One critical component of diabetes management is knowing the guidelines and keeping them front of mind. For most newly diagnosed diabetics this can be a challenge. Especially, when there are so many numbers floating around in your head.
But when it comes to managing Type 2 Diabetes, if you want to control type 2 diabetes long-term, knowing the basic guidelines can make the difference between slowing down or prevent complications or more and more medications being added on.
Most of the physicians that I work with stress the importance of knowing the guidelines with their patients. If you don’t know the guidelines, it’s like trying to play a game you don’t know the rules to. And the guidelines continue to change over the years. And they will continue to get tighter and tighter as we learn more and more about diabetes.
Type 2 Diabetes Basics
First off, diabetes is an age accelerator. It takes away from the vital years that we have and this is totally avoidable. By controlling it, we can add years and even decades to our productive years, which can allow us to be around to watch our grandkids grow up.
Type 2 diabetes is characterized by two core defects – insulin resistance and beta cell dysfunction, which lead to high blood sugar/hyperglycemia. Insulin resistance generally means your cells are resistant to insulin, so they can’t get the sugar they need for energy. Beta cell dysfunction generally means that the cells of the pancreas that are responsible for creating and releasing insulin aren’t working properly.
Second, high blood sugar leads to microvascular and macrovascular complications. Microvascular refers to damage to the small blood vessels. And Macrovascular refers to damage to the large vessels.
Macrovascular complications:
• Dyslipidemia – this generally means, lipid (cholesterol) abnormalities
• Hypertension – high blood pressure
• Atherosclerosis – plaque (cholesterol) deposits in your arteries that lead to narrowing of your arteries
• Coronary Artery Disease – blockage of the arteries that supply blood to the heart that leads to heart attack
*Cardiovascular events (MI and stroke) account for 80% of all deaths for people with diabetes
Microvascular complications:
• Retinopathy (Eye disease)
• Nephropathy (Kidney disease)
• Neuropathy (Nerve damage)
*Diabetes is the leading cause of blindness, kidney failure, amputations
Diabetes Management Guidelines
Here are some good information, terms and guidelines to know and be familiar with if you aren’t already:
- Fasting Blood Glucose (or Fasting Plasma Glucose): measurement of glucose levels after fasting for at least 8 hours. Normal Fasting is <100 mg/dL.
- Postprandial Blood Glucose (or Postprandial Plasma Glucose): measurement of glucose levels after a meal. In the beginning, postprandial glucose control is the problem with newly diagnosed Type 2 diabetics. This is usually the earliest sign of problems with blood sugar.
- Glycosylated Hemoglobin (A1C): tests your average blood sugar levels over a 2-3 month period. Commonly called an A1C test.
A1C Averages As It Relates To Your Blood Sugar Level
Average Glucose Level (A1C Chart/Fasting Blood Sugar Levels Chart)
| A1C(%) | mg/dL |
| 6 | 126 |
| 7 | 154 |
| 8 | 183 |
| 9 | 212 |
| 10 | 240 |
| 11 | 269 |
| 12 | 298 |
The American Diabetes Association A1C target is <7%
*Normal ranges are between 4% and 6% for and A1C test.
Looking at the above chart, an A1C of a 9 is equal to an average blood sugar level of 212 mg/dL over a 2-3 month period. This is useful for a physician because it gives them a snapshot of where your blood sugar levels have been.
One thing you should know is that Type 2 diabetics who have pretty good glucose control usually should focus on their postprandial (after a meal) glucose levels.
While people who are poorly controlled overall, usually have higher A1C levels, and should focus more on fasting levels.
The bottom line with type 2 diabetes is you have to get and keep your blood sugar around normal levels to prevent the complications that come from high blood sugar levels. That’s it.
Prior to using any of this material, please consult with your physician.