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Diabetes: How high the long-term blood sugar value should be at maximum

In people who diabetes suffer, two laboratory values ​​​​are measured regularly: on the one hand the fasting blood sugar and on the other hand the long-term blood glucose level (HbA1c). Which limit the latter should not exceed in order to diabetes-related damage to avoid, a new study shows.

Long-term blood glucose (HbA1c) can be used to determine a person with type 1 diabetes’ risk of developing eye and kidney complications. According to a study that followed people more than 30 years after the onset of type 1 diabetes, this value should be less than 53 mmol/mol (7%). The study results were published in the journal Diabetes Care.

avoid complications

As explained in a recent statement from Sweden’s Linköping University, people with diabetes can suffer damage to the small blood vessels in various organs.

The reasons for this are unclear, but it has been known since the 1990s that a good control blood sugar reduces the risk of complications. However, until now it has not been clear what long-term blood glucose (HbA1c) level people with type 1 diabetes should have to avoid serious damage to blood vessels in the eyes and kidneys.

“Our study precisely determines the values ​​of the long-term sugars, which can avoid complications. This knowledge can increase a person’s motivation to keep their blood sugar levels under control.”says Hans Arnqvist, professor emeritus at Linköping University and leader of the study.

Study from Sweden

The researchers in the current study observed all children and adults under the age of 35 who were hospitalized in the South-East Healthcare Region of Sweden in the period 1983-1987 type 1 diabetes were treated.

All 447 people newly diagnosed in this region during this period were included in the study. The research team tracked the patients’ HbA1c levels, which matched their average blood sugar levels reflect over a longer period of time.

The scientists also have the development of Eye and kidney damage observed in these patients over a period of 32 to 36 years after diagnosis.

Damage to blood vessels in the eyes and kidneys

The small blood vessels in Eye are particularly susceptible to damage in type 1 diabetes. Almost all patients experience minor bleeding in the eye that does not impair vision.

In some cases, new blood vessels develop in the retina. This “proliferative retinopathy” can lead to blindness. Another impact of diabetes affects the area of ​​the retina known as the “macula,” where highly focused vision resides. Damage here leads to blurred vision.

the kidneys are not as sensitive to high blood sugar levels as the eye, but here too the important small blood vessels can be damaged. A consequence of such damage is the excretion of blood proteins in the urine.

Albumin is the protein with the highest concentration in the blood, and when it is present in the urine, the condition is called “albuminuria” designated. Damage to the kidneys eventually leads to impaired kidney function and, in severe cases, kidney failure.

This is a life-threatening conditionif left untreated, and the patient must either be on dialysis or have a kidney transplant.

Long-term glucose level below 53 mmol/mol

Healthy people without diabetes usually have one HbA1c value between about four and six percent (20 and 40 mmol/mol).

“The results of our study show that people who have been living with type 1 diabetes for at least 32 years should keep their mean long-term blood glucose level below 53 mmol/mol (7.0%) to serious damage to avoid completely”explains Hans Arnqvist.

“The risk of eye and kidney complications increases as levels rise. Our conclusions relate to the avoiding complications due to blood vessel damage. But if a patient has problems with low blood sugar, hypoglycemia, it is not possible to control the blood sugar level so tightly”according to the scientist.

The one suggested by the results of the study target value for HbA1c is consistent with individual target values ​​recommended by the American Diabetes Association.

However, the experts also point out that the study no conclusions to the recommended blood sugar levels for people who have been living with type 1 diabetes for more than 30 years. (ad)

Author and source information

This text corresponds to the requirements of medical specialist literature, medical guidelines and current studies and has been checked by medical professionals.

Sources:

  • Linköping University: Recommended blood sugar levels to avoid diabetes-related damage, (accessed: September 14, 2022), Linköping University
  • Hans Arnqvist, Malin Westerlund, Mats Fredrikson, Johnny Ludvigsson & Maria Nordwall: Impact of HbA1c Followed 32 Years From Diagnosis of Type 1 Diabetes on Development of Severe Retinopathy and Nephropathy: The VISS Study; in: Diabetes Care, (published: 09/12/2022), Diabetes Care

Important NOTE:
This article contains general advice only and should not be used for self-diagnosis or treatment. He can not substitute a visit at the doctor.

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