Hello everyone, The topic is what is my blood sugar goal? Again this is a common question we get and we are going to address it today. Let's move on for the real deal now.
So what is my blood sugar goal? Common question now you're gonna find stuff on the Internet. You know your blood sugar goal should be. This should be that the problem with that. When you say my when you say mine then everything changes. The general guidelines are there and I'll talk to you about general guidelines and I'll tell you how your situation can be different and I will divide patient groups according to. Certain characteristics now you can decide. What characteristics you have and what gold you should have for you as a person? because i'm not going to you one single number that can fit every one that never happens right so let's get started. Now the general guideline is seven percent, so that you can actually understand where they've unseat years and come back to this post.
You know majority of the people think that they have to go below 7, but your goal may be different and then to get to 7% avanc. Let's talk about this. How do you really get to 7% A 1C that magic number that everybody wants all? As I said, your goal could be 6% or even 8%. Depending on what type of person or patient you are, but for 7% this is the rule of thumb. If you are less than 130.Before meals consistently and you're less than 180.One to two hours after meals. Then you are going to be at 7%. Why do I say that? Because 7%, like we discussed,That percentage 7% equals to an average blood sugar number, so 7% in this case is 150 milligram per deciliter and to achieve 150 milligram per deciliter without having severe fluctuations.Less than 130 before eating less than 180 after eating, you can get to 7% so or below.
Avon C is not the greatest tool because it doesn't really tell you highs and lows. It just tells you the average. So you can still get to 7% if your blood sugars are 50 and 2:50 every time, and you're High Roller coaster, you can still get down to 7%. It doesn't mean that you're doing really well, but the bottom line is 7% is a common goal less than 130 before me is less than 180. Is is a common goal for most patients. Now, of course.
Another thing you have to pay attention to is the patient characteristics. What we look at is how young is a patient and how healthy is a patient. The younger and the healthier you are.And the more strict we can be with you. So and then, how willing are you to actually bring your ABC down? How willing are you to do diet and exercise? How willing to to take medications and so forth? A lot of factors play into it.
Medication costs are there and this and that. But the bottom line is for a motivated patient, a young individual, you can easily go below 6%. I have a lot of patients down to 5.5 or even down to 5%.With or without medications, depending on the individual, but that's very achievable, so I always say as low as reasonably achievable. So why do I say reasonably? Because you don't want to go there by causing a lot of low blood sugars like blood sugars down to 5040. You know you don't want to do that. You don't want to go below 70. You want to stay above 70 and but you want to stay less than 130 as well. So if your blood sugars are ranging from.90 to 1:30. You know, some days you're you're behaving, you're good, you're you're your blood. Sugar is 90 to 100 before meals. Next day you know it's a weekend you're you're doing stuff and you're eating out whatever and then you go to 12130. That's OK, you know, like you're a human being. As long as you keep that upper threshold below 180 and you keep most numbers down to 9000 range, you can still get your A1C down to six, 6.5 or less than 6.5. So again, that's all. About the average numbers right so and then your blood sugar? How much you Spike also determines it.
So I generally recommend checking blood sugars after meals sometimes as well, to make sure that you are staying below 180. Now if you want to really go down to six percent, 6.5 or 6% or below, you want to go below 16150 after meals, then you are really going to be able to achieve that A1C level.So like for example, another question is what should my blood sugar be at bedtime? Now it depends on what medication you're on typically, but I would suggest being below 150 is a general rule of thumb, because bedtime is not necessarily after dinner. So even if after dinner.
let's say, 170 or so, you should be able to go down to 150 before bedtime. So what ends up happening is.A lot of people start eating snacks and fruits and stuff like that.Watching TV, God knows and then their blood sugar starts climbing. So although they didn't have a big dinner but these snacks carry them up to 200 at night and then sometimes if they're having fatty snacks that may affect the morning blood sugars as well, and then that becomes a constant problem. So that's why people will say why my blood sugar is in the morning fluctuating so much because those snacks.
you know, the dinners that you're eating the fat content in them can be a big major.Doctor, let's talk about older individuals or individuals with more problems, such as people with chronic kidney disease, people with liver disease.
We are more careful with them just because they tend to have more susceptibility to low blood sugars, and these people are typically have been diabetic for 15-20 or more years and then they are.On multiple medications, multiple insulins and there are more on the older age. You know, especially somebody is like 75 + 80 plus.They do not respond well to low blood sugar problem.
And they may be alone, and they may not fix it themselves, or they are more at risk. So for those people we relax the blood sugar goals and we tell them, look, you know basically.Yes, you have a chronic kidney disease.
But you have a lot of other problems. We actually look at the patient. You know what are we? What are we looking here? How many years this patient may have, you know, let's say 510 years all this chronic problems and we don't foresee any major problems from a slightly high blood sugars, but we see more harm from a very strict blood sugar control. And there have been a lot of studies about this. You know when they try to bring these older frail patients down to a very tight blood sugar control, they actually end up dying more.
so that's why we are easy on them. We tell them OK, your blood sugar goal is not, let's say 8% A 1C we can live with that. If your blood sugar is less than 1:15 in the morning, I can live with that. You can live with that, especially if they didn't have major complications so far. Some people are resistant to complications of diabetes for an unknown reason. You know they have been, let's say seven 8% in their entire life for 20 years, and now they don't really have much of anything going on.They have a good kidney function. You know there's another factor. You know when you look at people, so they have been diabetic for 20 years and they don't have any eye disease. No kidney disease, no heart disease. Obviously some people are reacting differently to high blood sugars and I look at them. Look, you're already 75. You don't have any complications you have diabetic for 20 years. Let's just relax because this is you don't really have to kill yourself to go down to 6% because going down to 6% sometimes can kill you fast. Way faster than if you were.Up to 7.5 or 8%.
So it is an art. We look at our patient. We look at, you know what's the best thing for them. What is best thing for a patient can be different from the patients standpoint because the doctors go to school for that. So the same thing when I take my car to a mechanic, what I think best for my car is totally different. And and harm. So as I said, older people less stringent 8% ANC less than 1:50 in the morning is fine, less than I would say 200 at bad times. OK, for those older people, but for younger people who have been newly diagnosed go as low as you can, 4.5% even C go for it.It's just that you have to be careful about what you're doing to get there. You know if you're doing this with diet and lifestyle, great. But,
sometimes people will come to me and they say, Oh my blood sugar is 120. That's horrible. What am I gonna do? I'm like look 120 is not bad, you know. And you're dieting and exercising. You're doing everything you know. The next thing we have to do is put you on medication and they say, yeah, what's the medication? No, no worries, I'm like.
Well, that's OK. But The thing is, with the medications you know everything has a possible side effect. So so The thing is, sometimes you have to really understand what side effect you're looking for in the short term and long term, and what your goals are in the short term and long term. And what's the benefits and benefits in the short term and long term these are. These are the things that a lot of patients don't understand. They just get stuck on their number. Whatever they think is best in their mind. But I think you should really. Provide goose's of information and the have a good discussion with your docker night sugar empties be provided.
We have said a little communication were. Basically you can even get your meters and thus data through a settler towers we are using eighty and to collect blood sugar data without having the patient to enter blood. Sugar anywhere or keep logs or anything like that so all this data comes to us and know we manage. Our patients that way so we become very proactive instead of reactive most sort of time you know the traditional doctors the know you will go to the office. They'll say something you go you don't see them for not or three months good luck if he can reach out to them and then next thing you know your blood sugars are either to lower too high but you have to wait for your point month. His bunch of craziness and then by the time to get to the doctor.
Doctor will say okay because your blood sugars are they're gonna scream at you.
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