Table 6— Summary of recommendations for adults with diabetes

Glycemic control
    A1C <7.0%*
    Preprandial capillary plasma glucose 90–130 mg/dl (5.0–7.2 mmol/l)
    Peak postprandial capillary plasma glucose{dagger} <180 mg/dl (<10.0 mmol/l)
    Blood pressure <130/80 mmHg
Lipids{ddagger}
    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:
    • A1C is the primary target for glycemic control
    • Goals should be individualized
    • Certain populations (children, pregnant women, and elderly) require special considerations
    • More stringent glycemic goals (i.e., a normal A1C, <6%) may further reduce complications at the cost of increased risk of hypoglycemia
    • Less intensive glycemic goals may be indicated in patients with severe or frequent hypoglycemia
    • Postprandial glucose may be targeted if A1C goals are not met despite reaching preprandial glucose goals

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

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

{ddagger} 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 (34).

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