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Tight control of Blood Glucose

Tight control of blood glucose means keeping blood glucose as close to normal as possible and avoiding blood glucose highs and lows.



Achieving & maintaining glucose concentrations as near to normal as possible can prevent, defer & slow the progression of long term microvascular & macrovascular complications, reducing mortality & improving the quality of life. Good control of blood glucose can reduce complications of Eyes. Kidneys & the Nervous system by up to 60% amongst people with type 1 diabetes (DCCT).

The result of the 21 year long United Kingdom Prospective Diabetes Study (UKPDS) showed that high level of blood glucose is the major contributor to diabetes related complications in people with Type 2 diabetes. It also showed that there was up to 35% reduction in the risk of complications with tight control of blood glucose.



Your glucose control depends on choosing the right foods. The more you learn about how foods affect your blood glucose the more choices you will have. To continue enjoying favourite foods, use blood glucose monitoring to learn their effects.

Exercise is an important part of any health plan to control blood glucose levels as it makes insulin work better and lowers blood glucose. Testing regularly around exercise time will help you avoid blood glucose highs and lows.

Medication for diabetes in the form of tablets or insulin interacts with food, exercise and your body’s own insulin to determine your blood glucose level.

Monitoring your blood glucose regularly shows the effects of food choices, medication doses and other changes in your daily routine on your blood glucose levels. Without it, your health care provider may not know when & what changes are needed.

For best results, review information about your blood glucose, food, exercise and medication with your doctor.



Knowing your blood glucose levels-daily and over time – is the key to successful diabetes care.

Test often, as testing at different times give different information :

Fasting: glucose tells whether the insulin you make or take is controlling blood glucose overnight.

Pre-meal: glucose can help guide decisions about food and insulin for the coming meal.

After-meal: glucose tells whether you had the right amount of insulin to cover the food you ate. This is the test that helps you learn the most about your food choices.

Do extra tests when changing doses of diabetes medication, when changing either exercise or meal plans, when you think your blood glucose is low or high and when you are sick.


Biochemical Index Normal Goal Additional action suggested
Avg. Preprandial Plasma Glucose (mg/dl) <110 90-130 <90
Avg. Bedtime Plasma Glucose (mg/dl) <120 110-150 <110
HbA 1c (%)** <6 <7 >8

* American Diabetic Association (ADA 2001) Recommendation. Your goals may be different. Ask your doctor.
** In Additional to testing your blood glucose yourself, it is important to have a glycosylated haemoglobin (HbA1c) test every 3 to 4 months.

Poor Control of Blood Glucose


Poor control of blood glucose by people with diabetes and the duration of diabetes are closely related to development of diabetic retinopathy. Diabetes is one of the leading causes of acquired blindness amongst adults. Poor control of blood glucose results on account of lack of monitoring of blood glucose combined with inadequate maintenance of diet, exercise and therapy regime.


There is a strong association between duration of plasma glucose level and coronary heart disease (CHD). Patients with diabetes mellitus have a substantially (up to 2 to 3 times) higher risk of developing congestive heart failure compared with normal subjects. Early and continued correction of hyperglycaemia through regular exercise, diet and medication combined with regular monitoring of blood glucose leads to improved prospects of managing cardiovascular diseases.


The risk of kidney disease or nephropathy is known to increase with duration of poorly controlled diabetes, which if left alone could lead to highly painful and fatal consequences. The incidence of nephropathy is reported to be twice as high if glycemic control was poor compared to well controlled diabetes. There is a beneficial effect of good glycemic control through medication, diet and proper monitoring of blood glucose on various measures of kidney function.


It is well known that persons with diabetes mellitus experience a wide range of symptoms related to the nervous system including poor control of the genito urinary function, unawareness of hypoglycaemia and male sexual dysfunction or impotence. Various studies have established the relation between diabetes related sexual dysfunction and the duration of poorly controlled diabetes.


People with diabetes often suffer from foot ulcers or small areas of gangrene, which is a leading cause of hospital admission for patients and is an extremely expensive traumatic complication of diabetes. Education on proper foot care combined with regular monitoring and therapy is shown to reduce the number of major amputations in diabetes clinics.

Note: For more information on Diabetic visit......  Diabetic Help Center




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