What Should My Blood Sugar Actually Be? A Real-Talk Guide for the Newly Diagnosed
It's 2:47 am, and you're staring at your phone. Your blood sugar is 145 mg/dL. You've already scrolled through three Facebook groups where someone posted a perfectly flat CGM line at 95 all day (with seventeen comments congratulating them), and now you're convinced you're doing everything wrong. Sound familiar?
Let me tell you something: I see this question at least five times a week in diabetes communities. "What should my numbers actually be?" And honestly? It's not your fault you're confused. You've probably gotten different answers from your doctor, your diabetes educator, that well-meaning aunt who "knew someone with diabetes," and approximately forty-seven strangers on the internet.
So let's sort this out once and for all.
Typical Blood Sugar Ranges
Here's the truth that nobody wants to tell you upfront: people without diabetes cruise along between 70-100 mg/dL most of the time. They'll barely nudge above 140 mg/dL even after demolishing a stack of pancakes. Their pancreas just... handles it. Automatically. While they sleep, while they work, while they binge-watch Netflix without a second thought.
And then there's you.
Your pancreas has gone on permanent vacation, and now you're doing its job with injections, pumps, carb counting, and a whole lot of mental math. So when your doctor casually mentions that your target range is 70-180 mg/dL, and you're sitting there thinking "wait, that's higher than normal people?"—yeah. It is.
But here's what that number actually represents: it's the acknowledgment that you're doing the work of an entire organ, manually, and doing it pretty damn well. If you're spending most of your day in the 70-180 range, you're not falling short of some standard. You're succeeding at something genuinely difficult.
The Morning After (Syndrome)
Let's talk about that 2 am panic I mentioned. You went to bed at 110 mg/dL feeling pretty good about yourself. You wake up at 160 mg/dL, wondering what fresh hell this is. Welcome to the dawn phenomenon, that delightful quirk where your liver dumps glucose into your bloodstream early morning because it thinks you need energy to hunt mammoths or whatever our ancestors did at dawn.
Your doctor wants your fasting blood sugar—that first reading before breakfast—somewhere between 80-130 mg/dL. Is 140 or 150 ideal? No. Is it the end of the world? Also no. It's a pattern to notice and maybe adjust your basal insulin for, not a personal failing that requires a 3 am shame spiral.
And after meals? You're aiming for under 180 mg/dL about one to two hours after eating. Notice I said "under 180," not "exactly 100." Your blood sugar will rise after eating because that's literally how food works. The glucose has to go somewhere before insulin can act on it. A spike to 160 after dinner and then a smooth glide back down? That's not a problem—that's your insulin doing its job.
The Magic 70% Rule (Or: Permission to Be Human)
If you're using a continuous glucose monitor, you've probably heard about "time-in-range." This is the percentage of time you spend between 70 and 180 mg/dL, and the goal is 70% or more.
Let's do the math on that. Seventy percent of a 24-hour day is about 17 hours. Which means you could be out of range for 7 hours a day and still have excellent control. Seven hours! That's almost a full work day of "not perfect" numbers built right into the definition of success.
I love this metric because it acknowledges reality: you're going to have highs. You're going to have lows. That pizza will betray you. Stress will spike you. Exercise will drop you. The goal isn't perfection at every moment—it's getting it right most of the time.
I personally have a higher percentage in range because I combine:
Modern Medical Treatment,
Low- to Medium-Carb Diet,
LISS (Low-Intensity-Steady-State) Exercises, And
Meditation and Mindfulness for Stress Management.
Because of that combination, I’m just better in control, and my typical time-in-range is higher than 95%. But that’s me, and you should start with the doctor-recommended 70% before you start optimizing.
When Robots Join the Team
Now, if you're using an insulin pump with one of those fancy automated systems, things get a bit more interesting. These pumps are essentially micromanaging your blood sugar every 5 minutes, making tiny adjustments you couldn't possibly make manually. So their targets are tighter:
The Tandem Control-IQ system aims for about 110-120 mg/dL, with a slightly tighter 112.5 mg/dL when you activate sleep mode (because nobody wants alarms at 3am if they can help it). I use the sleep mode 24-7 with my Tandem insulin pump.
The Omnipod 5 lets you set a target anywhere from 110 to 150 mg/dL, giving you a bit more wiggle room depending on what works for your body.
And the new Twiist AID system? It's the overachiever of the group—you can set targets as low as 87 mg/dL or adjust them upward from there, depending on how aggressive you want the system to be.
But here's the critical point: if you're on multiple daily injections and comparing your manual results to someone's automated pump numbers, stop. You're comparing your handwritten letter to someone's word processor. Both work, but one has autocorrect, and you don't. That doesn't make your job less valuable.
The A1c Decoder Ring
Every few months, you'll get your A1c test, and your doctor will either nod approvingly or suggest some adjustments. The A1c is basically your blood sugar's GPA—a 2-3 month average that tells you how you've been doing overall.
