Skill Checkup: A 55-Year-Old Man With Type 2 Diabetes and High A1C Level Despite Previous Treatments

Romesh Khardori, MD, PhD


April 27, 2023

In usual clinical care, the 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%. More stringent goals may be beneficial in some patients, like this one, who have few comorbid illnesses and no evidence to date of cardiovascular or renal disease. Lower goals may be associated with more hypoglycemia and potential complications in older patients or those with more comorbidity, and for such patients, a goal between 7.0% and 8.0% may be better. Given this patient's younger age and relative fitness, a target goal of 6.5% could be beneficial and, if achieved, reduce his risk for diabetes complications in the years ahead.


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