Goal Fasting Blood Glucose for People with Diabetes

Standard Targets for Nonpregnant Adults

The American Diabetes Association recommends a preprandial capillary plasma glucose target of 80-130 mg/dL for the majority of nonpregnant adults with diabetes, which correlates with achieving an A1C <7% 1, 2
Peak postprandial glucose should remain <180 mg/dL when measured 1-2 hours after beginning a meal, as recommended by the American Diabetes Association 1, 3

The American Diabetes Association suggests adjusting the target based on a systematic assessment of patient factors, such as disease duration, life expectancy, and comorbidities 1, 2
More stringent goals (targeting lower end of 80-130 mg/dL or even 70-120 mg/dL) may be appropriate for newly diagnosed diabetes with short disease duration, long life expectancy, and absent or minimal comorbidities 1, 2
Less stringent goals (targeting higher end of range or even >130 mg/dL) may be appropriate for long-standing diabetes with established complications, limited life expectancy, and severe comorbidities 1, 2

For hospitalized patients (critically ill), the American Diabetes Association recommends initiating insulin therapy when glucose persistently ≥180 mg/dL and targeting a range of 140-180 mg/dL 4, 5
For hospitalized patients (non-critically ill), the target range is 100-180 mg/dL, with premeal targets generally <140 mg/dL if treated with insulin 4, 5
For gestational diabetes, the American Diabetes Association recommends a fasting plasma glucose target of <95 mg/dL 6

The American Diabetes Association advises against relying solely on fasting glucose to assess control, and recommends checking postprandial glucose values to identify excessive postprandial excursions 1, 3
The NICE-SUGAR trial demonstrated that targeting glucose <110 mg/dL in critically ill patients increased mortality compared to more moderate targets of 140-180 mg/dL, as reported by the American Diabetes Association 4
The American Diabetes Association warns against ignoring hypoglycemia risk, as fasting glucose <100 mg/dL predicts hypoglycemia within the next 24 hours in hospitalized patients 4, 2

The American Diabetes Association recommends monitoring fasting glucose frequency based on treatment regimen, with at least 4 times daily (including fasting) for patients on multiple daily insulin injections, and daily fasting checks for patients on basal insulin only 6, 5