Tight Diabetes Control
Managing blood glucose can prevent or slow the progress of many complications of diabetes, giving you extra years of healthy, active life.
What Does Blood Glucose Management Mean?
Managing diabetes means getting as close to a normal (nondiabetic) blood glucose level as you safely can. Generally, this means levels between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, with a glycated hemoglobin (A1C) level less than 7 percent. Those targets should be individuallized depending on a variety of factors. Set your goals with your doctor.
You do not need to figure these things out on your own. Your diabetes care team (your doctor, dietitian, diabetes educator, and other health care professionals) should spend time teaching you about it. Your team will help you make guidelines for how much insulin to take and when. Ask about going to a Diabetes Self-Management Education and Support class. You can find an ADA Recognized Program at diabetes.org/findaprogram or by calling 1-800-DIABETES (800-342-2383).
A good diabetes care team is a must. Choose a doctor who understands diabetes well or is willing to learn for your sake. Your doctor should have ties with other health professionals you need, such as dietitians and a mental health worker. If you don't have good options in your area, think about options a little farther away.
How Does It Help?
No one knows why high glucose levels cause complications in people with diabetes. But keeping glucose levels as low as possible prevents or slows some complications.
For the Diabetes Control and Complications Trial (DCCT), researchers followed 1,441 people with type 1 diabetes for several years. Half of the people continued standard diabetes treatment while the other half followed an intensive-control program. Those on intensive control kept their blood glucose levels lower than those on standard treatment, although the average level was still above normal.
The results? Here's what they found in the tight-control group as compared with the standard-treatment group:
- Diabetic eye disease started in only one-quarter as many people.
- Kidney disease started in only half as many people.
- Nerve disease started in only one-third as many people.
- Far fewer people who already had early forms of these three complications got worse.