Select Your Target Blood Sugars
With your health care provider’s help, select a target range for before meals, 2 hours after meals, and at bedtime. Constantly aim for reasonable target ranges for your day to day blood sugars. Your target range covers the numbers you would like your blood sugars to stay within at least 75% of the time. This starting range can be tightened and improved gradually until you are ready for a more ideal range.
The targets you select will depend on your current control, age, living conditions, employment responsibilities, and ability to recognize low blood sugars. If you are a woman who wants to become pregnant, your blood sugar targets will be significantly lower than at other times in your life to ensure a successful pregnancy. If you have been having severe lows in the middle of the night, your target at bedtime may first be set at a higher level and later lowered after your insulin doses have been readjusted to prevent the night lows.
What makes up ideal blood sugar control varies for different people and for different times of the day. Table 1 gives three typical target goals: the first represents the goals used for tight control in the Diabetes Control and Complications Trial, the second is typical for pregnancy, and the third for people who have Hypoglycemia Unawareness.
Your target blood sugars may be the same or different from these. With your physician’s help, be sure to clearly determine your personal pre-meal and post-meal target blood sugars to work toward.
| Table 1: Target Blood Sugars | |||
|---|---|---|---|
| Time | DCCT | Pregnancy | Hypo Unawareness |
| Before meals | 70-120 mg/dl (3.9 to 6.7 mmol) |
60-90 mg/dl (3.3 to 5.0 mmol) |
80-150 mg/dl (5.6 to 8.3 mmol) |
| 2 hr. after meals | < 180 mg/dl (< 10 mmol) |
< 120 mg/dl* (< 6.7 mmol*) |
< 200 mg/dl (< 11.1 mmol) |
| 2 a.m. | > 65 mg/dl (> 3.6 mmol) |
60 to 90 mg/dl (3.3 to 5.0 mmol) |
> 90 mg/dl (> 5.0 mmol) |
| HbA1c | < 7.0% | 4.8% or 20% less than your lab’s upper limit for normal |
< 8.0% |
*During pregnancy, the desired goal is less than 120 mg/dl (6.7 mmol) at one hour after eating.
Current TDD
An accurate history of your insulin doses is needed to determine your current TDD. If you are not doing so already, start recording all the insulin doses you take each day. Add up your daily doses of bolus and basal insulin and average these over at least the last five to seven days.
Include correction boluses that are used to correct high readings, unless these correction boluses are causing your blood sugar to drop too low. A good way to account for correction boluses is to add up all correction bolus units of insulin you have given during the last week and divide this total by 7. Take this average of the correction units you use each day and add about half this average to your TDD to estimate how many units you may need to add to your usual basal and bolus doses.