Target Non-Fasting Blood Sugar

Standard Glycemic Targets

The American Diabetes Association recommends a peak postprandial capillary plasma glucose of less than 180 mg/dL, measured 1-2 hours after the beginning of a meal, for most nonpregnant adults with diabetes 1
Measurements should be taken 1-2 hours after the beginning of the meal, when glucose levels generally peak in patients with diabetes 1
Postprandial glucose should be specifically targeted if A1C goals are not met despite reaching preprandial glucose goals 1

The American Diabetes Association recommends a preprandial target of 80-130 mg/dL for most nonpregnant adults with diabetes 1
This range was specifically raised from the previous 70-130 mg/dL to limit overtreatment and provide a safety margin when titrating glucose-lowering medications 1

The American Diabetes Association recommends a hypoglycemia alert value of less than 70 mg/dL, which requires immediate treatment with 15-20 g of fast-acting carbohydrate 1, 2
The American Diabetes Association classifies hypoglycemia into three levels: Level 1 (<70 mg/dL and ≥54 mg/dL), Level 2 (<54 mg/dL), and Level 3 (severe cognitive impairment requiring external assistance) 2

For critically ill hospitalized patients, the target range is 140-180 mg/dL, and insulin regimens should be reassessed if blood glucose falls below 100 mg/dL to prevent hypoglycemia 3, 4
Patients with hypoglycemia unawareness, history of level 3 hypoglycemia, pattern of unexplained level 2 hypoglycemia, renal impairment, hepatic disease, or elderly status should have higher glycemic targets to strictly avoid hypoglycemia 1, 2, 4

The American Diabetes Association recommends never administering insulin or sulfonylureas when blood glucose is less than 70 mg/dL, and always checking blood glucose before each dose 2, 4
If glucose is less than 70 mg/dL, hypoglycemia should be treated first with 15-20 g fast-acting carbohydrate, then reassessed 2
For high-risk patients, consider holding medications when glucose is less than 100 mg/dL 4

The American Diabetes Association recommends not targeting overly aggressive postprandial goals, as the less than 180 mg/dL target balances glycemic control with hypoglycemia risk 1
The American Diabetes Association recommends not ignoring postprandial measurements, as postprandial glucose is likely the culprit if A1C goals are not met despite good preprandial control 1
The American Diabetes Association recommends not administering glucose-lowering medications in the hypoglycemic range, as this significantly increases risk of severe hypoglycemia with potential for seizures, coma, and mortality 2
The American Diabetes Association recommends not using the same intensive targets for all patients, as those with hypoglycemia unawareness, advanced complications, or limited life expectancy require less stringent goals 1