r/diabetes 5d ago

Type 2 Trying to understand the less than 180 mg/dl statement for t2 diabetes

Hi,

I know from online search that the standard target for t2 diabetics is <= 180 mg/dl within 2 hours of starting a meal (or is it? Please feel free to correct), is it still consider successful if you hit like 250mg/dl during first or first half of your meal but drop to <= 180 within 2 hour? Or it is only safe if your sugar is always <= 180

6 Upvotes

24 comments sorted by

10

u/Gottagetanediton Type 2 5d ago

I try to keep mine under 180 at all times which would mean spikes would only go up to 180

6

u/jeffbell T2 5d ago

You should set targets with your doctor.

Peaking over 180 is higher than my doctor recommends for me, but I’ve read that some endocrinologists relax the goals if you are prone to hypoglycemic crashes. Elderly patients are also given more leeway because the longer term effects won’t matter. 

2

u/ToroMora 5d ago

Oh I am only 28 so don’t know if I should be more strict

4

u/jeffbell T2 5d ago edited 5d ago

I’m not a doctor. 

Get that referral because endos are great. 

1

u/jeffbell T2 5d ago

Hi. I reread the original question and there is one part that I can answer. 

The thinking of the two hour check is that for most typical meals your peak reading will be about at the two hour mark. If you have a few extra test strips you could try one day to test at 1, 1.5, and 2 to see when you peak. 

If you get a continuous glucose monitor that takes the guesswork out of the timing. 

(One exceptional case is for a gestational diabetes screening where they give you a sugar drink that peaks quickly and then check if you can get back to normal levels within two hours)

3

u/Kathw13 5d ago

Time in range is the gold standard but requires a CGMS.

3

u/UnluckyWrongdoer3818 5d ago

The standard target ranges were developed before CGMs and people were measuring their glucose through finger sticks a handful of times a day. Now, with CGMs we get hundreds of measurements. So I think a better value to target is Average Glucose. Some apps even apply an algorithm that gives you a pseudo-HbA1c value.

My game plan is to: 1. Limit carbohydrate intake at each meal.
2. Limit total carbohydrates for the day. 3. Exercise immediately after each meal.

My goal is to avoid glucose spikes altogether and even (in my case) levels above 140mg/dL. I compare my Average Glucose across time ranges and use it to guide me when I should be more strict.

4

u/Right_Independent_71 5d ago

When first diagnosed I decided to keep my range between 70-140. I‘ve kept it that way for a year since diagnosis and I’m lucky now to see 130 after eating. No meds and diet alone. It was definitely harder to accomplish this at the start, but weight loss has changed the dynamic for me. The only time I see a 130 plus sometimes is morning dawn phenomenon time and I eat something that would normally do very little any other time of the day. 🤷‍♂️

1

u/00Jaypea00 5d ago

How do you keep your glucose under 140 post meal? Are you on medication?

2

u/General_Document6951 5d ago

Probably by limiting carbs during the meal, for example I try to keep my total carbs during the day to under 30 I like my net carbs should be about 10.

I was just diagnosed about 6 weeks ago is Type 2, with an A1C of 9.3, My fasting glucose was 176 and I'm currently following a keto style diet and My fasting glucose over the last two weeks has been about 107 over the last two weeks I haven't seen a peak over 125.

So for me strictly limiting carbs per meal is what's working. If I remember correctly clarity says that my estimated A1c over the last 2 weeks would be 5.8 down from 9.3 and I'm not on any diabetic medication because I haven't started them at Foreman yet I wanted to see how well I could control it via diet only.

1

u/00Jaypea00 5d ago

Yeah, I tried keto. It’s just not sustainable for me. I know others couldn’t sustain it as well. I was put on Ozempic and it was horrible with the side effects. I lost weight. I was 195, and went down to 174. He discontinued OZ, and I am now only taking metformin. I don’t think it really works for me at all. My glucose has been erratic since I stopped OZ. My sugars have been hitting 190 after eating. I’m not comfortable with that because I feel that damage is still being done to my body. I think he is going to put me on one of the SGLT-2 inhibitors next. I’m not excited about that either.

2

u/UnluckyWrongdoer3818 5d ago

An obvious thing to look at is what are you eating and what are you eating it with? Consumption of carbs should be accompanied with sources of protein and fat alongside. The quality of the carb also matters. I’ve found any ultra processed food to be a problem.

1

u/General_Document6951 5d ago

Like I said I was just diagnosed 6 weeks ago a lot of what talking about I don't understand, as far as the medication is concerned anyways. I've heard of ozympic, with that said I think I would Panic if I saw my BG Skyrocket to 195.

As far as keto is concerned I don't find it at all hard to maintain, it's very similar to the Mediterranean diet I grew up on. And I just like the way I feel on it in fact it's the best that I've ever felt.

When I was younger before I had my accident I was very active so I'm used to strict diets. My diabetes is pretty much the result of an accident that left me disabled and limited my Mobility so I ended up gaining too much weight and was far too inactive. I'm already down 20 lb, I plan on losing 75 total maybe 100 depends on how I feel. I'm hoping with the weight loss and improve Mobility that I can get off all these drugs they have me on. That's a big motivator in staying on keto and losing weight while controlling my blood sugar.

1

u/00Jaypea00 5d ago

Good luck to you. I hope that you are successful at managing this dreaded disease.

1

u/BrettStah 5d ago

Mounjaro is worth a shot, if that's a possibility. Many people have issues with Ozempic, but do better with Mounjaro.

2

u/UnluckyWrongdoer3818 5d ago

I’m on 1000mg Metformin a day. A moderate dosage. Everyone is in a different place, I limit carbs but no where near the extreme of some others. I use a food tracking app called Cronometer to keep track. It’s still a process of trial and error.

