The primary goal of treatment for patients with diabetes is to lower blood glucose and reduce acute and chronic complications, while preventing the risk of hypoglycemia during treatment. A high preprandial glucose indicates that the patient is not producing enough insulin and that the dose of glucose-lowering medication is inadequate during treatment. A low preprandial glucose indicates that the patient is overdosing on glucose-lowering medications during treatment or that the choice of glucose-lowering medications is poor.
High or low preprandial glucose can have an impact on the overall treatment of the patient. Too high is prone to acute and chronic complications, and too low is prone to hypoglycemia. The current target values for preprandial glucose control are mainly determined by age and risk of hypoglycemia.
Patients at different ages are at different risks of acute and chronic complications and hypoglycemia. If patients of advanced age have poor adherence to diabetes treatment and do not take their diet and medications as prescribed, they are at risk for complications.
Patients of the same age are at significantly higher risk of spontaneous hypoglycemia in some patients than in others because of their own organismic differences. Recurrent hypoglycemic episodes may occur during the course of diabetes treatment. Such patients should not have their pre-meal glucose controlled too low.
In summary, if you are a senior patient or have frequent hypoglycemic episodes, it is recommended to control your preprandial blood glucose slightly higher to avoid hypoglycemic complications. For those not mentioned above, pre-meal blood glucose needs to be controlled to the normal range.