Isn't this a bit high??

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Callista

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At risk of diabetes
I've seen this on Google, and thought, isn't this a bit high for guidelines??

"Target blood sugar levels differ for everyone, but generally speaking: if you monitor yourself at home – a normal target is 4-7mmol/l before eating and under 8.5-9mmol/l two hours after a meal.17 Jan 2023"

www.nhsinform.scot

Hyperglycaemia (high blood sugar)

Hyperglycaemia is the medical term for a high blood sugar (glucose) level - a common problem for people with diabetes. Learn about its symptoms and treatment.
www.nhsinform.scot www.nhsinform.scot

Not being cynical, but as it is from NHS Scotland, maybe they are allowing for all those deep friend Mars bars??!!!!!!!!!!!!!

If those figures are OK, though, then maybe I haven't got such a problem as I thought I had!! (But, actually, to be on the safe side, I think I'd better not trust them?!)
 
Callista said:
I've seen this on Google, and thought, isn't this a bit high for guidelines??

"Target blood sugar levels differ for everyone, but generally speaking: if you monitor yourself at home – a normal target is 4-7mmol/l before eating and under 8.5-9mmol/l two hours after a meal.17 Jan 2023"

www.nhsinform.scot

Hyperglycaemia (high blood sugar)

Hyperglycaemia is the medical term for a high blood sugar (glucose) level - a common problem for people with diabetes. Learn about its symptoms and treatment.
www.nhsinform.scot www.nhsinform.scot

Not being cynical, but as it is from NHS Scotland, maybe they are allowing for all those deep friend Mars bars??!!!!!!!!!!!!!

If those figures are OK, though, then maybe I haven't got such a problem as I thought I had!! (But, actually, to be on the safe side, I think I'd better not trust them?!)
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That article is a tad confusing, because it starts off mentioning Type 1 and Type 2 diabetes, but then the targets it quotes are those that are normally aimed at people with Type 1. (and believe me, it’s difficult for us Type 1s to stay within those limits, and a deep fried mars bar has never passed my lips.)
 
the targets it quotes are those that are normally aimed at people with Type 1.
**

But aren't the targets uniform for everyone? As in, there are 'safe' levels for BG, and 'less safe'??

Glad you've never had a DFMB! They sound revolting!!!
 
Callista said:
the targets it quotes are those that are normally aimed at people with Type 1.
**

But aren't the targets uniform for everyone? As in, there are 'safe' levels for BG, and 'less safe'??

Glad you've never had a DFMB! They sound revolting!!!
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No they are not really the same for everyone as Type 2 are relying on diet and maybe oral med to manage blood glucose in conjunction with their own insulin production whereas Type 1 will be reliant on injected insulin with the risk of Hypos if they don't get it quite right so need a wider target range.
 
Callista said:
the targets it quotes are those that are normally aimed at people with Type 1.
**

But aren't the targets uniform for everyone? As in, there are 'safe' levels for BG, and 'less safe'??

Glad you've never had a DFMB! They sound revolting!!!
Click to expand...
Keeping them within the 'time in range' on a Libre, between 3.9 and 9.0 is reckoned roughly to give an HbA1c of 48. Past research has shown that diabetic complications are less likely to occur if this target can be achieved, increasing in likelihood as the HbA1c rises. For a person with Type 1 on insulin, this is probably a reasonable target, because the tighter the control, the more likely episodes of Hypoglycaemia will occur, and if awareness is eroded by frequent hypos, this can be fatal. For people who aren’t on insulin, or other glucose lowering drugs, it’s open to them to aim at lower targets, or even remission.
 
Ah, OK, so in fact Type 2 is a 'tougher' (as in 'tighter') range (because, as you say, we still have our own insulin to regulate us), whereas Type 1 can (indeed, 'must') have a little slack - or is it the other way round?

