Skill Checkup: A 65-Year-Old Woman With Treated Type 2 Diabetes Presents With Shortness of Breath and Lightheadedness

Romesh Khardori, MD, PhD


February 23, 2023

In usual clinical care, measurement of HbA1C gives the most complete picture of a patient's diabetes control because it reflects glycemic control over time. The current recommendations from the American Diabetes Association (ADA) state that most patients should strive for a glycemic goal < 7.0%. For individual patients, the goal can be modified on the basis of patients' factors such as older age, higher risk for hypoglycemia, or multiple comorbidities, such patients may be better served with a goal between 7.0% and 8.0%. More stringent goals may be beneficial in some patients but have also been associated with more hypoglycemia and potential complications.

Despite this patient's newly diagnosed HFrEF, she has few other comorbidities and is otherwise active and relatively healthy. For her, a target goal < 7.0% as recommended would be beneficial and, if achieved, reduce her risk for diabetes complications in the years ahead.


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