between around 83 or between 80 to 90 either fasting or after food; while Dr. Bernstein also recommends that A1C should be between 4.2 to 4.9 which is as normal as non diabetics as possible.
Dr Bernstein mentioned in his book that a lot of his patients were able to keep their A1C level at 4.2 using low carbohydrate diet along with exercise and right medication.
As a matter of fact Dr. Bernstein is almost 79 years old now and he got type 1 diabetes since he was 12 years old and he keeps the BS target numbers in the normal range that he advocates.
Dr. Bernstein considered, in his book, that the ADA blood sugar target recommendations mentioned above - as out of control.
Jenny Ruhl, the author of Blood sugar 101 book and diet 101 the truth about low carb diets book; says that Doctors consider normal fasting BS for non diabetic should be between 70 to 100 while there is a lot of studies proved that people who wake up with BS above 92 most likely to be diagnosed diabetes over the next decade!!
Jenny also said, regardless of what non diabetics eat; most of them have BS reading around 100 after eating.
Jenny said that there is an Atherosclerosis Risk in Communities study tracked 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease. for 15 years.
It found no association between fasting blood sugar and risk of heart disease, but A1c was a different story. The table below summarizes the correlation of baseline A1c with the risk of developing cardiovascular disease.
5%: 0.96 (0.74-1.24)
5% to < 5.5%: 1.00 (reference)
5.5% to < 6%: 1.23 (1.07-1.41)
6% to < 6.5%: 1.78 (1.48-2.15)
= 6.5%: 1.95 (1.53-2.48)
As you can see; if your A1C is 6.5 you are almost 100% more prone to get heart disease compared to a person who has A1C of 5 to 5.5
As Jenny said it right: it isn't whether you have diabetes that decides your risk, it's whether you have abnormal blood sugars, and the more abnormal, the more the risk. But "abnormal" blood sugars are those that doctors now treat as normal!
So; I say here that you really need to redefine your blood sugar target or another word your normal blood sugar target.
In my opinion; we, as diabetics, need to try as hard as possible to get ourselves in the normal zone of blood sugar whether in fasting, post meal and A1C, another way to say that is try to achieve the numbers of non diabetics non insulin resistant to avoid complications and / or risk of getting diagnosed with heart diseases.
Beware that the numbers that your Dr. tells you it is normal (something like below 180 after meals) - it is not - please consider the above normal range because actually it is your efforts that needed here, it is your eyes, heart, kidneys, foot that you want to protect.
The best thing that you may want to do to yourself as diabetic is, at least, to stop your BS to get over 140 after meals.
Dr. Rob Thompson says in his great book of Low starch Diabetes solution that Doctors differ in their recommendations to their patients.
You will notice some Drs. want to keep some bothersome symptoms like frequent urination, thirst. etc.. away from their patients - While some other Drs. care a lot to reduce your numbers as close as to normal. These Drs usually do not give you instructions but they teach you how to do that yourself, they improve your inner compass of controlling your disease.
You need to know that diabetes, in specific, requires a lot of hour to hour management and this kind of unstoppable management depends mainly on you, not on your Dr., because of the followings:
- You are the one who knows his numbers and decides to live with it.
- You are the one who will suffer from the consequences of bad numbers
- You are the one who reads and measures once a day carelessly or the one who monitors his BS all day long to know his pattern.
- You are the one who watches TV for 4 hrs after work or you are the one who exercises 5 days a week and push hard to get fit.
- You are the one that eats bread and pasta, potato and refined flour products or eliminate fast acting Carbohydrate from his life.
- You are the one knows very well, that neuropathy, retinopathy, heart problems, foot problems are there for you in the future - as a result bad controlling.
So if you know all the above and you are kind of convinced of it; let us agree that you need to readjust your BS target again and here I will tell you what I believe Blood Sugar targets should be based on many trusted books and researches published over the net - as follows:
- If you wake up more than 100 then you have a problem - beware your target is not 130; even if your Dr, told you it is OK.
- If your readings above 140 (some researches recommends 120) and Dr, Bernstein says less than 100 after meals then you have a problem - beware your target is not 180 or 200; unless you want to get all possible complications.
- If your A1C is more than 5 or at least 5.5 then you have a problem - beware your target is not 7 here !
These targets are hard but achievable - a lot of people achieved it, as a matter of fact there is a group of people that named themselves the 5% club (please read about them on www.bloodsugar101.com) , read their stories , it will inspire you to work hard in achieving good numbers - just need some hard work and you will get used to it.
To achieve these targets you need to do the following:
- Learn and learn hard about Diabetes- be insistent in learning - be like Bruce Willis in die hard series....
- Exercise - make exercise a ritual in your life and do not say I don't have time, we are all busy but successful people are those who can schedule their priorities not prioritize their schedule as Stephen Covey said in his great book The seven habits of highly effective people - just walk briskly an hour a day for 5 days a week and watch the results of your insulin sensitivity.
- Learn about food categories and their effect on you by monitoring your BS continuously to see what is the effect of different types of food on you.
- Choose the right Dr. that believes in good and tight control.
- Eliminate fast acting Carbohydrate like rice, bread (white and whole wheat), pasta, potato, flour products and refined foods - do this and notice the instantaneous results on you, if you like it then it is your way to go.
At the end; do not take no one word for granted, search for the right information and try hard to apply it on yourself and you will be able to achieve those tight targets.
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