The Value of Targets

You and your team will decide on your individual targets. 

Here is what the American Diabetes Association recommends in its 2024 Standards of Care for most people with type 2 diabetes:

A1c less than 7%

Before meals 80 - 130 mg/dl

After eating less than 180 mg/dl

Let’s look at each of these targets:

A1c

When red blood cells are traveling in a bloodstream with excess sugar, some of that sugar sticks to the outside of the RBCs. The amount of sugar sticking to the cell gives a good idea of how high the blood sugar has been over the last 2 to 3 months. This value is represented by the A1c.

A1c is often used to see how well your diabetes treatment is working. If your A1c is above target, you and your team might consider making a change to your treatment.

A1c is a good measure on its own, but you get more clues about your blood sugar if you also know the sugar levels before and after eating.

Before Meal Targets

Remember in Post 1 we learned that the body has ways to provide the cells with glucose, even when we haven’t eaten in hours?

A blood sugar reading before eating will tell you how well those processes are working.

One organ important to this process is the liver. I like to think of the liver acting a bit like a furnace with a thermostat. When blood sugar is low, the liver can kick-on and supply more glucose to be circulated to the cells.

When the sugar level is once again up to where the body likes it, the liver should turn off the glucose it was supplying.

Imagine your blood sugar dips a bit low while you are sleeping. Your liver responds to correct the problem. What would happen if the liver were a bit sluggish about shutting down after the proper sugar level is reached?

The result could be an overcorrection. Your before-breakfast sugar level would probably be above the target you were shooting for.

This situation is one you and your team can work to correct.

After Meal Targets

It makes sense to learn how your body responds to different kinds and amounts of food.

There are many opinions about how a person with type 2 diabetes should eat. The ADA 2024 guidelines state there is not a one-size-fits-all eating pattern they should follow.

They advocate “healthy eating patterns” that can

• Help achieve weight goals

• Help prevent or delay long term complications 

• Help reach targets for the ABCs (A1c, blood pressure, and cholesterol)

• Help maintain the pleasures of eating!!

They encourage the use of Diabetes Self-Management Education and Support (DSMES) classes and visits with Registered Dieticians to help with these goals.

Just as keeping your eyes on your pre-meal blood sugars can give you a heads up about your current treatment plan, watching out for post-meal readings above target can tell you that you and your team need to do a reevaluation and find a way to get those numbers back in the target range!