Know The Blood Sugar Level at Which Permanent Organ Damage Occurs!

Research conducted with human patients, mice, and pancreas beta cell cultures all point to a single threshold at which elevated blood sugars cause permanent damage to your body. What is that level?

140 mg/dl (7.8 mmol/L)

NOTE: All blood sugar levels discussed on these pages refer to plasma calibrated meter readings. Users of blood calibrated meters, including most people in the UK, should divide the numbers given here by 1.12 to get the blood calibrated equivalents.

The AACE Recommends Post-Meal Numbers Below 140 mg/dl

The American Association of Clinical Endocrinologists recommends that blood sugar should not be allowed to rise above 140 mg/dl two hours after a meal.

Their published recommendations stated:

. . .a large number of highly robust cross-sectional and prospective epidemiologic studies have clearly implicated a close association between postchallenge or postprandial hyperglycemia and cardiovascular risk. These studies encompass diverse populations and disparate geographic regions, from Honolulu to Chicago to Islington to Paris. A recent analysis of 25,000 patients in Diabetes Epidemiology:Collaborative Analysis of Diagnostic Criteria in Europe (DECODE)Study supports the concept of an important link between postchallenge glycemia and macrovascular risk. Furthermore, Hanefeld et al showed that moderate postprandial hyperglycemia (148 to 199 mg/dL) not only is more indicative of atherosclerosis than fasting plasma glucose levels but also may exert direct detrimental effects on endothelium. . . .

In subjects without diabetes, blood glucose levels typically peak approximately 1 hour after the start of a meal and return to preprandial levels within 2 to 3 hours; 2-hour postprandial blood glucose levels rarely exceed 140 mg/dL.

Therefore, the consensus panel recommends a treatment-targeted 2-hour postprandial blood glucose level of 140 mg/dL to facilitate tighter control of glycemia without increasing the risk of hypoglycemia.

Read the whole AACE "Outpatient Implementation Position Statement"

In 2007, The International Diabetes Federation Adopted the 140 mg/dl (7.8 mmol/L) Post Meal Blood Sugar Target

The International Diabetes Federation (IDF) recommends tighter control of blood glucose levels after meals in people with diabetes.

As of September 19, the IDG is recommending the same post-meal blood sugar target that the AACE adopted years ago. Only the ADA drags its feet in adopting this standard, probably because it is not attainable for most people with Type 2 diabetes unless they t restrict carbohdrate intake.

Most Doctors are Still Recommending Much Higher, Damaging Levels

Because the American Diabetes Association still recommends maintaining blood sugars at much higher levels, as high as 180 mg/dl (10 mmol/L) after a meal, many doctors who are not specialists in diabetes --and some that are--still advise patients that post-meal levels much higher than 140 mg/dl are safe.

The reason doctors recommend this higher, dangerous level is because they believe that patients are too lazy and undisciplined to make the changes needed to bring their blood sugars down to truly safe levels.

The other reason is because it is usually impossible to attain these healthy levels using anti-diabetic drugs alone. These targets can only be reached by cutting way down on your carbohydrate intake.

If your doctor doesn't stress the importance of maintaining truly safe blood sugar levels, print out the AACE guidelines linked above and bring them with you to your appointment. If that doesn't help, find a new doctor.

Remember: It's your eyes that go blind, your nerves that die, and your kidneys that fail, not your doctor's. He can afford to have low expectations for you. You cannot. Keep your blood sugar at safe levels!

Click HERE to see more research that backs up the importance of not exceeding 140 mg/dl (7.8 mmol/L) after meals.

Why Do I Feel Shaky and “hypo” When I Achieve Normal Blood Sugars?

If you have had high blood sugars for a while—even only moderately high blood sugars—you may find that you feel shaky and even downright sick when you bring your blood sugars down into the normal range.

This is because over time, your body has become accustomed to those much higher blood sugars and it interprets the normal blood sugar as being dangerously low. When this happens, the body secretes those “fight or flight” counter-regulatory hormones to push the blood sugars back up to what it erroneously thinks is the safe zone. The stress hormones associated with the counter-regulatory response can make you feel like you are having some kind of dreadful attack. They may include a pounding pulse, shakiness, a raised blood pressure, and symptoms similar to a panic attack.

After a counterregulatory response you may feel shaky for another hour or two, because of the changes the stress hormones have made in your body, and you may be a bit more insulin resistant than usual. But after some period of time which varies from person to person, your body will get used to these new, normal blood sugars.

So no matter what you feel when you first reach normal levels, try to wait it out. Your body is getting all the glucose it needs when your blood sugar is above 75 mg/dl (4.2 mmol/L). Doctors do not consider true hypoglycemia (low blood sugar) to begin until under 70 mg/dl (3.9 mmol/L). It does not become dangerous until it reaches levels like 45 mg/dl (2.5 mmol/L).

You can make the adaptation process a bit easier by proceeding in stages, setting your blood sugar targets progressively lower, a step at a time, especially if your post meal blood sugar has been extremely high for a while. But don’t stay at higher than normal levels for any longer than is absolutely necessary. Once your body does adapt, you will probably feel much better and much more energetic than before.

So be patient while your body becomes accustomed to new, healthy, blood sugar levels.

Don’t respond to feeling as if you were having a hypo by eating carbs to push up your blood sugar as long as your blood sugar tests at 80 mg/dl (4.4 mmol/L) or above. This is a normal blood sugar. In fact, many normal people will have a fasting blood sugar as low as 70 mg/dl (3.9 mmol/L).

Give your body a chance to adapt and eventually you will feel completely normal when you have a normal blood sugar and may feel surprisingly toxic when your blood sugar reaches the dangerously high levels that you used to feel normal at.

Lower is Better

The 140 mg/dl (7.7 mmol/L) blood sugar target is a good start, but many of us find we get much lower blood sugars and much more normal health if we shoot for truly normal blood sugars. That means keeping blood sugars under 120 mg/dl (6.6 mmol/L) at all times and getting back into the 80s (4.5 mmol/L and up) by three hours after every meal. If you can do it, go for it. Now that we know that heart attack risk rises significantly at A1cs in the mid 5% range, getting to true normal is that much more important.