Re: Target BG levels

[Guest guest]

Fred

Different authorities have settled for different levels for the various BGs.

But the reason some of us strive for even lower figures is that we want to

reduce the risk of progression and complications. When they make a graph and

plot BGs and the risk of complications (especially retinopathy) they create

a J-curve. That is the risk increase quite dramatically for every point you

go up in BG.

So, in the beginning it's good to set a realistic goal to come down to

" normal " BGs, but then if you want to reduce the risk of complicationsyou go

that extra step to below the cut off between normals and impaired.

Bea

Target BG levels

> Looking at the chart I found in the files section, it appears that

> the normal levels would be <115 fasting, & <140 after meals.

> Why then, do I read posts where people are agonizing about breaking

> 100's at any time?

>

> I'm way too new at this,

>

[Guest guest]

Because those are probably diabetic target ranges you have found. The

American Diabetes Assoc has standards that most of us who aim to be

tightly controlled think are FAR too high for the prevention of future

complications. We aim to make non-diabetic ranges our target.

Non-diabetics usually range between 70 - 100 at all times even after

eating. Of course most of us are not going to be able to achieve this

ideal most of the time & even aiming for this range is difficult. But

the struggle is worth it in the less likelyhood of complication later

on.

In my case I am not " agonizing " over numbers over 100. I was in a

competition with myself after having under 100 for several days & was

annoyed to have gone over 100 for a louzy 1/2 c of cereal which I should

have known would send me up as I have long been unable to eat grains

without going higher than I wish to see. This always happens whether the

grains be healthy whole grains or less healthy more processed junk.

cappie

Greater Boston Area

T-2 10/02 9/04 A1c: 5.3

max 100 carb diet, walking, Metformin.

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Chromium P, Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

1/05:146 lbs (highest weight 309),

5' tall /age 67,

cappie@...

[Guest guest]

The studies that support the goal of tight control considered tight control

to be an a1c of under 7. Those were the big studies. There have been some

smaller studies that say that under 6.5 would be better, and under 6.0 even

better than that, as in most labs, under 6.0 is considered to be non-diabetic.

Generally, an a1c of 6 corresponds to an average BG of 135.

The jury isn't completely convinced of the benefits of a1c's under 5. The

tradeoff made to acheive that kind of number (average BG of 100 or less) is not

something most people are willing to live with, and the benefits aren't so

great compared to staying under 6 that it makes sense for all people to try for

it (as compared with staying under 6 as opposed to staying under 7 where the

benefits have been measured and are substantial).

YMMV of course.

Also, not all people can accomplish an average BG of 100 or less or even 135

or less, as for some, it means that there are a lot of low blood sugars

occuring, and it would be safer to be at or above 6.

The ADA goals of under 115 fasting and under 180 two hours after a meal are

quite high and would normally lead to an a1c in the 6.5 range. Since only a

small percentage of diabetics have a1cs under 7, they may not be wrong in having

a higher goal. Getting someone who's had an a1c of 9 for ten years down to

6.8 is a major improvement. If people can get below 6, great, but under 7 for

a majority of diabetics would be a great acheivement.

Stacey

[Guest guest]

The studies that support the goal of tight control considered tight control

to be an a1c of under 7. Those were the big studies. There have been some

smaller studies that say that under 6.5 would be better, and under 6.0 even

better than that, as in most labs, under 6.0 is considered to be non-diabetic.

Generally, an a1c of 6 corresponds to an average BG of 135.

The jury isn't completely convinced of the benefits of a1c's under 5. The

tradeoff made to acheive that kind of number (average BG of 100 or less) is not

something most people are willing to live with, and the benefits aren't so

great compared to staying under 6 that it makes sense for all people to try for

it (as compared with staying under 6 as opposed to staying under 7 where the

benefits have been measured and are substantial).

YMMV of course.

Also, not all people can accomplish an average BG of 100 or less or even 135

or less, as for some, it means that there are a lot of low blood sugars

occuring, and it would be safer to be at or above 6.

