Glycemic control and type 2 diabetes mellitus: The optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians

Amir Qaseem*, Sandeep Vijan, Vincenza Snow, J. Thomas Cross, Kevin B. Weiss, Douglas K. Owens

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

119 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)417-422
Number of pages6
JournalAnnals of internal medicine
Volume147
Issue number6
DOIs
StatePublished - Sep 18 2007

ASJC Scopus subject areas

  • Internal Medicine

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