DAM: Diabetes & Blood Sugar Levels

1154350_32525829A blood sugar or blood glucose level is the number that often gets spouted off by a person with diabetes (or a family member or a medical professional), telling the world how much sugar is rolling around in their body. (It doesn’t really roll so much as swim. Backstroke or doggy paddle? Have no idea.)

For those of you whose beta cells didn’t take early retirement, your blood sugar levels consistently stay between 70 and 130 mg/dl. Doesn’t matter how much you eat, don’t eat, run a marathon, or watch TV all day. Your body does what it’s supposed to do – regulate your blood sugar levels so your body and your brain have the right balance of glucose in your system so you live.

Not quite so easy for those with diabetes. We have to do a little a lot a huge stupidly gargantuan amounts of work to keep our blood glucose levels within a range that is doable.

Let me start off my explanation of blood sugar levels by channeling one of my favorite people, Bennett Dunlap:

“Your Diabetes May Vary.”

Every person with diabetes has their own version of what their optimum blood glucose level range is – and that’s between the PWD (person with diabetes) and their medical team. The various experts have interesting ideas on what should be the right range:

The American Diabetes Association says:

  • Prepranidal (which is a fancy word for before eating a meal) blood glucose: 70-130 mg/dl
  • 1 to 2 hours postprandial (again, fancy word for after beginning a meal) blood glucose: less than 180 mg/dl
  • A1C: Less than 7%

Joslin Diabetes Clinic gets a little more detailed:

  • Fasting blood glucose: less than 100 mg/dl
  • Preprandial blood glucose: less than 110 mg/dl
  • 2 hours postprandial blood glucose: less than 140 mg/dl
  • Bedtime blood glucose: less than 120 mg/dl
  • A1C: Less than 6%

* Note that Joslin says at the bottom of the page that this comes from information obtained from Joslin Diabetes Center’s Guidelines for Pharmacological Management of Type 2 Diabetes.

But wait… it gets more confusing. If you read their Clinical Guidelines for Adults with Diabetes (updated 2/2013), it says this:

  • Fasting blood glucose: 70 to 130 mg/dl
  • 2 hours postprandial blood glucose: less than or equal to 180 mg/dl
  • Bedtime blood glucose: 90 to 150 mg/dl

Then there is the Pre-Existing Diabetes with Pregnancy Clinical Guidelines (updated 6/2011):

  • Fasting and premeal glucose: 60 – 99 mg/dl
  • 1 hour postprandial blood glucose: 100 – 129 mg/dl

These ranges also change for older individuals with Type 1 diabetes, young children with Type 1 diabetes, PWDs who have complications, etc.

The end goal for a person with diabetes is to die happily at a ripe old age with as few complications as possible. Sort of the opposite of: “The person who dies with the most toys, wins.” Having a target blood glucose range is a start, but there’s so much more than just checking blood glucose levels – once you have the number, you need to know what to do with it. I’ll be sharing my thoughts on that in the next few days…



  1. So much more is so true. But if I may, for a moment, pay homage to my CGM (despite the fact that I curse it on a near-daily basis), it’s that there are few surprises. With it, I always have a general idea as to how my blood sugars are at any given moment, and I don’t have those “holy crap! how did I get to be 508 (or 58)??”. It’s so much more valuabe than just giving an early-warning of lows, which seems to be the common selling point.

  2. I’m am really enjoying your DAM posts. 😉 Also agree with Scott. CGM is the game changer in diabetes management in the 21st century. My tombstone should probably read, “squeeked out 15 more years because of DexCom.”

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