While some might say the answer to this question is cut and dry (after all, the American Diabetes Association does have specific recommendations on glucose throughout the day), I believe there is a lot of nuance to it.
Sure, it’s a lot easier for me to say “your blood sugar level should be XYZ after eating a meal,” but that doesn’t leave room for the reality of actually living with and managing diabetes. So come on down the rabbit hole with me as we venture into the nuance of diabetes… Come on in, the water’s fine, I promise!
What are your goals for diabetes care?
First and foremost, what are your goals with your diabetes management? For many of my clients, the goal is to live a long, rich and fulfilling life with diabetes. If that is the case for you, it’s crucial that in addition to looking at your glucose numbers, we’re also looking at the quality of your life. That includes not only your physical health but also your mental, relational, emotional and spiritual health.
Why do we care about blood sugar levels?
The reason we care about diabetes is to prevent complications (heart disease, vision loss, kidneys, nerve damage, etc.). Preventing these complications can absolutely be done by keeping an eye on blood sugar levels over time.
There are a few different ways we can look at this, and each of these gives us a different angle for helping us understand what is going on in the body. It’s like if you were to go visit the Eiffel Tower - looking at it up close is going to be a lot different than seeing it on the skyline from a building window or balcony a few miles away.
View No. 1: A1c
Ah, the infamous A1c – the snapshot of your average glucose over the past few months. It's like peeking into a crystal ball, but remember, it's not the whole story. Check out my previous post on A1c for more insights about this!
Looking at an estimated average glucose (eAG) from your most recent A1c lab value can help you get a sense of what your glucose is day-to-day. Here’s an example:
If your most recent A1c was 8.5%, that means your estimated average glucose level is 197.
So if we say your goal right now is for blood sugar levels to be 80-130 upon waking up, that might be a little too strict, considering your most recent average was much higher than that.
I want you to be successful as you set goals for yourself, so setting a goal of 140 at first might be a little more reasonable.
The American Diabetes Association recommends setting A1c goals at <7% to reduce risk of complications. The American Association for Clinical Endocrinology recommends <6.5%.
View No. 2: Continuous Glucose Monitor (CGM)
To CGM or not to CGM, that is the question. While these gadgets can be game-changers for some, they're not one-size-fits-all. All you peeps without diabetes, take a backseat – CGMs aren't for you. The truth here is that we don't have a good understanding of whether or not the data is actually helpful for bodies without an actual diabetes diagnosis.
But for my friends with diabetes, CGMs can be a helpful ally in managing diabetes. Just remember, don't let the numbers consume you. Use them as a guide, not gospel.
If you’re curious about using a CGM, consider giving it a 2-week trial and remind yourself you can change your mind any time. Here are some tips for you if you decide to try a CGM:
If you’re finding yourself starting to feel anxious about the numbers, try asking yourself "If I didn't know what my blood sugar was right now, what would I do in this moment?" Would you eat the food you were thinking about? If you're hungry, would you wait to eat or eat right now? Does a walk sound good, or are you forcing yourself to go for a walk because you see your blood sugar climbing? There’s no right answer here, but this can help you remember to partner with your body rather than doing things to your body.
Look out for obsession. Are you checking your glucose levels 45 times a day? If so, that is a sign you’re overdoing it. Try not to check just for the sake of checking. Ask yourself “What am I going to do with these numbers?” Check back in with your intention at the beginning of this journey.
Use time in range as a guide - see below for more about this.
If after a few days you’re feeling more overwhelmed than supported, you can consider stopping your trial. Don’t fret - that is good information too! Now you know less is more for where you are in your blood sugar information gathering journey.
View No. 3: Time in range
Since the advent of continuous glucose monitors, we now have a LOT more information about what blood sugar levels do throughout the day. These give us additional metrics to look at such as “time in range.”
“Time in range” refers to the amount of time that a person's blood glucose levels stay within a target range considered optimal for people with diabetes. This target range most often is considered between 70 and 180 milligrams per deciliter (mg/dL), although specific targets may vary depending on individual circumstances and recommendations from healthcare providers.
If someone’s blood sugar stays between 70 and 180 mg/dL more than 70% of the time, they are following the recommendations by the ADA and AACE. But hey, let's keep it real – nobody's perfect, and that's perfectly okay! Striving for 100% perfection only leads to stress and frustration. Let's focus on progress, not perfection.
View No. 4: Glucose Meter
Another way to monitor glucose levels is a glucose meter (AKA glucometer). These use a drop of blood, usually from your fingertip, to tell you what your glucose levels are at that exact moment. Glucose levels vary throughout the day, so the most common times are to check are before and after meals.
For reference, here is what is recommended in the ADA Standards of Care 2024 (the annual definitive guidelines for diabetes treatment):
Before meals | 80–130 mg/dL (4.4–7.2 mmol/L) |
Peak after meals (usually 2 hours after) | <180 mg/dL (<10.0 mmol/L) |
Again, make sure you are setting reasonable expectations for yourself! If your glucose levels aren’t where you’d hope, talk with your doctor or diabetes treatment team for reasonable goals and strategies for improvement.
I hope this gives you a starting point for understanding your individual goals for your blood sugar levels. If you’re tired of trying to DIY your diabetes care, check out my 6-week group, Navigating Type 2 Diabetes Without Diet Culture or apply for 1-on-1 Diabetes Foundations Coaching!