Fast Five Quiz: Glycemic Control in Type 2 Diabetes

Romesh Khardori, MD, PhD


January 12, 2022

Although the American Diabetes Association does propose general glycemic targets, it also stresses the importance of individualizing A1c goals to take into account patient-specific criteria, including hypoglycemia risk, disease duration, life expectancy, comorbidities, vascular complications, patient preference, and the patient's resources and support system. These individualized targets should also be revisited over time with these factors in mind.

Research has shown that an A1c target less than 7% (less than 53 mmol/mol) reduces microvascular complications, and so this is an appropriate goal for many adult nonpregnant women and men. More stringent goals (eg, less than 6.5% [48 mmol/mol]) may be acceptable if this can be achieved safely without hypoglycemia or other treatment-related adverse effects. But less stringent A1c goals (eg, less than 8% [64 mmol/mol]) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular complications. These less stringent goals may also apply where long-standing uncontrolled diabetes remains despite self-management education; appropriate glucose monitoring; and effective doses of multiple glucose-lowering agents, including insulin.

Learn more about glycemic targets in type 2 diabetes.


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