title: Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians.
abstract: This guidance statement is derived from other organizations' guidelines and is based on an evaluation of the strengths and weaknesses of the available guidelines. We used the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) appraisal instrument to evaluate the guidelines from various organizations. On the basis of the review of the available guidelines, we recommend: STATEMENT 1: To prevent microvascular complications of diabetes, the goal for glycemic control should be as low as is feasible without undue risk for adverse events or an unacceptable burden on patients. Treatment goals should be based on a discussion of the benefits and harms of specific levels of glycemic control with the patient. A hemoglobin A1c level less than 7% based on individualized assessment is a reasonable goal for many but not all patients. STATEMENT 2: The goal for hemoglobin A1c level should be based on individualized assessment of risk for complications from diabetes, comorbidity, life expectancy, and patient preferences. STATEMENT 3: We recommend further research to assess the optimal level of glycemic control, particularly in the presence of comorbid conditions.
authors: American College of Physicians, Philadelphia, Pennsylvania 19106, USA. aqaseem@acponline.org
authors: Amir
authors: A
authors: Qaseem
authors: Sandeep
authors: S
authors: Vijan
authors: Vincenza
authors: V
authors: Snow
authors: J Thomas
authors: JT
authors: Cross
authors: Kevin B
authors: KB
authors: Weiss
authors: Douglas K
authors: DK
authors: Owens
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin