HbA1c Targets Should Be Personalized in Type 2 Diabetes
WEDNESDAY, June 20, 2018 -- For non-pregnant adults with type 2 diabetes, hemoglobin A1c (HbA1c) targets should be personalized, according to a Clinical Guidelines Synopsis published in the June 19 issue of the Journal of the American Medical Association.
Elizabeth L. Tung, M.D., from the University of Chicago, and colleagues developed an updated guidance statement relating to optimal glycemic targets for non-pregnant adults with type 2 diabetes.
The authors note that HbA1c goals should be personalized for patients with type 2 diabetes based on discussions of the benefits and harms of pharmacotherapy, patient preferences, health, and life expectancy; the burden of treatment; and costs associated with care. In most patients with type 2 diabetes, the target should be an HbA1c level between 7 and 8 percent. For patients with type 2 diabetes and HbA1c levels <6.5 percent, deintensification of pharmacologic therapy should be considered. For patients with a life expectancy of less than 10 years due to advanced age, nursing home residence, or end-stage chronic conditions, type 2 diabetes should be treated to minimize hyperglycemia symptoms and HbA1c targets should be avoided.
"High-quality, long-term randomized trials have improved knowledge of glycemic control in type 2 diabetes, but important gaps remain," the authors write. "Despite consensus that personalizing goals for glycemic control is important, little evidence exists for how to personalize goals consistently."
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Posted: June 2018