Blood glucose goals
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Blood Glucose Goals in Diabetes Management
Optimal Fasting Blood Glucose Targets
Fasting Blood Glucose (FBG) and HbA1c Goals
Research indicates that achieving specific fasting blood glucose (FBG) targets is crucial for managing type 2 diabetes (T2D) effectively. A study involving Chinese individuals with T2D using insulin glargine found that an optimal FBG target of 3.9-6.1 mmol/L significantly increased the likelihood of achieving an HbA1c level of less than 7% without increasing the risk of hypoglycemia 12. This target range was associated with better glycemic control and fewer hypoglycemic events compared to higher FBG levels 12.
Empirical Blood Glucose Targets
The A1c-Derived Average Glucose (ADAG) study provided empirical data to establish average blood glucose levels needed to achieve specific HbA1c targets. For instance, to achieve an HbA1c level of 6.5-6.99%, the average fasting blood glucose should be around 142 mg/dL, while postmeal and bedtime blood glucose levels should be approximately 164 mg/dL and 153 mg/dL, respectively . These findings help set realistic day-to-day self-monitored blood glucose (SMBG) targets for patients aiming to meet individualized HbA1c goals .
Blood Glucose Goals in Intensive Care
Perioperative Blood Glucose Management
In the perioperative setting, managing blood glucose levels in patients with diabetes is critical. Studies suggest that a therapeutic range of 7.8-10 mmol/L (140-180 mg/dL) is optimal for hospitalized patients with diabetes, balancing the need to avoid hypoglycemia while preventing hyperglycemia-related complications . Continuous intravenous insulin administration under high-quality monitoring conditions is recommended to achieve these targets .
Comprehensive Diabetes Management
ABC Goals: Glucose, Blood Pressure, and Cholesterol
The Brazilian National Health Survey highlighted the importance of achieving comprehensive diabetes management goals, including glucose, blood pressure, and cholesterol (ABC goals). The study found that only about half of the individuals with known diabetes achieved each of these goals, and a mere 12.5% met all three targets . This underscores the need for personalized treatment strategies and better adherence to treatment protocols to improve overall diabetes care .
Goal-Setting Interventions
Goal-setting interventions have been shown to significantly reduce HbA1c levels in diabetes management programs. A systematic review and meta-analysis revealed that interventions incorporating goal-setting as a primary strategy led to notable improvements in HbA1c, although more research is needed to explore the effectiveness of various behavior change techniques (BCTs) within these interventions .
Conclusion
Achieving optimal blood glucose levels is a multifaceted challenge in diabetes management. Research supports specific FBG targets to improve HbA1c outcomes, particularly in T2D patients using insulin. In intensive care settings, maintaining blood glucose within a defined range is crucial to avoid complications. Comprehensive management, including goal-setting interventions and adherence to ABC goals, is essential for effective diabetes care. These insights provide a foundation for setting realistic and individualized blood glucose targets to enhance patient outcomes.
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