American College of Physicians lowers blood sugar goals

Henrietta Strickland
March 6, 2018

Guidance has been developed for hemoglobin A1c (HbA1c) targets for glycemic control among nonpregnant adults with type 2 diabetes; the guidance statement was published online March 6 in the Annals of Internal Medicine.

The ACP now not only recommends aiming for an HbA1c level of between 7 and 8 percent but also advises that people who dip below 6.5 percent have their diabetes medication doses lowered.

According to the most recent estimates, nearly 30 million people in the United States have type 2 diabetes, which amounts to over 9 percent of the entire US population. The way doctors can tell how well-controlled a diabetic is is with a blood test called A1C, which measures a person's average blood sugar level over the previous two or three months.

But some studies have pointed out that the HbA1c test may now be overused in the US, and they have suggested that such over-testing may lead to over-treating patients with hypoglycemic drugs.

Additionally, as some researchers have pointed out, "Excessive testing contributes to the growing problem of waste in healthcare and increased patient burden in diabetes management".

Around 29 million Americans have type 2 diabetes and half a dozen medical groups are working to find out the best treatment guidelines for them. It's recommending an A1C level between 7 and 8 percent. That's because the main goal of treatment for this group is to prevent symptoms that occur from high blood sugar, such as increased urination, dehydration, and unwanted weight loss, he adds.

"The evidence for reducing serious complications was inconsistent", Dr. Ende said.

Achieving the lower A1C numbers often requires taking more than one drug or higher doses, which raises the risks of sometimes driving blood sugar too low which can be very unsafe.

The reason for this is that for patients in this category, the potential side effects of hypoglycemic drugs outweigh the advantages.

The new guidelines unveil that a lower treatment target along with diet and lifestyle modifications is completely appropriate.

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