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I’ve heard that tight blood glucose control might be a good way to control my diabetes. What is it, and why should I do it?

According to the American Diabetes Association (ADA), the general blood sugar goals for people with diabetes are 80 to 120 mg/dl before meals, 180 mg/dl two hours after meals, and 100 to 140 mg/dl before bedtime. Goals for blood glucose levels depend on the time of day they're checked. And individual goals can vary from person to person.

Studies have shown that tight blood sugar control can lower risks for medical problems in people with type 1 and also likely type 2 diabetes. Both of these conditions can lead to problems such as eye and kidney disease, nerve damage, and a greater risk of heart disease. In studies, tight blood sugar control resulted in a 50–75 percent decrease in complications in people with type 1 diabetes, and a 25 percent decrease in people with type 2 diabetes.

Although generally beneficial, tight control can lead to problems if you overshoot your goal and end up with low blood sugar, which can be dangerous.

Certain groups of people should not try for tight blood glucose control. These include most children under the age of 13, people over the age of 70, those with severe diabetes, and people who've had a stroke or have heart disease. These people either have a greater risk of low blood sugar or may not get much benefit from tight control.

Keep in mind that many different things can affect blood glucose levels, including food, medicines, illness, and stress. Talk to your doctor to determine your blood glucose goals and to find out if tight blood glucose control is right for you.

Sources:
American Diabetes Association Complete Guide to Diabetes. American Diabetes Association, 1997.
Tight Diabetes Control. www.diabetes.org. American Diabetes Association. Last accessed 12/2006.
101 Tips for Improving your Blood Sugar. American Diabetes Association, 1999.
American Diabetes Association. "Standards of Medical Care for Patients with Diabetes Mellitus" Diabetes Care 23 (2000).
DCCT Research Group. "The Effects of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus." The New England Journal of Medicine 329 (1993).
UKPDS Group. "Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)." The Lancet 352 (1998).
American Diabetes Association. "Implications of the Diabetes Control and Complications Trial" Diabetes Care 23 (2000).

This answer prepared 5/26/2000.
This information updated 12/6/2006.

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