ACP's diabetes guidelines: HbA1c 7-8% for most.

[PlutoBoy]

Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update From the American College of Physicians

In new guidance, the American College of Physicians (ACP) recommends a target HbA1c of 7% to 8% for most nonpregnant adults with type 2 diabetes.

ACP Guidance Statement on HbA | Annals of Internal Medicine | American College of Physicians

Thoughts? The ADA and AACE stand by the current target <7% for most people.

I wonder what this will do to quality measures.

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[alternatecharacter]

I mean it's always been clear a one size fits all goal doesn't make sense. The 92 yo with every complication from diabetes should be getting an A1c goal 2-3% higher than the 29 yo with no complications from dm2 and a long life ahead of him. Quality measures have nothing to do with quality care, unfortunately.

And for the record, for the 29 yo I'd recommend <6.5

 

[PlutoBoy]

I mean it's always been clear a one size fits all goal doesn't make sense. The 92 yo with every complication from diabetes should be getting an A1c goal 2-3% higher than the 29 yo with no complications from dm2 and a long life ahead of him. Quality measures have nothing to do with quality care, unfortunately.

And for the record, for the 29 yo I'd recommend <6.5

All groups (ACP and ADA/AACE) advocate for individualizing therapy. The difference is that the ACP is recommending a less intense treatment regiment and even calls for deescalation of therapy for patients with a HbA1c <6.5%, in general.

FWIW, I intend to follow the recommendations of the ADA.

 

[rokshana]

http://media.aace.com/press-release...ogists-american-diabetes-association-american

individualized therapy is the key with the avoidance of hypoglycemia...to give a blanket statement that the same level of control is appropriate for everyone is just bad medicine.