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Settings Goals & Keeping Your Body Healthy

Deciding what hemoglobin A1C (A1C) and blood sugar goals are right for you depends on many factors. Talk to your doctor to decide what goals will work best for you.

Blood Sugar Ranges & Diabetes

Diabetes occurs when the body can no longer control the sugar levels in the blood. As a result, blood sugar levels in people with diabetes are higher than normal. This is called hyperglycemia, or high blood sugar. It can lead to problems like blindness, kidney failure, amputation, and heart problems.

Low blood sugar (below 70) can sometimes happen, especially with insulin and some diabetes pills.

What blood sugar goal is right for me?

Because people with diabetes are different in their risk for low blood sugar, are in different stages of the disease, and have different complications, blood sugar and A1C goals should be matched to each person. The chart below shows you what blood sugar ranges are recommended based on individual factors. You and your doctor should decide together what the best goal would be for you.

Recommended Blood Sugar Goals for People with Diabetes Based on Individual Factors
About You If You:

  • Are newly diagnosed
  • Are under 65 years old
  • Are less likely to have low blood sugar
  • Have no or minor complications
If You:

  • Are over 65 years old
  • Have kidney failure, heart disease, or other serious complications
  • Have been diagnosed with other serious health problems
  • Have frequent low blood sugar
Goal Before Breakfast 80 – 130iv 100 – 180v
Goal After a Meal Under 180vi Under 250
Goal at Bedtime Under 180 Under 250
Some patients may want to get even closer to the normal range of 70-99 before a meal and below 140 after a meal. You and your doctor should talk about what the right goal is for you based on your individual factors. If you are prone to low blood sugar or are dealing with a major illness, having a goal that is a bit higher can be better for you.

How can I monitor my blood sugar & keep my body healthy?

Home glucose meters show what your blood sugar level is at that moment. Measuring your blood sugar level at the same times each day can show you if there is a pattern when your blood sugars are out of range. It will also tell you how food, exercise, and medication affect your blood sugar levels. For instance, some people have higher blood sugars when they wake up in the morning and some have higher levels after certain meals.

A1c blood tests show what your average blood sugar levels have been over the last three months. It is a simple blood test that is done at the doctor’s office or at the lab every 3 to 6 months.

The normal A1c range is 4.5 to 5.6%.viii The A1c level goes up or down as the average blood sugar level goes up or down, but the A1c test cannot tell how much your blood sugars are fluctuating throughout the day.

The overall goal of treating diabetes is to prevent damage to the body and to keep people with diabetes healthy and feeling good. Wide swings in blood sugar levels can make you feel bad and may cause more harm to the body.

What A1c goal is right for me?

Please print this page and circle the answers to the following questions to help you and your doctor talk about what the right blood sugar and A1C goals are for you. It can be helpful to aim for a range instead of a fixed goal.

How long have you had diabetes?
Do you ever have low blood sugars? Almost never Sometimes Often a problem
Can you tell when your blood sugar is low? Yes Sometimes No
Have you had any vision changes? No Some Yes, I have problems with my vision
Do you have neuropathy or nerve pain? No Some Yes, I can’t feel my feet and/or my fingers
Have you had a heart attack, stroke or bypass surgery? No Yes
Have you had a heart stent or angioplasty? No Yes
Do you have kidney or liver problems? No Unsure Yes
Do you have good support at home? Yes Some help No
Do you have other major health problems? No Yes
How much do you know about diabetes? I have a good understanding I want to learn I don’t understand diabetes
How much time and effort can you devote to managing your diabetes? Whatever it takes Some I don’t have much time in my schedule for this
Are you concerned about your blood sugar while at work? No Sometimes Yes
Are you able/willing to test your blood sugar? As many times as needed More than two times Once or twice
Suggested A1c Goal 8.0%6.5%

It is important that you discuss this with your doctor as your answers may fall across a spectrum.

What is hypoglycemia & why should I avoid it?

Hypoglycemia happens when your blood sugar falls below 70. Because some people are more likely to have problems with low blood sugar, they may need to set their goal a bit higher to prevent their blood sugar from falling too low.

Just as having blood sugar levels that are high can cause problems, having blood sugar levels that are too low can also cause problems.

Hypoglycemia is more likely with certain diabetes medications, including insulin.

The overall goal of treating diabetes is to prevent damage to the body and to keep people with diabetes healthy and feeling good. Wide swings in blood sugar levels can make you feel bad and may cause more harm to the body.

Medications That May Cause Hypoglycemia
Glyburide (Micronase) Glimiperide (Amaryl)
Repaglinide (Prandin) Nateglinide (Starlix)
Any type of Insulin Glipizide (Glucotrol)

Exercise, skipping meals, and big changes in what you eat at meals can also cause low blood sugar. If blood sugar falls too low, it can damage your body, just as high blood sugar can. It is best to try to avoid low blood sugar as much as possible.

Signs and Symptoms of Hypoglycemiaix
Mild: Below 70
  • Hunger
  • Nervousness and shakiness
  • Sweating
Moderate: Below 55
  • Dizziness
  • Sleepiness
  • Confusion
  • Difficulty speaking
  • Feeling anxious or weak
Severe: Below 35-40
  • Seizure of convulsion
  • Loss of consciousness or coma

Conditions That May Lead to Problems with Low Blood Sugar
Older age Kidney problems
Cirrhosis of liver Dementia (Alzheimer’s)
Inability to feel when blood sugar is low

Factors that may make low blood sugar more dangerous

  • Having a heart condition
  • Living alone with no one to assist you if you have a low blood sugar attack
  • Using heavy equipment, mining, law enforcement, working with chemicals, or working in isolated situations can make having a low blood sugar attack more dangerous.

Health Tip: If you get hypoglycemia, drink some juice or eat something that contains sugar, like hard candies. You can also take glucose tablets to bring your blood sugar into normal range.

  • i Standards of Medical Care in Diabetes—2013. American Diabetes Association. Diabetes Care. 2013; 36:1: S11-S66.
  • ii Ibid.
  • iii Ibid.
  • iv The recommended blood sugar goal of 80-130 is based on a consensus recommendation intended to help patients avoid low blood sugar reactions (hypoglycemia) in patients on insulin.
  • v The recommended fasting blood sugar goal of 100-180 is based on a consensus recommendation for patients aiming to meet an A1C goal of 8%
  • vi Standards of Medical Care in Diabetes—2013. American Diabetes Association. Diabetes Care. 2013; 36:1: S11-S66.
  • vii Nathan, DM et al. Translating the A1C Assay Into Estimated Average Glucose Values. Diabetes Care. 2008;31:8: 1473-1478.
  • viii Standards of Medical Care in Diabetes—2013. American Diabetes Association. Diabetes Care. 2013; 36:1: S11-S66.
  • ix Molitch, M. and Umpierrez, G. Adapted from Hormone Health Network Fact sheet, Tyoe 2 Diabetes & A1C”. March 2010.