I was diagnosed with type 1 diabetes a week ago. Over the last few days, my sugar levels became a lot more normal. The first week, I usually had readings under 10 mmol/L [180 mg/dl] during the day (between 6 mmol/L [108 mg/dl] and 10 mmol/L [180 mg/dl]), but they went up during the night to approximately 14 mmol/L [252 mg/dl]. The readings at night gradually improved and after exactly a week, my readings were between 4 mmol/L [72 mg/dl] and 6 mmol/L [108 mg/dl] the entire day. The day after this, my blood sugars were slightly higher, mainly because I ate more at lunch. I didn’t increase my insulin shot as I was advised not to do so yet. After lunch, up until I went to bed, the readings were between 8 mmol/L [144 mg/dl] and 9 mmol/L [162 mg/dl]. I constantly read the levels for “normal” people are between 3.5 mmol/L [63 mg/dl] and 6.5 mmol/L [117 mg/dl]. Is this the range for people with diabetes, too?

Target blood sugar values should be a point of discussion between you and your physician. The normal blood sugars that are quoted are ideal. However, a person with newly diagnosed type 1 diabetes does not have an ideal situation. You are learning how to care for yourself in a variety of situations. You need to have a target range that is appropriate for your situation. That can only be determined by you and your healthcare team. Let’s say you are not good at counting carbohydrates and have a history of giving more insulin than is necessary. If you are at risk for hypoglycemia, you may not want to use the ideal range. Rather, set slightly higher goals with the idea that the lower values can be used once your skills are up to speed. It should also be noted that in clinical trials where normal glucose levels are the goal, the rate of clinical hypoglycemia is much higher. Hypoglycemia is the great limiting factor in diabetes care. Therefore, goals need to be set with consideration of your risk of hypoglycemia versus the benefit of good glucose control. Worrying about absolutely normal blood sugar control with newly diagnosed diabetes is the right mind set, but it may not be altogether practical. That is why the hemoglobin A1c is so helpful. It allows you to know how close you are coming to goal. An additional point to consider is that shortly after diagnosis, and with resumption of good blood sugars, your body has a tendency to start making glucose again. This is sometimes referred to as the honeymoon period. During this time, you have to significantly pull back insulin dosing to avoid hypoglycemia. This should also be a discussion point with your physician.

JTL