Most doctors want you below 7%, which translates to an average blood sugar of about 154 mg/dL. See that? 154 mg/dL average. Not 100. Not 110. One hundred and fifty-four.
If you're rocking a 6.5% A1c, your average is around 140 mg/dL. An 8% puts you at about 183 mg/dL. The goal is steady improvement, not immediate perfection.
And here's something they don't always tell you: an A1c of 6.0% with constant low blood sugars is actually worse than an A1c of 7.2% with stable numbers. The average doesn't show the dangerous roller coaster hiding underneath. Your doctor cares about the whole picture, not just the final number.
Based on my time-in-range that I mentioned above, I’m usually around 6 or lower. But again, this is the optimized outcome of my approach and doesn’t have to be your target.
The Panic Button Guide
Okay, so when should you actually worry?
If you're dropping below 70 mg/dL, that's hypoglycemia, and you need to treat it with fast-acting carbs right now. Below 54? That's severe—treat it, don't drive, and if it keeps happening, call your doctor today, not next week. Personally, I start eating at 85, so I don’t drop too low.
On the flip side, if you're hanging out above 250 mg/dL for hours, check for ketones. One post-pizza spike to 220? Annoying, but not an emergency. Waking up at 280 with ketones? That's a call-your-doctor situation.
But that random 200 after you got stuck in traffic and your stress hormones went bananas? That's just Tuesday. Correct it and move on.
The Facebook Comparison Trap
Let me paint you a picture. Someone posts their CGM screenshot: a perfectly flat line at 95 mg/dL for 24 hours straight. Seventeen people comment "goals!" and "amazing!" You look at your CGM, which resembles a seismograph during an earthquake, and feel like you're failing.
Here's what you don't see:
They might be three weeks into her diagnosis, still producing some insulin (the "honeymoon phase"), and those numbers won't last. Or she's having lows throughout the day that she's overcorrecting, creating a false average. Or she's on an automated system that's doing the heavy lifting. Or maybe—and this is important—she's cherry-picking her best day out of thirty.
Your endocrinologist has access to your full data: every high, every low, every 3 am excursion. If they say your control is good, believe them. They're not grading you on a curve against Facebook's highlight reel.
The Fine Print: Your Mileage May Vary
Everything I've told you comes with an asterisk, because diabetes is personal. Your targets might be different if:
You're a kid or teenager—doctors often set wider targets because growing bodies are unpredictable and low blood sugars during school or sports are genuinely dangerous.
You're pregnant or trying to be—buckle up, because targets get strict. We're talking fasting below 95 mg/dL and one-hour post-meal below 140 mg/dL. It's temporary, it's tough, but it's important.
You're older or dealing with other health issues—your doctor might actually raise your targets to reduce the risk of dangerous lows, especially if you live alone or have trouble recognizing low symptoms.
You're in the honeymoon phase—if you were just diagnosed and you're hitting near-normal numbers easily, enjoy it, but don't get too attached. Most people's remaining insulin production fades within a few months. When your numbers start climbing, it doesn't mean you're doing something wrong. It means your pancreas has fully retired.
The Permission Slip You've Been Waiting For
Here's what I want you to know: that reading of 165 before lunch doesn't define your diabetes management. Neither does the 210 you hit after stress-eating during a work deadline, nor the 60 you dropped to during your evening walk.
What matters is the pattern over days and weeks. What matters is catching those patterns and adjusting—maybe tweaking your insulin-to-carb ratio, maybe changing when you take your long-acting insulin, maybe just accepting that Tuesdays are weird for reasons science hasn't figured out yet.
Good diabetes management looks like spending most of your time between 70 and 180 mg/dL, avoiding dangerous lows, keeping your A1c below 7% (or whatever you and your doctor agree on), and—crucially—living your actual life without constant panic.
You're learning to manually operate a vital organ while also going to work, taking care of your family, pursuing hobbies, and doing everything else that makes life worth living. Some days you'll nail it. Some days, you'll wonder why you bothered counting carbs when your blood sugar did whatever it wanted anyway.
Both of those days count as you showing up and trying. That's the real target.
The 2 am Conversation We Should Have Had
So let's go back to where we started: it's 2:47 am, you're at 145 mg/dL, and you're spiraling. Here's what I'd tell you if I could reach through the screen:
That number is fine. Not perfect, but fine. Give yourself a small insulin dose, and you can go back to sleep. Tomorrow you might notice a pattern and adjust your evening basal rate, or you might realize you had a late snack, or you might discover it was just... Wednesday, and diabetes is weird on Wednesdays.
But tonight? You're okay. Your blood sugar is managed. You're doing a good job at something genuinely difficult.
Close the Facebook group. Put down the phone. Get some sleep.
Tomorrow you'll do it all over again, and that's not a burden—that's what living with diabetes looks like. One day at a time, one correction at a time, one small victory at a time.
You've got this. Even at 2:47 am, when it doesn't feel like it.
These are general guidelines based on common medical recommendations. Your personal targets should always be set with your healthcare provider, who knows your complete health picture and can provide individualized advice.
