Target Blood Chemistry Results for Diabetic Patients

HbA1c Targets

The American Diabetes Association recommends an HbA1c target of <7% for many nonpregnant adults with diabetes 2, 3
The American College of Physicians recommends an HbA1c target range of 7-8% for most patients with type 2 diabetes 4, 5
More stringent targets (closer to 6.5%) may be appropriate for patients with newly diagnosed diabetes, long life expectancy, and no significant cardiovascular disease, if achievable without significant hypoglycemia 1, 4
Less stringent targets (7.5-8.5%) are appropriate for patients with limited life expectancy, extensive comorbid conditions, history of severe hypoglycemia, or advanced complications 6, 5

The American Diabetes Association recommends a preprandial blood glucose target of 80-130 mg/dL 2, 1

The American Diabetes Association recommends a postprandial blood glucose target of <180 mg/dL 2, 1

Hypoglycemia is defined as blood glucose <70 mg/dL 2
Level 2 hypoglycemia (blood glucose <54 mg/dL) requires immediate treatment and may warrant adjustment of glycemic targets 1
Patients with hypoglycemia unawareness, history of severe hypoglycemia, or pattern of unexplained hypoglycemia should have their glycemic targets raised to avoid further hypoglycemia 2, 1

HbA1c should be measured at least twice yearly in patients meeting treatment goals with stable glycemic control 3, 6
HbA1c should be measured quarterly in patients whose therapy has changed or who are not meeting glycemic goals 3, 5
Self-monitoring of blood glucose (SMBG) is an essential tool to assess therapy and detect incipient hypoglycemia 2
Continuous glucose monitoring (CGM) can be particularly useful for patients with complicated diabetes or frequent hypoglycemia 2

The American College of Physicians recommends assessing patient characteristics, such as age and life expectancy, to select appropriate HbA1c targets 7, 5
The American Diabetes Association recommends selecting HbA1c targets based on patient characteristics, such as duration of diabetes and comorbid conditions 3, 4
The American College of Physicians recommends setting corresponding blood glucose targets, such as preprandial and postprandial targets, based on individual HbA1c goals 5, 2

Setting overly aggressive targets (HbA1c <6.5%) for patients with multiple comorbidities or at high risk for hypoglycemia 7, 5
Failing to adjust targets as patient circumstances change (e.g., development of comorbidities, aging) 5
Not considering the increased risk of hypoglycemia with intensive control, especially in patients with renal impairment 5