Your blood sugar goal can vary depending on whether you have diabetes, the type of diabetes you have, and whether you are pregnant.
Monitoring one’s blood sugar levels is an essential component in the management of diabetes. Along with the potential for diabetes-related issues in the future, monitoring one’s glucose levels on a regular basis is an essential element of living with this condition in one’s day-to-day life. This monitoring can be done with a fingerstick meter or a continuous glucose monitor (CGM).
But what exactly does it mean to have “normal” amounts of sugar in the blood when talking about blood sugar?
Because diabetes affects people in unique ways, the ideal blood glucose levels will be different for each diabetic patient and will rely on a wide range of personal and medical factors. In spite of the fact that this is a topic that should be discussed with your diabetes care team, the medical profession as a whole has established guidelines about the levels of blood glucose that specific individuals should attempt to achieve.
What should your glucose levels be?
There is no single number that will perfectly describe your blood sugar levels. However, the goal of the majority of diabetics is to maintain a blood glucose level that is lower than 140 mg/dL on average.
At a high level, glucose levels and the goals that persons with diabetes should aim toward are explained by a number of authorities, including the Centers for Disease Control and Prevention (CDC)Trusted Source and the World Health Organization (WHO)Trusted Source. These two organizations are examples of authorities. The American Diabetes Association (ADA) published the 2022 standards, which are a collection of guidelines that are followed by a significant number of professionals working in the field of diabetes. This graphic provides a breakdown of the goals for various subgroups of diabetic patients.
| Before meals (fasting) | After meals (post-prandial) | Other | |
|---|---|---|---|
| Adults with type 1 diabetes (see guidance) | 80–130 mg/dL | < 180 mg/dL (1 or 2 hours after) | |
| Adults with type 2 diabetes (see guidance) | 80–130mg/dL | < 180 mg/dL and (1 or 2 hours after) | |
| Children with type 1 diabetes (see guidance) | 90-130 mg/dL | 90–150 mg/dL at bedtime/overnight | |
| Pregnant people (T1D, gestational diabetes) (see guidance) | < 95 mg/dL | 140 mg/dL (1 hour after) | 120 mg/dL (2 hours after) |
| 65 or older (see guidance) | 80–180 mg/dL | 80–200 mg/dL for those in poorer health, assisted living, end of life | |
| Without diabetes | 99 mg/dL or below | 140 mg/dL or below |
Importantly, the American Diabetes Association (ADA) revised its recommendations for glucose levels in 2015 to reflect a shift in thinking about the dangers of overtreating and hypoglycemia. The goal of 70 mg/dL was the minimum acceptable level. In spite of this, a study that was conducted at the timeReliable Source discovered that adults, children, and older people would be more likely to receive an excessive amount of treatment, particularly if they take changing amounts of insulin or drugs that lower glucose levels.
As is the case with the care of diabetes in its entirety, the medical community utilizes these guidelines as a point of departure. The specific needs of each person gives rise to a unique set of goals for that person. Be sure to discuss your options with both your primary care physician and the rest of your diabetes care team before making any decisions.
Why do blood sugars matter in diabetes?
Monitoring the levels of glucose or sugar in the blood is an essential component of diabetes management.
When a person has type 1 diabetes, their pancreas is unable to create the necessary amount of insulin for them. When a person has diabetes of type 2 (T2D), their bodies may no longer produce or utilise insulin correctly.
The objective in managing either type 1 or type 2 diabetes is to keep blood glucose levels as stable as possible. Depending on the kind of diabetes and the individual’s requirements, insulin or diabetes drugs may at times be required. The levels of glucose in the blood are affected by a variety of factors, including meals, physical activity, insulin, drugs, stress, and so on.
Targets for glucose levels can be different for each person because everyone has different requirements.
What is a normal blood sugar level?
It is not entirely accurate to say that one has achieved a “normal” blood sugar or glucose level. When discussing someone’s blood sugar levels, it is common to use the phrase “normal” to allude to what those levels might be for someone who did not have diabetes.
This language, however, is inaccurate because even people who do not have diabetes can experience rises in their blood sugar, particularly after eating and after consuming food with a high sugar content or a complex carbohydrate like pizza or pasta. This is especially true after eating.
