Fast Five Quiz: Glycemic Control in Type 2 Diabetes

Romesh Khardori, MD, PhD


February 21, 2023

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. For most adult patients with type 2 diabetes, a hemoglobin A1c of ≤7% is a reasonable goal of therapy. Although intensive control of A1c reduces the absolute risk for microvascular complications, it must also be balanced against the risk for hypoglycemia. Less stringent A1c goals (eg, < 8% [64 mmol/mol]) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, or advanced microvascular or macrovascular complications. For example, the ACCORD trial suggested that a target A1c of 7.0%-7.9% may be safer for patients with longstanding type 2 diabetes and those at high risk for cardiovascular disease compared with a target A1c of 6.0%.

Learn more about glycemic targets in type 2 diabetes.


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