— Theresa, Alabama Yes, there is a safe blood sugar level. It is the optimum range that safely provides the body with adequate amounts of energy. For the average person, it is 70 to 105 mg/dl in a fasting state. (Diabetes is diagnosed when the fasting blood glucose level is at or above 126 mg/dl.) Glucose values vary depending on the time of day, your activity level, and your diet. Your sugar level of 154 mg/dl, which is high, may not have been determined while you were fasting. If it had been, a physician would have repeated the test. Your doctor did, and your level was determined to be normal at 74 mg/dl. In this case, daily monitoring is probably not necessary. If your levels are elevated in the future, you will be diagnosed with diabetes. Treatment can include lifestyle modification, diet, and exercise. If these strategies are not adequate to control your blood glucose level, your physician may prescribe oral medicines or insulin. Having a laboratory examination during your yearly physical and maintaining a healthy lifestyle are adequate for now. Why is it important to keep your glucose level within a normal range? An excess of glucose in the bloodstream causes various chemical changes that lead to damage to our blood vessels, nerves, and cells. Each cell in the body has a function that requires energy, and this energy comes primarily from glucose. The energy allows you to perform various tasks, including talking and walking. It allows your heart to beat and your brain to produce chemicals and signals that help you think, breathe, regulate your internal temperature, and digest and absorb food. The body is a veritable industrial complex! But this complex is also quite delicately balanced. The very cells that process glucose and convert it to energy can be damaged by excess glucose. Imagine a car engine being damaged when it is flooded with gasoline. Good luck with your blood glucose management, and don’t hesitate to ask your doctor about ways to maintain and improve your health. Q2. My mother has type 2 diabetes, and her doctor told her that it was okay to use brown sugar in place of regular sugar in her diet. It seems to me that brown sugar would affect her blood glucose just like any other kind of sugar, so I’d really like to clear this up. Ah! The ever-confusing sugar recommendation. Whether it’s brown sugar, white sugar, raw sugar, sucrose, or fructose, much debate always surrounds this simple crystal. Admittedly, we physicians typically do not keep abreast of all the cutting-edge science in nutrition, and any real dialogue between nutrition scientists and medical doctors seems almost nonexistent. As a result, most patients look to other sources for information — the Internet (which can be misleading), the patient’s friends and family (who can propagate myths), and the pharmaceutical industry (which tries to cash in on the growing market for nutritional pharmaceuticals). Here’s a basic overview of sugars: Sugar is a form of carbohydrate. There are three types of simple sugars that are important to human beings — glucose, fructose, and galactose. Glucose is found in small amounts in some fruits and vegetables. Fructose is the main sugar in honey and fruit; high-fructose corn syrup is also used in many processed foods. Galactose is found in milk, yogurt, and unaged cheese. The most important thing to remember here is that the body converts both fructose and galactose into glucose after digestion. In that light, what’s the difference between white and brown sugar? When glucose and fructose are combined, they make another sugar, called sucrose. Beet sugar, cane sugar (“table,” or white, sugar), molasses (a by-product of sugar refining), and maple syrup are all types of sucrose. Brown sugar is basically white sugar (sucrose) mixed with molasses (also sucrose); it has slightly more calories than white sugar. In terms of the impact on blood glucose levels, there is not much difference between white and brown sugar. All sucrose sugars are broken down to glucose, which is what you measure in your blood. It is best to concentrate on the overall effect of sugar on your mother’s blood glucose level and seek alternative sweeteners or try to avoid sugar completely — no matter its form. Learn more in the Everyday Health Type 2 Diabetes Center.