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Targets for Glycemic Control

Targets for Glycemic Control. Key Messages Optimal glycemic control is fundamental to the management of diabetes. Both fasting and postprandial plasma glucose levels correlate with the risk of complications and contribute to the measured glycated hemoglobin value. Targets for Glycemic Control.

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Targets for Glycemic Control

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  1. Targets for Glycemic Control Key Messages • Optimal glycemic control is fundamental to the management of diabetes. • Both fasting and postprandial plasma glucose levels correlate with the risk of complications and contribute to the measured glycated hemoglobin value.

  2. Targets for Glycemic Control Key Messages • When setting treatment goals and strategies, consideration must be given to individual risk factors such as age, prognosis, presence of diabetes complications or comorbidities, and their risk for and ability to perceive hypoglycemia.

  3. Targets for Glycemic Control 2008 CPG Recommendations • Glycemic targets must be individualized; however, therapy in most individuals with type 1 or type 2 diabetes should be targeted to achieve an A1C ≤ 7.0% in order to reduce the risk of microvascular [Grade A, Level 1A (1-4)] and, in individuals with type 1 diabetes, macrovascular complications [Grade C, Level 3 (5)].

  4. Targets for Glycemic Control 2008 CPG Recommendations • A target A1C of ≤ 6.5% may be considered in some patients with type 2 diabetes to further lower the risk of nephropathy [Grade A Level 1A (4)], but this must be balanced against the risk of hypoglycemia [Grade A Level 1A (4,5)] and increased mortality in patients who are at significantly elevated risk of cardiovascular disease [Grade A Level 1A (4)].

  5. Targets for Glycemic Control 2008 CPG Recommendations • In order to achieve A1C of ≤ 7.0%, people with diabetes should aim for: • An FPG or preprandial PG target of 4.0 to 7.0 mmol/L [Grade B, Level 2 (1), for type 1; Grade B, Level 2 (2,3), for type 2 diabetes]; and • A 2-hour postprandial PG target of 5.0 to 10.0 mmol/L [Grade B, Level 2 (1), for type 1 diabetes; Grade B, Level 2 (2,3), for type 2 diabetes]. If A1C targets cannot be achieved with a postprandial target of 5.0 to 10.0 mmol/L, further postprandial BG lowering to 5.0 to 8.0 mmol/L can be considered [Grade D, Consensus, for type 1 diabetes; Grade D, Level 4 (18,19), for type 2 diabetes].

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