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 |
<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: |
|
| • 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.
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 (34).
For women, it has been suggested that the HDL goal be increased by 10 mg/dl.