The ADA goals of under 115 fasting and under 180 two hours after a meal are

quite high and would normally lead to an a1c in the 6.5 range. Since only a

small percentage of diabetics have a1cs under 7, they may not be wrong in having

a higher goal. Getting someone who's had an a1c of 9 for ten years down to

6.8 is a major improvement. If people can get below 6, great, but under 7 for

a majority of diabetics would be a great acheivement.

Stacey

[Guest guest]

In a message dated 1/17/2005 1:13:33 PM Eastern Standard Time,

staceypmartin@... writes:

> Generally, an a1c of 6 corresponds to an average BG of 135.

>

One of the issues to be considered as one strives for tight control is what

type of blood glucose is being reported by the meter? Is it an estimate for

whole-blood or plasma? A plasma reading, such as obtained by a laboratory, is

about 12% higher than a whole blood reading.

A finger prick measures whole blood, but the result is readily calibrated by

the meter to read plasma. I purchased my plasma-calibrated meter a few years

ago. At that time there were plenty of whole blood-calibrated meters in use.

I'm wondering whether today's new meters are all calibrated for plasma results.

It would seems logical to try and make home tests agree with lab tests.

Just another variable to consider when discussing specific blood glucose

levels.

[Guest guest]

In a message dated 1/17/2005 1:13:33 PM Eastern Standard Time,

staceypmartin@... writes:

> Generally, an a1c of 6 corresponds to an average BG of 135.

>

One of the issues to be considered as one strives for tight control is what

type of blood glucose is being reported by the meter? Is it an estimate for

whole-blood or plasma? A plasma reading, such as obtained by a laboratory, is

about 12% higher than a whole blood reading.

A finger prick measures whole blood, but the result is readily calibrated by

the meter to read plasma. I purchased my plasma-calibrated meter a few years

ago. At that time there were plenty of whole blood-calibrated meters in use.

I'm wondering whether today's new meters are all calibrated for plasma results.

It would seems logical to try and make home tests agree with lab tests.

Just another variable to consider when discussing specific blood glucose

levels.

[Guest guest]

cappie wrote:

> In my case I am not " agonizing " over numbers over 100. I was in a

> competition with myself after having under 100 for several days &

was

> annoyed to have gone over 100 for a louzy 1/2 c of cereal >

Cappie, I guess I'm the one doing the agonizing. It is so

frustrating sometimes - I'm not informed enough yet (and I thank you

for helping me to figure this out). Trying to stay under 100 at all

times just seems impossible to me. But I understand that my

metabolism is still adjusting to the weight loss, decreased average

bg, and these elf-sized meals. So I'll be patient. And hungry.

Fred

T-2 dx 12/04

[Guest guest]

Fred, about 8 to 10 years ago, I was sent to a Wellness Center by the

insurance company that covered me, thru my husband. A really nice idea,

run by the health plan and limited to health plan members.

As part of my education, I met with two CDEs. One covered the

psychological aspects of this chronic disease, he was a type 1. The

other, no diabetes, no thyroid, covered the actual treatment protocols.

She told me that they routinely helped patients achieve readings

hovering around 100. I had already done all the reading I could, and

had never heard of this. It was hard to believe, but she assured me it

was quite true. So a lot depends on the information you get, from

people who can assure you that normal numbers for diabetics are possible.

OTOH, when I was in cardiac rehab, they didn't want to let me go home

without drinking orange juice if my number was 100 or below. I knew

better and constantly reassured them I would not hypo on the short trip

home. At that time I was not using insulin.

That was an interesting experience too: if I was high when I came in I

could usually count on a decent drop by the end of exercise; if normal,

then my bgs would stay level. I would imagine my liver had a lot to do

with that.

Helen

[Guest guest]

Fred, about 8 to 10 years ago, I was sent to a Wellness Center by the

insurance company that covered me, thru my husband. A really nice idea,

run by the health plan and limited to health plan members.

