Diabetes and serious mental illness often coincide, making the treatment of both conditions difficult and leading to higher rates of complications.1
The American Diabetes Association (ADA)’s “Standards of Medical Care in Diabetes” recognizes that hemoglobin A1C targets for patients should be individualized.2 We consider it important to discuss challenges and limitations with each patient.
For example, a more lenient A1C goal may be appropriate when:
the assessment of the patient shows that he or she is struggling with active symptoms of mental illness
new medications with undesirable metabolic effects are prescribed or titrated
social support is poor
patients have limited confidence in their ability to accomplish tasks and goals