Tight Type 2 Diabetes Control

Submitted by Thiruvelan on Wed, 04/10/2013
Tight Type 2 Diabetes Control

Tight control means getting as close to or within a normal (non-diabetic) blood-glucose range as you safely can be without frequent hypoglycemia. 

What Does Tight T2D Control Mean?

Tight diabetes control is worthwhile in almost every case; it requires the test, analyzes, modifies, and again; repeat until you reach your target. You need to lowering carb in your diet, physically more active, stick to regular exercising, manage stress effectively, get adequate sleep, quit smoking, limit alcohol consumption, and medication/insulin (only if necessary).

For tight T2D control, what will be the best blood sugar (BS) range?

BS target1: American Diabetes Association suggested the below said target: Fasting blood sugar number 70 mg/dl to 130 mg/dl and the postprandial blood sugar number less than 180 mg/dl.

BS target2: Once you have accomplished the above-suggested target, try achieving closer BS numbers: Fasting BS under 110 mg/dl (or 6-mmol/l), postprandial BS one hour after meals under 140 mg/dl (or 8-mmol/l) and two hours after meals under 120 mg/dl (6.5-mmol/l).

Why would be diabetic assume they would always be higher than non-diabetic?  

You can reverse diabetes; it is quite possible to manage it close to a normal range, even within the non-diabetic range.

Many experience diabetic just achieving it even if most newly diagnosed never know it. It is your good practice, knowledge, and motivation can take you to the best non-diabetes range, thus do not underestimate you. Keeping your BS close to normal, helps you feel better and stop (or reverse) your diabetes complications.

Once you have achieved the above-suggested target, and then try to maintain your BS in the non-diabetic range: fasting BS under 100 mg/dl (5.5-mmol/l), postprandial BS one hour after meals under 126 mg/dl (7-mmol/l), and two hours after meals under 100 mg/dl (5.5-mmol/l).

BS target4: You can even try achieving a blood-glucose range that is free from any diabetes complications. Such a best BS number is fasting within 70–90 mg/dl (or 3.89 to 5.00-mmol/l), one hour after a meal within 90–125 mg/dl (or 5.00 to 6.94-mmol/l), and two hours after a meal within 90–110 mg/dl (or 5.00 to 6.11-mmol/l).

Does tight diabetes control worthy?

Close control of diabetes will reduce your risk of diabetes complications. The United Kingdom Prospective Diabetes Study confirms this. And it was the most extensive study of diabetes type2 patients. This test result shows the benefits of tight control; you can be able to lower your A1C even up to 6.2%. For every 1% drop in A1C, you can expect:

  1. There is a significant reduction in nerve damage.
  2. Your eye damage risk in the next ten year can reduce by 35%.
  3. Your kidney damage risk in the next ten years can reduce by 35%.
  4. Your heart-attack risk in the next ten year can reduce by 18%.
  5. Your chances of dying within ten years can reduce by 7%.

There are amazing benefits in tight diabetes control; however, it can increase your risk of hypoglycemia episodes. If you are not able to prevent hypoglycemia episodes, then close diabetes control is not for you. Elderly and those who have had a heart attack or stroke can stop trying tight diabetes control; instead of benefits, it only harms them. 

ACCORD (Action to Control Cardiovascular Risk in Diabetes) and ADVANCE (Action in Diabetes and Vascular disease: Preterax and Diamicron MR Controlled Evaluation). Those studies did not show stringent control is harmful. Instead, control by a combination & overdosage of oral medication and or insulin treatment may not be right for diabetic health. Additionally, these studies have carried out by advising the diabetes patients to have an extremely low-fat (means high carb) diet. Which experienced diabetes patient and some smarter health care professionals have been opposing? If you decide to be in tight control your diabetes with diet (lowering carb), exercise (more active life with regular aerobic and resistance training) and without or low dosage of medication/insulin. It is undoubtedly beneficial to you without any form of harm.

A1C target: American Diabetes Association (ADA) suggests people with diabetes aim for A1C levels of 7% or less, equivalent to 150 mg/dl average blood sugar. Once you have achieved this target, next, you should try for pre-diabetes A1C range of 5.7 to 6.5%. After attaining this pre-diabetes range, you can even try for non-diabetes A1C range of below 5.7. You can try shifting your target up to non-diabetic range only if you are not experiencing frequent hypoglycemia episodes. If you are newly diagnosed t2d, then it is possible to reset the clock and stop any further damage to your pancreatic beta cells.

Experienced people in various diabetes communities have achieved an A1C of less than 6% by making changes to their diet (low-carb diet), post-meal testing, and increasing exercise. Additionally, those people do not seem to be encountering any of the problems warned about in ACCORD and ADVANCE. Thus, it is the time to keep aiming for a blood-glucose level and A1C of a healthy non-diabetic range (if possible without medication/insulin).