Most physicians believe that the closer to normal the diabetic maintains his sugar over the years, the less likely he will suffer the deadly complications of the disease. This is particularly important in the young, insulin-dependent diabetes mellitus patient.
In the adult, with whom other factors like cigarette smoking, hypertension and weight control are at least as important as sugar control, efforts should be aimed not at a target blood sugar but rather at a blood sugar level that keeps diabetics symptom-free. Diet, exercise, oral medication and insulin should be balanced to minimize excessive thirst, the need to get up at night to urinate, weight loss, fatigue and other signs of high blood sugar.
Particularly in the elderly, efforts should be made to ensure that sugar is not too low. Such hypoglycemia, particularly when the patient also has vascular or heart disease, is more dangerous than is moderately elevated sugar. Not only does a sharp drop in sugar increase the risk of strokes and heart attacks, it can cause a loss of consciousness -- making driving a car or walking down a stairway exceedingly dangerous.
Pharmacists should tell patients to strive for a fasting blood sugar level of 140. The reading two hours after the patient has eaten should not be greater than 50% of the fasting level, or about 210. But if these goals result in attacks of hypoglycemia, patients should settle for slightly higher readings. It is better to be too high than too low.