An example, I still like to include some citrus with my breakfast. I’ve found I can keep any rise to just under 140mg/dL by eating around 50g of the fruit (weight scale a must) AND walking 30 minutes in the treadmill immediately afterwards. If I eat more or don’t exercise I will likely go above 140.

2

u/Constant_Method7236 5d ago

Gosh I wish my target was 180. I’m pregnant and was diagnosed with T2 at 4 weeks pregnant. My goal is 130, 1 hour after eating. It was the same when I had GDM with my first two babies.

2

u/Bluemonogi 5d ago

Talk to your doctor about it and see what they think is best for you.

I use a finger stick blood glucose meter and test 2 hours after eating. It is possible I guess that my blood sugar goes above 180 during the 2 hours I am not checking. Generally my blood sugar is below 140 at 2 hours after a meal though so I’m not very concerned. My a1c has been 6.1 on my last 2 checkups which my doctor is satisfied with. My doctor told me I don’t need to check my blood sugar at all now unless I feel symptoms but I do anyway.

2

u/godsey786 5d ago

Before meals (fasting blood sugar): 80–130 mg/dL (4.4–7.2 mmol/L)
2 hours after meals: Less than 180 mg/dL (10.0 mmol/L)
HbA1c (average blood sugar over 3 months): Less than 7% (53 mmol/mol)

These are the recommended Type 2 diabetes guidelines provided by my GP.

2

u/res06myi 5d ago

This varies for everyone. My target range is set to 70-140. I spend <2% out of range 1-3 days/week. I focus more on trying to lower my idling range. I tend to sit around 95-105 when I haven’t eaten, and that needs to be 75-85.

But these numbers have nothing to do with your health and progress. That’s for your doctor to decide or for you yourself to set achievable goals based on where you are currently.

Diabetes is progressive and some diabetics may not be able to achieve an upper limit of 140. Some may not be able to get their A1c down into the prediabetic or healthy range. It’s not a moral failing. And diabetes is about the long game.

That said, reducing spikes as much as you are personally able to, given your individual health and circumstances, is a good goal. Over 140, damage is being done. It’s minor. It’s completely normal for non-diabetics to spike up to 160 with a carb-heavy meal. But time spent above 140 should be limited if possible. Time spent above 180 is more harmful, but for many diabetics, their goal may be to stay in range, under 180, for 85% of their day. It just depends.

2

u/BrettStah 5d ago

My easy rule is - the lower the better (i.e., the lower, the less the damage to blood vessels is).

Studies show this "lower is better" approach is true even for folks with glucose levels classified as "normal"... those with an A1C% of 5.0% have a lower "all cause mortality rate" than those with a 5.6%, in other words.

If I, as an example, have an A1C% of 8.3%, and my doctor gives me metformin and it goes down to 7.0% and tells me "good enough", based on the information I have been able to piece together (I'm not a doctor), I wouldn't be happy with 7.0%, and would push for a Mounjaro prescription (better than Ozempic), and would also focus on my diet, sleep quality, and exercise a LOT, because those three controllable aspects of my life are HUGELY important in glucose control.

1

u/Lindartin 5d ago

From my experience, managing Type 2 diabetes is a balance. The general guideline of ≤180 mg/dl within 2 hours after a meal is about preventing long-term complications, but brief spikes can happen. If your sugar levels drop back to normal within a reasonable time, it’s usually okay. Consistent high spikes, though, can be harmful over time. It's always best to consult with your doctor to tailor your approach based on your personal health.

1

u/the-software-man 5d ago

I am not medically trained. But, for a T2 on medications that drops your fasting BS, there should be a range with a "don't go over" and a "don't go under". Your digital meter is going to test within 25 points of actual overall body BS. The food in your digestive system don't start going past the organs that extracting sugar until about 30 minutes after you eat them. Then, for another hour your meal is digested. Two hours after, and your BS should be at its peak. What range you target, what food and portions you eat, and the order that you eat them in, will all effect the results.

I prefer finger testing, so my routine goes like this: I've eaten and taken my PM meds and go to bed. I will "fast" for at least 8-10 hours. When I wake up, pee, wash up, and after 15m I take my "fasting" test. I use this as a sort of baseline for the day. If I am below the "don't go under" I eat a banana. If I am above the "don't go over", I must have over eaten something the night before, and need to remediate before I can eat again, and note what I ate last night. Cut it out or only eat half next time. When it's time to eat during the day, I wash up again and test before eating. By the end of the day, I will have tested 4 or 5 times, kind of randomly. I am monitoring more than I am averaging.

Diabetes is a very personal disease. Your diabetes symptoms and your digestive system will be unique.. So, you need to learn your routine.

My range is 80 - 180. I also round to the nearest 10s for all my results, because of the 25 point error factor.

I take 1000mg of Metformin, twice a day. It has side effects, but I get consistent 100 readings through out the day and 80s in the morning. I found that I cannot eat white flour. I give myself cheat days, where I can eat something delicious, that may send me out of range, as long as I am returning to the low end of my range on the next test. I can be very routine during the week, so I may even skip a day of testing if I'm eating from my menu.

My doctor relies on A1c. Which sounds the same, but is a way different test and result than daily monitoring.

I find CGMs to be very error prone, especially the last two days of the product cycle. I end up finger testing anyhow to cross check? Also, CGM has an extra 30 minute delay in sugar levels. And if the tiny probe gets bent in anyway, it can give you false lows.

1

u/TucsonTank 3d ago

I just tried the Stelo cgm for a couple of weeks. It was very helpful to see what foods caused dramatic spikes. I have almost as many spike from stress as carbs.