Table 6—

Summary of recommendations for adults with diabetes

Glycemic control
    A1C<7.0%*
    Preprandial capillary plasma glucose90–130 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 (>1.0 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 (121).

  • §

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