As part of my education, I met with two CDEs. One covered the

psychological aspects of this chronic disease, he was a type 1. The

other, no diabetes, no thyroid, covered the actual treatment protocols.

She told me that they routinely helped patients achieve readings

hovering around 100. I had already done all the reading I could, and

had never heard of this. It was hard to believe, but she assured me it

was quite true. So a lot depends on the information you get, from

people who can assure you that normal numbers for diabetics are possible.

OTOH, when I was in cardiac rehab, they didn't want to let me go home

without drinking orange juice if my number was 100 or below. I knew

better and constantly reassured them I would not hypo on the short trip

home. At that time I was not using insulin.

That was an interesting experience too: if I was high when I came in I

could usually count on a decent drop by the end of exercise; if normal,

then my bgs would stay level. I would imagine my liver had a lot to do

with that.

Helen

[Guest guest]

Fred, about 8 to 10 years ago, I was sent to a Wellness Center by the

insurance company that covered me, thru my husband. A really nice idea,

run by the health plan and limited to health plan members.

As part of my education, I met with two CDEs. One covered the

psychological aspects of this chronic disease, he was a type 1. The

other, no diabetes, no thyroid, covered the actual treatment protocols.

She told me that they routinely helped patients achieve readings

hovering around 100. I had already done all the reading I could, and

had never heard of this. It was hard to believe, but she assured me it

was quite true. So a lot depends on the information you get, from

people who can assure you that normal numbers for diabetics are possible.

OTOH, when I was in cardiac rehab, they didn't want to let me go home

without drinking orange juice if my number was 100 or below. I knew

better and constantly reassured them I would not hypo on the short trip

home. At that time I was not using insulin.

That was an interesting experience too: if I was high when I came in I

could usually count on a decent drop by the end of exercise; if normal,

then my bgs would stay level. I would imagine my liver had a lot to do

with that.

Helen

[Guest guest]

hello all I just joined. Hopefully we can help each other.

My problem is exercise I have osteo arthritis in both knees so normal exercise

is out. This one of the reason my readings are always high. Also is it normal

for us to tire easily. I get very sleepy especially after eating. I'm 54 and I

weigh 280#.

Any help or advice would be appreciated.TY

Just Tappin' the key's .....Dennis

http://www.picturetrail.com/blueliquidstar

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[Guest guest]

Hi, Dennis...welcome to the list. Sorry you had to join us but you'll

get good support and advice here.

I'm going to paste on my " standard newby letter " . I hope you'll find a

lot of helpful suggestions in it.

There are people on this list who also have physical problems that limit

the amount and kind of exercise they do and I'm sure they'll add

something. One thing I remember they suggest is water aerobics. Can you

get to a pool?

And I'm sure your doctor (and probably everyone else) has told you that

if you lose weight that will help, so I won't add that <g>.

Here's my standard letter " for all newbies:

First of all, let me refer you to two of the best books about diabetes.

Read 'em and you'll learn a lot:

The first one is called

" The First Year, Type Two Diabetes, An Essential Guide for the Newly

Diagnosed " by Gretchen Becker. Gretchen is a list member and her book

is an excellent guide. It's in paperback and available online from

Amazon if your local bookstore doesn't have it.

The second book is called

" Dr. Bernstein's Diabetes Solutions " by K. Bernstein, M.D. You

can get it from the library but it's such a good reference that you

really should have it in your home library. Dr. Bernstein is a longtime

type 1 who controls his diabetes using a lowcarb diet as well as

insulin.. Many of us - both type 1 and 2 -- on this list have found

great success using his plan or a modified version thereof.

.

And here's the URL to Dr. Bernstein's website, where there's lots of

good stuff:

http://www.diabetes-normalsugars.com/index.shtml

These two books will give you good basic information on the ins and

outs of successful diabetes management.

