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Keeping your blood glucose levels as close to normal as possible can be a lifesaver. Tight control can prevent or slow the progress of many complications of diabetes, giving you extra years of healthy, active life. But tight control is not for everyone and it involves hard work.
Tight control means getting as close to a normal (nondiabetic) blood glucose level as you safely can. Ideally, this means levels between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, with a glycated hemoglobin (A1C) level less than 7 percent. The target number for glycated hemoglobin will vary depending on the type of test your doctor’s laboratory uses.
In real life, you should set your goals with your doctor. Keeping a normal level all the time is not practical. And it’s not needed to get results. Every bit you lower your blood glucose level helps to prevent complications.
No one knows why high glucose levels cause complications in people with diabetes. But keeping glucose levels as low as possible prevents or slows some complications.
For the Diabetes Control and Complications Trial (DCCT), researchers followed 1,441 people with type 1 diabetes for several years. Half of the people continued standard diabetes treatment while the other half followed an intensive-control program. Those on intensive control kept their blood glucose levels lower than those on standard treatment, although the average level was still above normal.
Far fewer people who already had early forms of these three complications got worse. To get tight control, you must do the following: Pay more attention to your diet and exercise. Measure your blood glucose levels more often. If you take insulin, change how much you use and your injection schedule. 
In intensive therapy, you provide yourself with a low level of insulin at all times and take extra insulin when you eat. This pattern mimics the release of insulin from the normal pancreas. There are two ways to get more natural levels of insulin: multiple daily injection therapy and an insulin pump. Both are good methods. Your choice should depend on which best fits your lifestyle.
In multiple daily injection therapy, you take three or more insulin shots per day. 
Until tomorrow: Knowledge without education is but armed injustice. 

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Dorothy Prats
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