@A DiabetesTeam Member sustained high blood sugar causes vascular damage - all diabetic complications are "vascular related" at their core

There is two broad types of vascular systems in the body that are damaged by sustained high blood sugar

Micro-Vascular, which damages the Eyes (retinopathy), Kidney's (nephropathy) and the Brain (Vascular Dementia), and

Macro-Vascular, which is the Heart and Large Veins/Arteries which lead to Peripheral Neuropathy, and Atherosclerotic Cardiovascular Disease (ASCVD) which can result in Stroke but more often, Congestive Heart Failure

Where the 8.7 and 7.8 (154 and 140) fits into the equation

At sustained levels above 8.7/154 that's where the "micro" damage occurs - so staying "below" 8.7 better than 75% of the time protects the eyes, brain and kidneys but still damages the (heart) and major blood vessels

To protect the Heart/Major Vessels you need to keep your sugar below 7.8, 75% of the time

This is why most Diabetics develop some level of Peripheral Neuropathy - you don't have to run "too high for too long" to mess up the Femoral Artery and then the smaller vessels it feeds in the Feet (which is where Neuropathy typically starts)

The Heart is kinda tough and it can take 20 years (of abuse give or take) to do you in even at elevated levels, but you would see the (complications) of congestive failure your last decade before it takes you out (sorry, it's blunt)

And of course "most" Diabetics do not have Diabetes in isolation - add in high cholesterol, blood pressure or triglycerides as well - all trying to do in our heart on their own, makes for a dangerous game - this is why something like 85% of Diabetics die from a (vascular event or disease)

But, if controlling to 7.8 is a little out of reach, keeping below 8.7 (again 75% of the time or better) does protect against vision, kidney and dementia problems - at least from blood sugar

Summary

Under 10.0 - better than nothing and buys you an extra 10 years
Under 8.7 - protects eyes, kidneys, brain
Under 7.8 - protects above plus the Macro (large vessel) Vascular system including the heart

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A Diabete...

We tested my wife who is non diabetic a couple of times after she consumed a high carb meal and her bg was 9.3 (167.4) and 10.1 (181.8) about an hour later. About 30 minutes later we tested and it was back to her baseline..4.5 (81) and 4.8 (86.4).. Her pancreas works just fine.. My system is incapable of this even with large doses of insulin which is why I maintain a very low carb diet. 😃

I was close - it's a Diabetes UK article

This is a (chart) from the piece

A Non-Diabetic can peak out at "1 hour after eating" just like a Diabetic although their own insulin is also faster to attack the peak (and they have less insulin resistance)

Where we cross the line is, without some kind of management or treatment we will still be above 7.8 mmols "2 hours" after eating

It's not the "peak" that gets us, it's the staying up there "too long" before returning to the Sub 7.8 level (this is the basis for the Tight Time In Range (TITR) of trying to stay below 7.8 or 140 "more than" 75% of the time with significant benefit every % above 75% that we can manage)

So it's not that they don't peak out, it's just their system recovers and they return to normal range AND their system does try to keep them below that 8'ish level during the whole digestive process but it wouldn't be (abnormal) for a non-diabetic to peak out around 10.0 (180) within the first hour of eating

And @A DiabetesTeam Member that 180 (10.0 mmols) at 2 hours after eating is just the "basic level of control" - it's not "great" - at those levels you will still develop complications but you will likely "delay" them for about 10 years (beyond doing nothing) but if you want to minimize or prevent Diabetic complications then keeping your two hour post meal number below 7.8 mmols/140 points is the best way - if you maintain "mostly" non-diabetic numbers you don't get the complications and 180 is not going to do it, but given that over 70% of Type 2's are "worse than that", that is what the medical community has determined to be an "initial target" - get them there and at least buy them a bit of time - ask your Doc to be honest and you may not like the answer

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A Diabete...