IOH Diabetes - What are normal and target blood glucose ranges?

Normoglycemia (Normal Blood Glucose) print normal & target ranges
Article by Lahle Wolfe, Islets of Hope, 03/08/2006

The American Diabetes Association sets certain guidelines for normal and abnormal blood glucose levels (appearing at the bottom of this article). However, as a person with diabetes, your doctor may set different ranges for you. Young children may have slightly higher target ranges than stable adults. And those starting out on insulin pump therapy or are newly diagnosed with diabetes may initially have higher target ranges to help avoid hypoglycemia during the initial phase of insulin pumping.

The following chart takes into consideration some of the possibilities that may alter target ranges. The ranges given are intended for general purposes only and not as a diagnostic tool, or, for you to change your own diabetes care plan. It is important that you know and understand the target ranges that your doctor sets specifically for managing your own diabetes.

Time of Day	Non- Diabetic	Diabetic Your doctor may set different ranges for you. USE THE TARGET RANGES YOUR OWN DOCTOR SETS FOR YOU!	Notes for Diabetics Only Your doctor will give you instructions tailored to your own medical needs. BE SURE TO FOLLOW YOUR OWN DOCTOR's PLAN DESIGNED FOR YOU!
Morning (Fasting)	70-99	90-130 (adults) 90-140 (children)	Morning highs may be from the Dawn Effect or the Simogyi Effect.
Before Meals	N/A	Typically: 90-130 adults & older children 100-140 children	"Before meals" means 2-4 hours after last meal was eaten. For those on rapid insulin only (pumps), generally by 2 hours you should be in, or close to, target range. Those on shot therapy may not be in range until about 4 hours after their last meal.
2-4 Hours After Meals	70-139	Less than 180 but high enough that hypoglycemia won't result from any "onboard" insulin if testing at only 1-2 hours.	Pumpers typically come into target range faster than those on shot therapy (assuming both have given the correct amount of insulin). Ask your doctor when you should test (2 or 4 hours after a meal)
Before Bedtime	N/A	Adults, usually 140-160 Children may have a higher pre-bedtime ranges than adults, up to 180	Have a pre-bedtime snack to help avoid nighttime lows. Note: high-fat snacks late in the evening can cause hyperglycemia (high BG) during the night.
Hypoglycemic⁽¹⁾ (low blood glucose)	70 or lower	70 or lower Newly diagnosed, and young children often have higher BG target for hypoglycemia (80-100); infants even higher.	Treat hypoglycemia anytime BG is 70 or lower. Newly diagnosed may be instructed to treat at 100. Stable, but young children may be advised to treat at 80-90. Bear in mind that 100 is fine 4 hours after eating but 100 would be too low only 1 hour after insulin. Be sure to ask your doctor WHEN (how long after insulin) to treat for hypoglycemia and not just by the BG reading alone.
Hyperglycemic (high blood glucose)	200 or higher may indicate diabetes	Over 180, 2-4 hours after a meal (2-4 for pumpers, 4 hours for those on shot therapy) Over 140, morning fasting	Test urine for ketones when blood glucose is 240 or higher. Call doctor for care instructions when scheduled BG reading is over 240 more than twice in one day.

(1) People that are newly diagnosed or just beginning a new type of therapy (such as insulin pumping or going from conventional insulin therapy to intensive insulin therapy) may have slightly higher target ranges set for a certain period of time. This is done to help avoid dangerous episodes of hypoglycemia (low blood glucose) while medication dose or method of delivery is being adjusted. Be sure to keep in close contact with your physician whenever your diabetes care plan changes.

What are normal and target blood glucose ranges?
American Diabetes Association Guidelines

The following general guidelines for normal blood glucose ranges in nondiabetics* are from the American Diabetes Association. However, there are variations to these guidelines. For example, young children, those who are newly diagnosed, or are beginning insulin pump therapy may have slightly different target ranges.

What if you are not in a "normal" range, but not in a "diabetic" range?
American Diabetes Association Guidelines

Blood glucose levels higher than normal, but lower than diabetic ranges, classify a person as having impaired glucose tolerance. To see how a person reacts to a glucose load an oral glucose tolerance test (OGTT) may be given to check blood glucose levels 2 hours after being given 75 grams of glucose to drink.

Both IFG and impaired glucose tolerance (IGT) are associated with an increase risk in developing type 2 diabetes and lifestyle changes, including weight loss and an exercise program, as well as possible oral medications such as Glucophage are sometimes indicated.

It is important to note that while there is no cure for type 2 (or type 1) diabetes, pre-diabetes can often be completely reversed with proper medical intervention and changes in lifestyle.

Diagnosing Gestational Diabetes
American Diabetes Association Guidelines

__________________________
(1) Some physicians use a lower cutoff and may recommend that a woman undergo an OGTT
if she is 130 mg/dL (7.2 mmol/L) or higher.

Gestational Diabetes Diagnostics Guidelines
Oral Glucose Tolerance Test During Pregnancy)

__________________________
(1) If two or more tests show blood glucose higher than the normal ranges above, gestational diabetes
will be diagnosed.
(2) A 75-gram glucose load may be used but may not be as reliable as the 100-gram glucose test.
If your doctor has you take the 75-gram test, you will not have blood drawn at the 3-hour mark.

For more information about gestational diabetes, please see "Gestational Diabetes."



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