Treatment Targets

Glycaemic control is fundamental to the management of diabetes. Glycaemic control is best judged by the combination of the results of the patient's HBGM measurements and the current HbAlC value. The HbAlC should be used not only to assess the patient's control over the preceding 2-3 months but also as a check on the accuracy of the metre and the self-reported measurements as well as the adequacy of the HBGM testing schedule [28]. The goal is to achieve an HbAlC as close to normal as possible - representing normal fasting and postprandial glucose concentrations - in the absence of hypogly-caemia. However, the goal can be difficult to achieve. According to the American Diabetes Association (ADA), treatment regimens that reduce average HbAlC to <7.0%, preprandial plasma glucose between 5.0 and 7.3 mM and peak postprandial plasma glucose <10 mM in non-pregnant individuals are recommendable [28] (Table 2). As seen in Table 2 the recommended targets for the glycaemic control judged by HbAlC is slightly lower for the International Diabetes Federation (IDF) and American Association for Clinical Endocrinology than for ADA. Less-stringent treatment goals are appropriate in people with severe or frequent hypogly-caemia and in people with limited life expectancy or older adults.

Table 2. Targets for the glycaemic control according to the American Diabetes Association (ADA), the International Diabetes Federation (IDF) and the American Association of Clinical Endocrinologists (AAEC).

ADA

IDF

AAEC

HbA1C %

<7.0

<6.5

<6.5

F-PG mM

5.0-7.3

<6.0

<6.0

PP-PG mM

<10.0

<7.5

<7.8

F-PG mM, fasting plasma glucose in mM; PP-PG mM, postprandial plasma glucose in mM

F-PG mM, fasting plasma glucose in mM; PP-PG mM, postprandial plasma glucose in mM

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