I have type�2 diabetes, and my last A1c was 7.2%, although it usually is slightly below 7%. Are there are guidelines on what my blood glucose test readings should be before meals and before bedtime?

The goals for appropriate blood sugar levels both fasting and after meals do need to be individualized, and should consider both patient safety and practicality. The American Diabetes Association lists goals as follows:

fasting and pre-meal: 80-120 mg/dl [4.4-6.7 mmol/L]
bedtime: 100-140 mg/dl [5.6-7.8 mmol/L]
hemoglobin A1c level: less than 7% or less than 1% above the upper limit for the lab doing the test.

Blood sugar control after a meal (postprandial) is also important. The American Association of Clinical Endocrinologists (AACE) recommends a two-hour postprandial goal of less than 140 mg/dl [7.8 mmol/L]. Many physicians use a post meal target range of 140-160 mg/dl [7.8-8.9 mmol/L].

Discuss these goals with members of your healthcare team and ask their assistance in personalizing your diabetes management plan. The bottom line is that aggressive control does reduce the risk of long-term complications and, if possible, should be the therapeutic goal for all persons with diabetes.

DMW