What are the target blood glucose (CBG) levels for a diabetic patient?

From the Guidelines

The target blood glucose levels for diabetic patients generally range from 80-130 mg/dL (4.4-7.2 mmol/L) before meals and less than 180 mg/dL (10.0 mmol/L) two hours after meals, with an HbA1c goal of less than 7% for most patients, according to the most recent and highest quality study 1.

Key Considerations

• The HbA1c goal may be individualized based on several factors including age, duration of diabetes, presence of complications, and risk of hypoglycemia, as noted in 1 and supported by earlier studies such as 1 and 1.
• Elderly patients or those with multiple comorbidities might have less stringent goals (HbA1c 7.5-8.5%) to reduce hypoglycemia risk, as suggested by 1.
• Pregnant women with diabetes typically aim for tighter control with fasting glucose below 95 mg/dL and 1-hour postprandial values below 140 mg/dL, although this specific guidance is not directly mentioned in the provided studies, it aligns with general clinical practice.

Maintaining Glycemic Control

Regular self-monitoring of blood glucose is essential for maintaining these targets, with frequency depending on the treatment regimen, as implied by the need for individualized care in 1 and the management strategies discussed in 1.

Preventing Complications

These targets help prevent both acute complications like hypoglycemia and hyperglycemia as well as long-term complications such as retinopathy, nephropathy, neuropathy, and cardiovascular disease by minimizing glucose fluctuations and maintaining overall glycemic control, a principle supported by the discussion of benefits and harms in 1 and the management guidelines in 1 and 1.

From the Research

Target Blood Glucose Levels

The target blood glucose (CBG) levels for a diabetic patient can be quantified by the following measurements:

• HbA1c levels:
  • Less than 7.0% is considered optimal for most patients 2
  • Less than 7.5% is considered good control for some patients 3
• CBG readings:
  • Between 4 and 10 mmol/l (72-180 mg/dl) is considered the target range 4
  • Achieving 60% or more readings within this range, with up to 30% readings above 10 mmol/l, may be a novel target for people with diabetes 4
• Fasting plasma glucose (FPG) levels:
  • Less than 130 mg/dl is considered optimal for most patients 5

Factors Affecting Glycemic Control

Several factors can affect glycemic control, including:

• Postprandial hyperglycemia: contributes to overall glycemic load and cardiovascular risk 3
• Caloric intake, carbohydrate consumption, and glycemic index of food: may contribute to plasma glucose levels, but no correlation was found in one study 5
• Type of medication: different medications, such as insulin glargine and pioglitazone, can have different effects on glycemic control 2

Monitoring and Targeting Glycemic Control

Monitoring and targeting glycemic control is crucial for managing diabetes. This can be achieved by:

• Regularly measuring HbA1c levels and CBG readings 4
• Targeting postprandial glucose regulation, in addition to FPG and HbA1c 3
• Adjusting medication and treatment plans as needed to achieve optimal glycemic control 2