Your right that was VBH, I think, must be old age or maybe my meter is reading high.
oooh a misunderstanding.
The missing bit there is ""for those not on insulin". The purpose of 1h testing for non-injectors is learning about the effects of the meal, to make better decisions in future. The 1h gives a far more meaningful result than 2h. For basal/bolus or mixed insulin users its a whole different kettle of fish because the purpose of testing is different
😉
Plus Andy was quoting official targets. The problem with official targets is that they assume that people hitting those targets will progress from diet controlled T2 to pills controlled T2 to insulin within 5 years.
Those who do better do not progress at that rate. Theres a myth that T2 is progressive. Some of it is down to genetics and how early it gets caught and diagnosed, but to some extent, T2 is as progressive as you allow it to be.
One of my myths series:
http://diabetesforum.org.uk/compone...essive-and-pills-or-insulin-mean-failure.html
(ok two related myths in one blog post)
The problem is that they expect us to fail and give us targets which are easier to hit rather than non-diabetic numbers, which many of us can achieve. The better your control, the slower any progression takes place (in most cases) and the rate of complications is FAR less.
I know people who have been told they are expected to be on insulin in 5 years. Many years on, they are pretty much where they started.
So just bear in mind when looking at official targets that they expect you to progress to insulin, get neuropathy, nephropathy, retinopathy and have a heart attack. Thats what the statistics say will happen and although the targets are designed to make a small improvement, we can do better.
Now then, back to the original question. For T2s not on insulin, the fasting
target should be 4.5 to 5.5, IMHO. 3.5 feels horrendous (from experience) and 6 gives you very few options for breakfast if you are going to stay below 8 at all times. The word "target" is important though. Its not an absolute and you will miss at least part of the time. Just learn something every time you do.
For those T2s on basal only, its a little more complicated and the docs tend to be convinced that you are going to hypo constantly if you attempt any kind of control better than "lousy". Mind you, if you follow their advice rather than the advice of experienced insulin users, they're probably right. So they tend to recommend high BG before bed to avoid hypos.
But if you can get your basal right then you should be able to get reasonable fasting BGs as well, though the targets will probably be a little higher than a non-injecting T2. I know part of the DAFNE literature includes the procedure to test basal (involving skipping meals) so perhaps someone has a decent link. I will try an get one of DF's T1s to write something for future posts. Still working on getting a lot of good articles up and got some good experienced writers, both T1 and T2 so will try and cover all bases.
Finally Vic, if you are dropping too low during the day away from meals then I think your basal is wrong., so you are quite right to look at modifying the morning dose.
