Diabetes: Tight control

If you have diabetes, you've probably read or heard about tight control from your doctor or another member of your care team.

Research has shown that when people practice tight control -- keeping their blood sugars as close to normal as possible -- they lower their risk of eye, kidney and nerve diseases.

The difference between tight and standard control

Standard control, for example, of type 1 diabetes usually involves one or two shots of the same amount of insulin every day and less than two daily tests of blood sugar.

Tight control requires that you check your blood sugar more often each day and decide what your dose of insulin should be depending on your test readings.

"Test my blood sugar more than I already do? I spend enough time dealing with it!" people often say about changing from standard to tight control.

Practicing tight control is challenging. Thinking positively can help. It's also important to realize that the more successful you are at controlling your blood sugar, the better your chances are of avoiding kidney disease, vision problems, and nerve damage, including the loss of arms or legs.

Who should practice tight control?

People in these categories should not practice tight control:

• children under age 13
• people with end-stage kidney disease, severe visual impairment and coronary artery disease
• people who do not experience warning symptoms when their blood sugar becomes too low (Tight control brings a higher risk of low blood sugar.)

People with type 1 diabetes who do not fall into the categories listed above may benefit from tight control.

People with type 2 diabetes have no one answer about whether tight control is for them. So talk with your doctor about your case.

Help from your care team

Ask your doctor if you are a good candidate for tight control. If you are, and you decide to try it, your diabetes care team will help you to figure out…

• what your blood glucose level should be before and after meals
• how to adjust your insulin to your lifestyle -- the type of work you do, your level of activity, the food you eat and when you eat it
• how often you should meet with a dietitian to review what you eat
• how you should take care of your diabetes if you become pregnant
• what your family and friends should do if your blood sugar becomes so low that you need their help

Related Links

Diabetes Condition Center

"Dialog: Living with Diabetes" newsletter

First published: 02/15/2000
Last updated: 10/03/2005

Reviewed by: Paul Kleeberg, MD, medical director, Allina.com