Patient-Centered Approach to Type 2 Diabetes

Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Glycemic Targets:

1. Target HbA1c < 7.0%

• In most patients to reduce the incidence of microvascular disease
• Mean plasma glucose of ~ 8.3-8.9 mmol/L
• Fasting and premeal glucose < 7.2mmol/L
• Postprandial glucose < 10 mmol/L

2. Target more stringent HbA1c (e.g., 6.0-6.5%)

• In selected patients such as short disease duration, long life expectancy, no significant cardiovascular disease (CVD) if this can be achieved without significant hypoglycemia or other adverse effects of treatment

 

3. Target less stringent HbA1c (e.g., 7.5-8.0% or even slightly higher)

• In patients with history of severe hypoglycemia, limited life expectancy, advanced complications, extensive comorbid conditions and those in whom the target is difficult to attain despite intensive self-managment education, repeated counseling, and effective doses of multiple gluocse-lowering agents, including insulin.

 

Reference:

1. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012;25:1364-79