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Tight Diabetes Control


Keeping your glucose levels as close to normal as possible can help prevent or slow some of the complications associated with diabetes. According to the Department of Health and Human Services, good control can lower the risk of complications such as eye and kidney disease as well as nerve damage. Tight diabetes control, according to the American Diabetes Association, means you must:

  • maintain a blood glucose level between 70 and 130 mg/dL before meals
  • have a glucose reading of less than 180 mg/dL two hours after meals
  • keep your glycated hemoglobin (A1c) level at or less than 7 percent

However, tight control is not for everyone. It does carry some risks and involves hard work. The benefits may not outweigh the risks or work it requires.

An important note: If you would like to pursue tight diabetes control, it’s imperative that you work with your healthcare team. You should set your goals with their assistance, as your personal health history may affect whether you’re a good candidate for keeping tight control of your blood sugar.

How do you practice tight diabetes control?

Tight diabetes control requires that you do the following:

  • Pay closer attention to your diet and exercise.
  • Measure your blood glucose levels more frequently.
  • Take pills or insulin injections if diet and exercise alone don’t control your blood glucose.
  • Alter insulin injection schedules to respond to changes in your glucose levels.

Your diabetes care team will set guidelines, including:

  • how much exercise you should get
  • how many calories you should eat in a day
  • if or how you should adjust your diabetes medications
  • how often you should test your blood

These guidelines will likely change frequently as you work to find a plan that best suits your lifestyle and gives you the results you’re aiming for.

Insulin involvement

People with type 1 diabetes will need to manage their blood sugar levels with multiple daily injections, or by using an insulin pump, if they want to have tight blood sugar control. For people with type 2 diabetes, your doctor may suggest that you begin using insulin injections or other diabetes medications if diet and exercise alone are not adequate in controlling your blood glucose levels.

For people with type 2 diabetes, the decision to begin using insulin depends on how well your diabetes is controlled by diet and exercise, how closely you plan to monitor and control your diabetes, and how frequently you may need injections.

What is the long-term plan?

Starting a program of tight diabetes control can be overwhelming, but the promise of a healthier, longer life may make the work worth it. Here are some ways to keep from burning out.

Make Realistic Goals

Your blood glucose readings will not always be perfect. Make adjustments based on the management plan you worked out with your doctor and healthcare team. If your numbers are consistently too high or too low, make an appointment to see your doctor and re-evaluate your plan.

Don’t Be in a Hurry

Implementing all the components of a tight diabetes control plan at one time may be overwhelming or hard to maintain, so start with one element, such as checking your blood glucose more often, and add the other components later.

Be Honest

You are the primary leader of your diabetes team, so you need to make sure that you choose what works best for you and are honest about how well your program is going. If you're not having the success you were hoping for or can no longer maintain a tight diabetes control plan, talk with your doctor about transitioning to a more conventional plan.

Are there any risks?

The greatest risks identified for those who are trying to achieve tight control of their blood sugar is the risk of frequent low blood sugar, and the risk of weight gain. These risks are primarily associated with insulin or medications that raise the insulin levels in the body. According to the Mayo Clinic, frequent low blood sugar reactions can lead to serious, life-threatening reactions. If you’re experiencing low blood sugar frequently, you need to meet with your healthcare team to adjust your treatment plan.


Tight diabetes control is not for everyone. In some cases, tight diabetes control can lead to more complications. According to American Medical News, elderly people, those who have had diabetes for a long time, those at risk for low blood sugar, and those with a history of stroke or heart attack, should avoid this type of diabetes management — hypoglycemia may cause strokes and heart attacks. Children should also avoid a tight diabetes control plan as having enough glucose in the blood is vital to brain development.

If your diabetes has progressed and you already have some complications, tight diabetes control may not be right for you. The complications may be too far advanced for you to benefit from tight diabetes control, and the routine may be too strenuous on your body.

Tight diabetes control can be beneficial for some and harmful for others. Be sure to work closely with your doctor to figure out if tight diabetes control is right for you, and be sure to follow your plan of care closely.

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