I would further refer you to an excellent informational website titled "

" What They Don't Tell You About Diabetes "

http://www.geocities.com/lottadata4u/

If it isn't there for some reason, let me know and I can email you the

contents -- I have it in my archives now.

I would also refer you to (formerly Rick) Mendosa's website, where

there's a wealth of diabetic information and good links. He also has

an online diabetes newsletter which is very good.

www.mendosa.com

Cutting carbs is an excellent way to control your BGs and the more you

cut, the better. Most of us find that the " whites " -- breads, cereals

and pastas, in fact anything made with grain - will raise our BGs.

Also, rice and potatoes will do the same. And of course, cakes and

cookies and sweets of all kinds, including fruits and fruit juices.

Watch out for " low calorie " foods; often they're higher in carbs. Learn

to read food labels. Dr. Bernstein recommends about 40 carbs a day

total. This is really only for the dedictated low carber and IMHO hard

to maintain over the long run. However, I've read that the average

American eats about 300 carbs a day, so the truth is somewhere in

between. The best thing you can do for yourself (if you haven't

already) is buy a meter and use it FREQUENTLY. At the beginning you

want to learn how different foods affect your BG and to do this you need

to eat one food at a time, testing first...then test one and two hours

afterwards. Weigh out the amounts and keep good notes. You'll use up a

lot of strips in the beginning but the rewards are definitely worth the

expense and bother because in the end, you'll know what foods to avoid

and which are okay. Diabetes is a very individual disease and we often

say " YMMV " - what works for one may not work for another.

You want to aim for postprandial (two hours after meal) BG of 120.

Keeping your BGs between 70 and 140 are your goals. If you can do this

longterm, you can probably avoid the dreaded consequences of longterm

poor BG control...and I'm sure I don't have to list those for you. (I

will if you want, though).

Here's my own list of pretty lowcarb veggies:

Spinach

Cauliflower

Broccoli

Summer squash (zucchini, crookneck)

Spaghetti squash

Mushrooms

Asparagus

Greenbeans

Cabbage

Sauerkraut

And of course lettuce and avocados which aren't a veggie but a

fruit .but they're definitely lowcarb. I have a large mixed lettuce

salad with avocado every night with dinner.

You can eat a reasonable portion (4-6 ounces) of meat, chicken, fish

without problem; it's all protein, no carbs.

Berries are the lowest carb fruit but even so, you should eat them very

sparingly. Here's the website of the USDA, which you'll find very

helpful. It has carbs, calories, protein, etc.

http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl

It's helpful to have a food scale. A cup measure isn't nearly so

accurate. I use a Salter scale. It weighs in both grams and ounces and

cost me somewhere around $35. I got mine at a local gourmet shop but

they're available online too. Just do a Google search for " Salter food

scales " .

The A1C is a test that measures your average BG for a three-month period

with slightly more weight given to the latest month. All diabetics

should have this test every three months. And you should ask for, and

keep, copies of all your lab reports.

Good luck. And keep those questions coming. There's a really steep

learning curve at the beginning of your diabetes education but hang in

there -- it will all make sense eventually. And remember -- the only

stupid question is the one you didn't ask.

BTW, being always sleepy and having no energy is one of t he symptoms of

extended high BGs. What was your A1C on diagnosis? If you get your BGs

down to more normal levels, you'll start feeling more energetic.

Vicki, diabetic since 1997, A1Cs comsistently under 6 for a long time,

no complications, planning on forever no complications,

smile.

Re: Re: Target BG levels

>

> hello all I just joined. Hopefully we can help each other.

> My problem is exercise I have osteo arthritis in both knees so normal

> exercise is out. This one of the reason my readings are always high.

> Also is it normal for us to tire easily. I get very sleepy especially

> after eating. I'm 54 and I weigh 280#.

> Any help or advice would be appreciated.TY

>

>

> Just Tappin' the key's .....Dennis

>

> http://www.picturetrail.com/blueliquidstar

>

[Guest guest]

Target ranges recently posted from the Mayo Clinic are so high it is

unreal. By those standards I have never had a glucose problem.

