Blood Glucose Testing Recommendations for Type 2 Diabetes

HbA1c Monitoring Frequency

The American Diabetes Association recommends measuring HbA1c every 3 months until glycemic targets are achieved, then reduce frequency to every 6 months for those with stable control 1, 2
For patients with type 2 diabetes, test HbA1c quarterly (every 3 months) when therapy has recently changed or when patients are not meeting glycemic goals 1, 2, 3
For patients with stable control, test HbA1c every 6 months 1, 2, 3, 4

Patients taking insulin or medications with hypoglycemia risk should perform finger-stick blood glucose monitoring 3, 5
Patients on multiple daily insulin injections or insulin pump therapy should test 3 or more times daily 3

CGM is indicated for patients with unexplained severe or recurrent hypoglycemia, asymptomatic hypoglycemia or nocturnal hypoglycemia, hypoglycemia unawareness, large blood glucose excursions, or refractory hyperglycemia 3, 6

The American Diabetes Association recommends a target HbA1c <7% (53 mmol/mol) for most nonpregnant adults with type 2 diabetes 1, 2, 6, 7
Consider HbA1c <6.5% for patients with short duration of diabetes, long life expectancy, no existing complications, and no significant cardiovascular disease 1, 2, 6
Target HbA1c <8% for patients with history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, or long-standing diabetes difficult to control despite comprehensive treatment 1, 2, 4, 6

Only use NGSP-certified HbA1c methods traceable to the DCCT reference assay 1, 2
Ensure patients receive proper SMBG training and routine follow-up evaluation of technique and data interpretation 3