What are the goal blood glucose values?

From the Guidelines

Goal blood sugar values should be individualized, but generally range from 80 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals for most adults with diabetes, with a long-term goal of maintaining an A1C level below 7%. For fasting blood sugar (upon waking), the target is generally 80-130 mg/dL 1. However, these targets may vary based on individual factors, such as age, health conditions, and pregnancy status. Older adults or those with multiple health conditions might have less stringent goals (such as A1C below 8%), while pregnant women need tighter control (fasting below 95 mg/dL and 1-hour post-meal below 140 mg/dL) 1. People without diabetes typically maintain fasting glucose levels between 70-99 mg/dL.

Key Considerations

• Individualization of glycemic goals is crucial, taking into account factors such as severe or frequent hypoglycemia, and the presence of complications or comorbidities 1.
• Less intensive glycemic goals may be indicated in patients with severe or frequent hypoglycemia, while more stringent glycemic goals (i.e., a normal A1C, <6%) may further reduce complications at the cost of increased risk of hypoglycemia 1.
• Postprandial glucose may be targeted if A1C goals are not met despite reaching preprandial glucose goals 1.

Monitoring and Adjustment

Regular blood sugar monitoring using a glucose meter or continuous glucose monitor is essential for tracking progress toward these goals 1. The results of blood glucose monitoring should be used to adjust treatment plans, including insulin doses and other medications, to achieve optimal glycemic control 1.

Special Populations

• Critically ill patients: blood glucose levels should be kept as close to 110 mg/dl (6.1 mmol/l) as possible and generally <140 mg/dl (7.8 mmol/l) 1.
• Non–critically ill patients: there is no clear evidence for specific blood glucose goals, but cohort data suggest that outcomes are better in hospitalized patients with fasting glucose <126 mg/dl and all random glucoses <180–200 mg/dl 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Goal Blood Sugar Values

The goal blood sugar values for individuals with diabetes are not explicitly stated in the provided studies. However, some studies mention the following:

• The American Association of Clinical Endocrinologists and the European Association for the Study of Diabetes have recommended a lower hemoglobin A1c target of <6.5% 2.
• The UK Prospective Diabetes Study reported that maintaining glycemic control is crucial, but the specific blood sugar values are not mentioned 2.
• In terms of insulin therapy, the goal is to achieve normalization of blood glucose levels, but the specific values are not provided 3, 4.

Factors Affecting Blood Sugar Control

Several factors can affect blood sugar control, including:

• The use of oral agents, insulin, and injectables 2, 5, 6.
• The type of diabetes, with type 1 diabetes requiring more complex insulin regimens 3.
• The presence of other health conditions, such as cancer or steroid therapy, which can impact insulin use 3.
• The use of combination therapy to target different pathogenic mechanisms and manage both fasting and postprandial blood glucose levels 2, 4.

Insulin Therapy

Insulin therapy is a common treatment for both type 1 and type 2 diabetes, with the goal of achieving normalization of blood glucose levels 3, 4. The types of insulin used include:

• Basal insulin, which suppresses liver glucose production 3.
• Meal-time insulin, which promotes glucose storage in skeletal muscle 3.
• Insulin analogues, which have enhanced our armamentarium of therapeutics for treatment of diabetes 2, 3, 4.