I guess, though, as someone at risk of D2, then I had better do the very best I can to be at 'best safe' levels. I do wish, however, that I had had my BG monitor the moment I got my Hb1Ac test results (45), rather than wait a couple of weeks when I'd already slashed my carb intake to 'quasi-keto', as that would have told me how 'bad' I'd got to reach 45 on the Hb test. Still, I guess I'll find out how much, if any, I've improved my BG levels once I get he results back from my next HB in a couple of weeks time.
 

​

If you have type 2 diabetes​

  • before meals: 4 to 7mmol/l
  • two hours after meals: less than 8.5mmol/l

Checking your blood sugar levels

Knowing your blood sugar levels helps you manage your diabetes and reduces your risk of having serious complications – now and in the future. What are blood sugar levels? Your blood sugar levels, also known as blood glucose levels, are a measurement that show how much glucose you have in your...
www.diabetes.org.uk www.diabetes.org.uk

Not really a lot in it.

a reading of 9 could be anywhere between 7.2 and 11.25 anyway, 8.5 isn't going to be much different.
 
Robin - OK, so is it that hypos are more immediately/acutely dangerous than hypers, so it is 'safer' to err towards higher BG than risk going 'too low'? (Ironically, though, if I've understood this (??), a hypo is faster to 'remedy' by eating sugary carbs, whereas with a hyper, presumably, you have to just wait it out for the BG to drop sufficiently?)(can you accelerate the reduction with exercise to 'mop up' blood glucose, or is that even more dangerous??)

Whereas T2s are far less likely to go hypo in the first place, and their hypers will be 'chronic' rather than 'acute'?
 
Callista said:
Ah, OK, so in fact Type 2 is a 'tougher' (as in 'tighter') range (because, as you say, we still have our own insulin to regulate us), whereas Type 1 can (indeed, 'must') have a little slack - or is it the other way round?
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No, that’s right. If someone with Type 2 went to a clinic appointment with an HbA1c of, say, 42, they’d be congratulated on beating their D into submission. If I went to a clinic appointment with a 42, I’d expect a telling off and an assumption that I was only managing such tight control by having too many hypos, or by micromanaging to such an extent that I might suffer burnout.
 
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Travellor - thank you. That's reassuring. Though I (risk of T2 as yet)(depending on my next Hb result of course!) am at the high end for the 'before meals' range, but lower for the 'after meals'.

I just feel I never quite 'drain out' the glucose from my blood down to those lower levels (in the fives, not the sixes) alas. I assume that is what is indicating insulin resistance - my insulin is just not 'clearing' enough glucose between meals. That's what I'm working on (diet and exercise)
 
Robin, again, thank you - it's salutary for the likes of me, new to all this world, to understand that what is 'good' for one form of Diabetes management is not necessarily the same for all types.
 
Callista said:
Robin - OK, so is it that hypos are more immediately/acutely dangerous than hypers, so it is 'safer' to err towards higher BG than risk going 'too low'? (Ironically, though, if I've understood this (??), a hypo is faster to 'remedy' by eating sugary carbs, whereas with a hyper, presumably, you have to just wait it out for the BG to drop sufficiently?)(can you accelerate the reduction with exercise to 'mop up' blood glucose, or is that even more dangerous??)
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We can treat a high blood sugar with an insulin correction dose, and bring it down within a few hours. If we left it to come down on its own, it would never happen!
The problem with hypos is, yes, if you feel them, you can treat them quickly with glucose and your levels will rise quickly. The problem comes with familiarity. The more hypos you have, the more your body becomes accustomed to the lower blood sugars, and doesn’t alert you with symptoms until you’ve got down to dangerously low levels, low enough not to be able to marshall your brain into telling you to treat it. There comes a point where irreversible brain damage and death occurs. Now we have Libre alarms, especially at night, it should become less common that people sleep through a hypo. There is a phrase 'Dead in bed syndrome' that used to be bandied around for people who hypo'd in their sleep and never woke up.
 
