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How can one assess blood glucose level?

Q: I have heard conflicting statements about normal blood sugar levels. What is considered to be the normal blood sugar level by most doctors? Also, is there a time test I can do to determine if the levels reach a normal level after eating?

A:The best way of assessing glucose control is HbA1c (glycosylated haemoglobin) test that measures the average blood glucose level during the past two to three months. The test is done by giving a small sample of blood from a vein or fingertip in a clinician’s office. The goal of HbA1c for most people with type 2 diabetes is 7.0 per cent or less, which corresponds to average blood glucose of 150 mg/dL. Your doctor can determine the optimal HbA1c goal for an individual person. HbA1c should be less than 7.0 perc ent and the preprandial (fasting) capillary plasma glucose should be in between 70–130 mg/dL (3.9–7.2 mmol/l). The peak postprandial capillary plasma glucose measurements should be made 1–2 hours after the beginning of the meal, generally peak levels in patients with diabetes. HbA1c is the primary target for glycaemic control, the goals should be individualised based on the duration of diabetes, pregnancy status, age, comorbid conditions, hypoglycaemia unawareness and individual patient considerations. More stringent glycaemic goals (i.e., a normal HbA1c, <6%) may further reduce complications at the cost of increased risk of hypoglycaemia. Postprandial glucose may be targeted if HbA1c goals are not met despite reaching fasting glucose goal. This is based on American Diabetes Association guidelines, which we tend to follow in our country. These are broad guidelines and target should be decided by treating physicians.

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