Ask the Diabetes Educator Archive

5/24/04

Q:
I have been testing myself for blood sugar daily. My blood sugar has averaged out about 150. If I try to push it down to 70 - 110, I feed dizzy, shaky, and lightheaded. Anything between 150 and 200 or so feels good to me. I think I have low blood pressure (115/70 is average for me). Basic physics implies lower blood pressure will put less stress on small blood vessels and mitigate damage from higher blood sugar to the eyes and extremities. I can't tolerate what the stated "average" blood sugar range. It it possible my normal RANGE is higher than the statistical range? I feel myself being packaged into something that doesn't fit.

A:
There may be some trade off here with lower pressure/higher sugars. Have you had a thorough cardiovascular evaluation, including a stress test? Am I to assume you have discussed this with your physician? Generally, we see the symptoms you are describing with people who have adapted to higher blood sugar levels for a long period of time, then try to get into tighter control too quickly. When done more gradually, they can adapt to lower blood sugars without feeling hypoglycemic. I do not know the extent to which lower blood pressure would offset the potential damage of higher sugars. The ranges for diabetes and pre-diabetes have been lowered because evidence of complications has occurred at the previously higher levels. Try targeting for a blood sugar of 120 for a time, then see if you can gradually work down. If you have no other clinical conditions, you would want to work towards more normal blood sugars.