Durgh, daft me - didn't think - of course, you inject insulin. Silly me, sorry.

The DiB syndrome sounds scary - I'm glad that continual monitoring is helping to prevent them.

The more I learn about diabetes, the more impressed I am by just how incredible a job the human body does in regulating itself (when not 'faulty'). It's incredibly complex and inter-related, and we take it for granted (until it goes faulty.....)
 
Callista said:
The more I learn about diabetes, the more impressed I am by just how incredible a job the human body does in regulating itself (when not 'faulty'). It's incredibly complex and inter-related, and we take it for granted (until it goes faulty.....)
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Yep! It’s those tight tolerances that make pretending to be our own pancreases quite tricky!

Interesting while 4-9 is the general guidance for fingersticks in T1, the international expert consensus on ‘time in range’ looks at aiming for 70% of time between 4 and 10 as being associated with an on-target HbA1c, and helping to reduce risks of long term complications.

So there can be a little slack in BG management without immediate harm - though obviously the more time one can spend 4-8ish (but not lower than 4!) the better 🙂
 
to me, that 70% 'time in range' seems sensible, as in, 'realistic', and, also 'sustainable long term'.

OK, I'm only threatened by D2, and I know I am very fortunate in that respect compared with what the D1's are coping with endlessly, but from my (fortunate) perspective, I think it's reassuring to know that we can both 'lapse through temptation' (oh dear, discovered that missing bar of chocolate so disposed of it in the quickest way possible!), and also through ''planned lapses' eg, Christmas, birthday, treat meals out etc etc, whatever it is.

being good 'all the time' is hard, so it is comforting to know that yes, we (or at least, D2) can lapse and then make up for it. However, of course, it's also essential to remember that lapses can become all-the-time-lapses.. (ie, permanent lapse-state)
 
Callista said:
to me, that 70% 'time in range' seems sensible, as in, 'realistic', and, also 'sustainable long term'.

OK, I'm only threatened by D2, and I know I am very fortunate in that respect compared with what the D1's are coping with endlessly, but from my (fortunate) perspective, I think it's reassuring to know that we can both 'lapse through temptation' (oh dear, discovered that missing bar of chocolate so disposed of it in the quickest way possible!), and also through ''planned lapses' eg, Christmas, birthday, treat meals out etc etc, whatever it is.

being good 'all the time' is hard, so it is comforting to know that yes, we (or at least, D2) can lapse and then make up for it. However, of course, it's also essential to remember that lapses can become all-the-time-lapses.. (ie, permanent lapse-state)
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It depends on your mindset.
I plan my overeats.
We're currently on holiday in Majorca.
The plan is at least to go away once a month now the world is open.
So, once again we are off the leash, and we'll be back on it when we are back home.
So long as my weight, (ie fat) is in range, I'm good.
That was my life plan, diabetes isn't going to burn that.
 
Callista said:
the targets it quotes are those that are normally aimed at people with Type 1.
**

But aren't the targets uniform for everyone? As in, there are 'safe' levels for BG, and 'less safe'??

Glad you've never had a DFMB! They sound revolting!!!
Click to expand...
No , read the first line of the article you quoted 'targets differ for everyone'
T2 Targets are determined by age, stage, complications and duration of diabetes.
The belief that 'Lowest is best' for T2s was exploded by Prof Craig Christie of Cardiff a decade ago with is J graph of complications/HbA1c.
 
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I plan my overeats
**

That's best, clearly - but doesn't allow for the 'oh, look, there's a hitherto-unnoticed choc bar in this drawer - must be a sign from God it needs eating up right now'....!!!!
 
Callista said:
I plan my overeats
**

That's best, clearly - but doesn't allow for the 'oh, look, there's a hitherto-unnoticed choc bar in this drawer - must be a sign from God it needs eating up right now'....!!!!
Click to expand...
I switched my sweet tooth for savoury right at the start.
Nowadays I prefer chilli to chocolate.
 
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