Table 6—

Summary of recommendations for adults with diabetes mellitus

Glycemic control
    A1C<7.0%*
    Preprandial plasma glucose90–130 mg/dl (5.0–7.2 mmol/l)
    Peak 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 intensive glycemic goals may further reduce microvascular complications at the cost of increasing 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.

  • 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 (53).

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