American Diabetes Association

Table 6—

Summary of recommendations for adults with diabetes

Glycemic control

AIC

<7.0%^*

Preprandial plasma glucose

90–130 mg/dl (5.0–7.2 mmol/l)

Postprandial plasma glucose^†

<180 mg/dl (<10.0 mmol/l)

Blood pressure

<130/80 mmHg

Lipids^‡

LDL

<100 mg/dl (<2.6 mmol/l)

Triglycerides

<150 mg/dl (<1.7 mmol/l)

HDL

>40 mg/dl (>1.1 mmol/l)^§

Key concepts in setting glycemic goals:

Goals should be individualized
Certain populations (children, pregnant women, and elderly) require special considerations
Less intensive glycemic goals may be indicated in patients with severe or frequent hypoglycemia
More stringent glycemic goals (i.e. a normal A1C, <6%) may further reduce complications at the cost of increased risk of hypoglycemia (particularly in those with type 1 diabetes)
Postprandial glucose may be targeted if AIC goals are not met despite reaching preprandial glucose goals

Referenced to a nondiabetic range of 4.0–6.0% using a DCCT-based assay.

†

Postprandial glucose measurements should be made 1-2 h after the beginning of the meal, generally peak levels in patients with diabetes.

‡

Current NCEP/ATP III guidelines suggest that in patients with triglycerides 200 mg/dl, the “non-HDL cholesterol” (total cholesterol minus HDL) be utilized. The goal is 130 mg/dl (61).

For women, it has been suggested that the HDL goal be increased by 10 mg/dl.

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