What Does "Tight Control" of Diabetes Mean?

Tight control means keeping blood glucose levels as close to normal as possible. This will delay the beginning of diabetes complications, such as eye, kidney, heart and nerve damage. If a person with diabetes already has these complications, tight control slows how quickly these conditions worsen. We know this good news from The Diabetes Control and Complications Trial (DCCT), a large study conducted from 1983 to 1993 by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health.

The goal for tight blood glucose control is keeping your levels as close to normal as possible. "Normal" levels are:

Before Meals: 90-130 mg/dl
Two hours after meals: less than 180 mg/dl

It is always best to check with your health care professional to establish your personal goals.

How Do I Know If My Blood Glucose Levels Are Within My Target Range?

The only way to know if your blood glucose levels are within your target range is to monitor your levels frequently — at least as often as your doctor recommends.

How Do I Reach My Target Levels?

When you discover higher or lower blood glucose levels on self-monitoring, use the following guide to help determine the cause and solution.

If Your Blood Glucose Levels Show a Pattern of Being Too Low, Check the Following:

Did I delay or skip a meal?
Did I eat fewer carbohydrates than usual at the meal or snack just before my low blood glucose readings?
Does my insulin and/or diabetes medication need to be adjusted?
Did I take the correct dose of insulin and/or medication?
Did I participate in more physical activity than usual?

If Your Blood Glucose Levels Show a Pattern of Being Too High, Check the Following:

Did I eat more carbohydrates than usual at the meal or snack just before my high blood glucose reading?
Does my diabetes medication need to be adjusted? Did I take the correct dose?
Did I participate in less physical activity than usual?
Was I ill or under stress?

Work with your health care team to choose the best plan to help you regain control. This might include the following actions:

Change the amount or timing of the carbohydrates you eat
Change the dose or timing of your insulin or oral diabetes medication (if you take them)
Change the amount of physical activity you participate in or change the time of day you exercise

Remember that frequent self-monitoring of your blood glucose level is key to finding the best solution.

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