Blood glucose targets

It is important to know your blood glucose targets. 

Different people have slightly different blood glucose targets. In addition, people might have different targets at different times of the day. The following targets come from national guidelines. 

Time of day	National Target
Breakfast	between 5 – 7 mmol/L
Before other mealtimes	between 4* – 7 mmol/L
Bedtime	between 4* – 7 mmol/L

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Personal Targets 

If you have had a lot of low glucose levels (hypos) and you don’t get many warning symptoms of these, you might be asked to aim for a higher level for a while until your awareness of low glucose improves. Ideally, you should be able to tell when your blood glucose has dropped below 4.0 mmol/L. 

If you have had a high average glucose (HbA1c) result for a while, you might also be given slightly higher interim targets, until you are ready to work towards the national targets. If your body has been used to a higher blood glucose level, you might get symptoms of a low glucose level (hypoglycaemia) at a much higher level (sometimes as high as 9.0 mmol/L). This will normalise over time. 

During and when planning pregnancy, you will be asked to aim for even lower targets. 

What is HbA1c? 

HbA1c is the main blood test used for monitoring long-term blood glucose levels. It will be measured by a standard blood test every time you attend the diabetes clinic.  The glucose in your blood sticks to haemoglobin (a protein in your red blood cells that carries oxygen throughout the body), making a substance called ‘glycated haemoglobin’ known as haemoglobin A1c or HbA1c for short. 

You and your diabetes team will discuss and agree on a personal HbA1c target. Generally, lower is better, as it reduces the chance of you developing complications from your diabetes.

The national guidance suggests ideally aiming for an HbA1c target of 48 mmol/mol (6.5%) is ideal. People with HbA1c lower than 58 mmol/mol (7.5%) are in a lower risk group for developing long term complications.

It is very hard to have perfect blood glucose levels all the time. Occasional highs and lows are fine, as long as you understand how to get them back to normal. You should aim to completely avoid severe hypos or diabetic ketoacidosis (see later).

Which is more important, the finger-prick test or the HbA1c measurement?

Both measurements are different and should be used together to get a more accurate picture of your blood glucose control; you may for example have very erratic (up and down) blood glucose levels on a day to day basis that average out at a good HbA1c level. A low HbA1C without too many high and low on a day to day basis is ideal.

The image below shows how HbA1C relates to average finger-prick blood glucose tests and the risk of developing complications:

What do you think of these blood glucose targets? Do you manage to stay on target? Let us know in the comment section below.