Table 8—

Summary of glycemic recommendations for adults with diabetes

A1C<7.0%*
Preprandial capillary plasma glucose70–130 mg/dl (3.9–7.2 mmol/l)
Peak postprandial capillary plasma glucose<180 mg/dl (<10.0 mmol/l)
Key concepts in setting glycemic goals:
  • A1C is the primary target for glycemic control

  • Goals should be individualized based on:

    • duration of diabetes

    • pregnancy status

    • age

    • comorbid conditions

    • hypoglycemia unawareness

    • individual patient considerations

  • More stringent glycemic goals (i.e., a normal A1C, <6%) may further reduce complications at the cost of increased risk of 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.