New Blood Sugar Targets Established for T1DM
(HealthDay News) — New hemoglobin A1c targets have been established for patients of all ages with type 1 diabetes, according to a position statement published online June 16 in Diabetes Care. The position statement was published to coincide with the annual meeting of the American Diabetes Association, held from June 13–17 in San Francisco.
The etiology and pathophysiology of type 1 and type 2 diabetes are distinct and should be considered separately. With this in mind, Jane L. Chiang, MD, from the American Diabetes Association in Alexandria, VA, and colleagues summarized data specific to the comprehensive care of patients with type 1 diabetes.
According to the guidelines, glycemic targets should be individualized with the aim of achieving the best possible control while minimizing the risk of severe hyper- and hypoglycemia. Based on clinical studies and expert opinion, the recommended hemoglobin A1c target should be <7.5 for all pediatric age groups (youth aged <18 years). This target, which is lower than the traditional recommendations, should be pursued as long as patients can avoid severe, recurrent hypoglycemia. For nonpregnant adults, the recommended glycemic target is <7.0%, which reduces the microvascular complications of diabetes. For older adults, the targets vary from <7.5 to <8.5% based on comorbidities. The statement also addresses the diagnosis of diabetes; initial evaluation and follow-up; assessment and treatment of psychosocial issues; monitoring of blood glucose and glycated hemoglobin; treatment options; and specific settings and populations.
"The 7.5% target is evidence-based; however, we want to emphasize that blood glucose and hemoglobin A1c targets must be individualized to safely achieve the best outcomes," Chiang said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.