Even though that individual’s body will immediately begin working to counterbalance that growing glucose level by creating more insulin, that person’s blood sugars may still climb for a brief time even above those “normal” ranges. This might happen even though the body will immediately begin working to offset that rising glucose level. The same thing can take place during strenuous activity or when a person is placed in a stressful setting if their natural glucose metabolizing processes are unable to swiftly restore equilibrium.
Because our bodies don’t produce or use insulin properly, those of us who have diabetes have to manually monitor our blood sugar levels and ensure that we take the appropriate amount of insulin or other medications that reduce glucose levels in order to maintain a healthy equilibrium.
Language matters in diabetes
Words make a difference when you’re talking about diabetes. That’s especially true in the context of blood sugar levels and how someone manages their health.
Here are some suggestions on language choices when talking with someone about their blood sugars and glucose levels.
- Try to avoid using terms like “good” or “bad” for higher or lower blood sugars.
- Instead, try to not tie value judgments to these numbers. Think about them as just numbers, “in range” or not, and pieces of data to help make a decision in diabetes care. Sometimes glucose numbers are too low or too high, and it’s helpful for the person with diabetes to understand why those glucose fluctuations are happening.
- Try to avoid judgment and blame with phrases like “What did you do?” when asking about higher or lower blood sugars.
- Instead, use phrases: “Tell me about…” or “Do you know why that happened?”
- Try to avoid asking a child or adult about their blood sugars as soon as you see them. This can make it seem like diabetes defines them and all you see is their numbers.
- Instead, try talking with them about their day and any highlights before moving into the diabetes discussion.
Often, children and adults with diabetes can feel disappointed, frustrated, and angry about their blood sugars and diabetes management overall. This can lead to feelings of shame and guilt, if they can’t achieve what they view as “perfect” results. As a result, that can lead to diabetes burnout for the child or adult and cause them to lose interest in managing their diabetes as needed.
Is A1C supposed to be the same as my blood sugar average?
A1C measures your average blood sugar over the past 3 months.
You can have your A1C measured with a blood draw in your doctor’s office or lab. Some doctors can also perform a fingerstick blood test to check your A1C level.
When sugar enters your bloodstream, it binds to a protein called hemoglobin. People with high blood sugar have a higher percentage of the hemoglobin protein coated with sugar. Your A1C result will give you an indication of what percentage of your hemoglobin is bound to sugar.
- Standard (no diabetes): Less than 5.7%
- Prediabetes: 5.7% to 6.5%
- Diabetes: 6.5% or higher
In general, the ADA and other clinical guidelines for people with diabetes is that you should work closely with your diabetes care team to determine what’s best for your A1C goal. Generally, clinicians advise for an A1C of being safely 7.0%, though that can vary depending on one’s individual care plan.
It’s important to keep in mind that A1C levels do not reflect all of the nuances of one’s diabetes management, meaning it doesn’t always reflect your glucose variability, meaning that A1C doesn’t offer insight into high or low blood sugars, and it can be manipulated if your blood sugars fluctuate regularly.
The A1C is not the same as your blood sugar average, which might be displayed on a fingerstick meter or your continuous glucose monitor (CGM). That’s because the A1C is limited in its scope and does not reflect your high and low blood sugars, nor does it reflect any glucose variability if you have dramatic spikes or drops in glucose levels.
As a result, many diabetes professionals have moved away from considering the A1C the sole “gold standard” for someone’s diabetes management. Instead, they use that A1C in addition to time in range (TIR) figures, showing how often your glucose levels are in your individualized target range.
Bottom line
The regulation of glucose levels is an essential component of diabetes care. There is no one specific value that can be used to define “normal” glucose or blood sugar levels. There are clinical standards that provide objective targets for blood sugar levels and A1C tests; however, it is imperative to keep in mind that “Your Diabetes May Vary.”
You should discuss your individualized care plan with your endocrinologist and diabetes care team in order to define your glucose goals in the most effective manner possible. In order to achieve ideal glucose levels and spend a good amount of time within range, you and your doctor may want to discuss the possibility of using a more advanced diabetic device such as a CGM.