But for me my body is much more than blood glucose and related

aspects. Grains and fruits are absolutely necessary for me. I had

eliminated much from those two food groups to the detriment of the

rest of my body. No fruit, no grains, no diabetic related medicine

for an A1C of 5.9 or fruit, grains, medicine for a 5.9. That is a

good trade off.

Betty

> Because those are probably diabetic target ranges you have found.

The

> American Diabetes Assoc has standards that most of us who aim to be

> tightly controlled think are FAR too high for the prevention of

[Guest guest]

Fred: don't agonize--good contol will come in time. I remember

thinking that I would never get even close to 100 when I first started.

BTW -- the weight that I lost came off when I cut back on carbs. I had

not planned or tried to lose, it just happened along with eating

healthier. However I must tell you that the weight loss itself never

made a bit of difference in my diabetes control -- I still need the same

amount of medication now as I did in the beginning & I have tried

several times to cut back a bit. I DO find tho that the amount of total

food I eat does have a bearing on my basil level so I guess eating elf

sized meals will be helpful to you--try having 5 or 6 or them a day.

cappie

Greater Boston Area

T-2 10/02 9/04 A1c: 5.3

max 100 carb diet, walking, Metformin.

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Chromium P, Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

1/05:146 lbs (highest weight 309),

5' tall /age 67,

cappie@...

[Guest guest]

Yep Betty a good tradeoff for you but I AM taking a diabetic med & STILL

can't eat grains altho I can usually eat one or two small servings of

friut a day (altho not always). It is ok tho, I don't really suffer

without grains--I sometimes yearn but that is ok.

cappie

Greater Boston Area

T-2 10/02 9/04 A1c: 5.3

max 100 carb diet, walking, Metformin.

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Chromium P, Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

1/05:146 lbs (highest weight 309),

5' tall /age 67,

cappie@...

[Guest guest]

I haven't been faced with the problem but at this point, you know

women allways have the right to change their minds, but if it meant

taking insulin for control I would do so.

Betty

> Yep Betty a good tradeoff for you but I AM taking a diabetic med &

STILL

> can't eat grains altho I can usually eat one or two small servings

of

> friut a day (altho not always). It is ok tho, I don't really suffer

> without grains--I sometimes yearn but that is ok.

>

>

> cappie

> Greater Boston Area

> T-2 10/02 9/04 A1c: 5.3

> max 100 carb diet, walking, Metformin.

>

> ALA/EPO, Coq10, B12, ALC, Vit C

> Cal/mag, low dose Biotin, full spectrum E,

> Chromium P, Policosanol, fish oil cap,

> fresh flax seed, multi vitamin,

> Lovastatin 20 mg, Enalapril 10 mg

>

> 1/05:146 lbs (highest weight 309),

> 5' tall /age 67,

> cappie@w...

[Guest guest]

If you can handle it, swimming is the easiest on your bod. You just have to not

push it

on your knees so much. It takes awhile to get used to something like that. I

have coped

out on the swimming since I had to get up so early and I still have a horrible

time with

sleep. I also use the Gazelle when I am willing. Right now I am not willing and

trying

to talk myself into it. You can goggle I guess and find that on the web.

Lou

Dennis Cook wrote:

>

> hello all I just joined. Hopefully we can help each other.

> My problem is exercise I have osteo arthritis in both knees so normal exercise

is out. This one of the reason my readings are always high. Also is it normal

for us to tire easily. I get very sleepy especially after eating. I'm 54 and I

weigh 280#.

> Any help or advice would be appreciated.TY

>

> Just Tappin' the key's .....Dennis

>

> http://www.picturetrail.com/blueliquidstar

>

[Guest guest]

I too have sleeping problems. All part of the program I guess.

I'm going to call the Y there only a few miles from here. I'll see what they

have.

