Myth: HbA1C < 6.5% is a fixed target for all patients with diabetes!
Fact: HbA1C goals need to be individualised based on the patient’s age/life expectancy, duration of diabetes, comorbid conditions, individual patient considerations, hypoglycaemia awareness diabetes history, known CVD or advanced microvascular complications.
Patients should discuss their HbA1C targets with their physician, as an HbA1C level that is safe for one patient may not be safe for another. HbA1C test must be recommended at least two times a year in patients meeting treatment goals (and have stable glycaemic control) and quarterly in patients whose therapy has changed or who are not meeting their glycaemic goals.
The ADA 2015 guidelines for HbA1C targets:
HbA1C < 6.5% (HbA1C goal for selective patients like those with short duration of diabetes, long life expectancy and no significant CVD. Suggested only if achieved without significant risk of hypoglycaemia or other adverse effects of treatment)
HbA1C ≤ 7 % (Reasonable HbA1C goal. If implemented soon after the diagnosis of diabetes has been shown to reduce microvascular complications)
HbA1C 7 to 8% Patient & disease factors are used by physician to set a goal. Taking into consideration - Disease duration, Life expectancy, Important comorbidities, Established vascular complications, Patient attitude and expected treatment efforts, Resources and support system....Dr Amit Gupta senior diabtoligist noida