From the Journals

ACP recommends new ideal hemoglobin A1c range for type 2 diabetes



Physicians should aim for hemoglobin A1c levels between 7% and 8% in patients with type 2 diabetes, according to recommendations by the American College of Physicians.

But the guidance drew strong condemnation from diabetes and endocrinology organizations, which warned the higher target range could do more harm than good.

Evidence presented in the ACP statement shows the intensive therapy commonly used to reach the previous target of 6.5%-7% is likely either to increase risk of adverse cardiovascular and hypoglycemic events or have the same risk as less intensive therapy.

“Treatment with drugs targeted to 7%, in contrast to 8%, does not prevent heart attacks or strokes,” said Jack Ende, MD, president of the ACP. “But it does result in substantial harm, including low blood sugar, increased medication burden, and increased cost.”

The ACP recommends clinicians should talk with patients about creating personalized treatment plans based on the risks and benefits of different drugs, what the patients prefers, life expectancy, and cost of care.


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