What is a good blood sugar target for someone with diabetes?

Where should your blood sugar numbers be? Like everything else in diabetes, there is not a 100% agreement on that issue amongst experts in the field. Most of the experts agree that under 115 mg/dl is where your blood sugar ought to be in the morning when you wake up: your fasting glucose. Some clinicians want it closer to 100. Depending on your meds, we really don’t want you too much below 90. After you’ve had something to eat we look toward the period of time two hours after you chow down. If you only test before you eat you are missing out on the important part of the game: how your meds help you to deal with sugar. The whole point of testing before the meal is to have a baseline for how much you go up after eating, which is what’s really important.

By the same token, if you only checked after meals it would be worthless. If you are 225 two hours after eating, should we be horrified? Well, yeah, if you started out at 118. But if you started out at 205, the meal itself went pretty well, but there is a baseline medication problem that needs to be addressed.

It is this after-meal number that is most hotly contested by various diabetes experts, with opinions ranging from 140 on the low side to 200 on the high side. I tell our patients to shoot for 150 but not to worry if some meals clock in at 180. I think if you are routinely above 180 two hours after a meal, you need to look at changing what you eat, or what medications you take, or both.