I'm on Insulin once a day. (Lantus). Dr. is thinking about putting me on 3 times

a day.(a different type of insulin)

Just Tappin' the key's .....Dennis

[Guest guest]

Doesn't the pedaling bother your knees. Could you give me more info on this

device. TY

Just Tappin' the key's .....Dennis

[Guest guest]

Dennis: in addition to spinal problems I also have arthritis & I have

tried those small pedal machines. I cannot use it for either my legs or

my arms as it bothers my knees & shoulders. YMMV

cappie

Greater Boston Area

T-2 10/02 9/04 A1c: 5.3

max 100 carb diet, walking, Metformin.

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Chromium P, Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

1/05:146 lbs (highest weight 309),

5' tall /age 67,

cappie@...

[Guest guest]

Where would you purchase this device ty...........

Just Tappin' the key's .....Dennis

http://www.picturetrail.com/blueliquidstar

Re: Re: Target BG levels

Dennis Cook wrote:

Doesn't the pedaling bother your knees. Could you give me more info on this

device. TY

Just Tappin' the key's .....Dennis

If I keep the pedaler at a decent tension, it doesn't bother my knees. The

trick is to get at the right seating position, also. I try to get as close

to recumbent bike position as possible, because that is easier on the knees.

As I said in another post, I use a Craftsman camping chair, and that works

best for me. I am very short, though, at 5'3 " . You may have to play around

to find a chair/pedal combination that works for you.

[Guest guest]

Sounds like a bunch of statistical chinese to me. I almost never have

a pp level of 150--most times it is 110 or below. I also almost always

have a fbg or pre prand bg in the 80's or low 90's. Yet my A1c is 5.3

which is 111 by my lab standards.

cappie

Greater Boston Area

T-2 10/02 9/04 A1c: 5.3

max 100 carb diet, walking, Metformin.

ALA/EPO, Coq10, B12, ALC, Vit C

Cal/mag, low dose Biotin, full spectrum E,

Chromium P, Policosanol, fish oil cap,

fresh flax seed, multi vitamin,

Lovastatin 20 mg, Enalapril 10 mg

1/05:146 lbs (highest weight 309),

5' tall /age 67,

cappie@...

[Guest guest]

In a message dated 1/19/2005 6:56:44 PM Eastern Standard Time,

jwilkins@... writes:

> Since going on insulin in June of 2004, my neuropathy of both legs has

> disappeared.

>

Great news, .

My labs work on the basis that an average BG range of 90 to 120 corresponds

to an A1c range of 5.0 to 6.0. Using this data, to achieve an A1c of 5.0 you

would have to EAT NOTHING if your FBG was 90.

These numbers illustrate the importance of FBG, and provide a good reason to

use a slow acting insulin like Ultralente. or Lantus to lower FBG. It's

working for me and also seems to be working for you.

[Guest guest]

Great math . My A1c on 1-10-2005 was 5.4%. During the 3 month period

before,

my BG's have been as high as 189, an on average I have 1 reading of over 120

everyday.

I eat 3 meals a day and correct for any reading over 120 mg/dl 2 hours after

eating.

I also test before bed and correct for any reading over 110 mg/dl. I think

5.4% is pretty good

for me, since for 22 years I had been chasing 8% on drugs. My answer was

insulin and I wish I had been

on it from the beginning. Since going on insulin in June of 2004, my

neuropathy of both legs

has disappeared.

S Wilkinson

Rome, NY

[Guest guest]

Cappie, I had been thinking that your A1c's should be in the 4's, with

the excellent numbers that you report. Sue

On Wednesday, January 19, 2005, at 12:51 PM, cappie@... wrote:

>

> Sounds like a bunch of statistical chinese to me. I almost never have

> a pp level of 150--most times it is 110 or below. I also almost always

> have a fbg or pre prand bg in the 80's or low 90's. Yet my A1c is 5.3

> which is 111 by my lab standards.