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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

The American College of Physicians developed this guidance statement to guide clinicians in selecting targets for pharmacologic treatment of type 2 diabetes.

Guidance Statement 1:  Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy, treatment burden, and costs of care.

Guidance Statement 2:  Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes.

Guidance Statement 3:  Clinicians should consider deintensifying pharmacologic therapy in patients with type 2 diabetes who achieve HbA1c levels less than 6.5%.

Guidance Statement 4:  Clinicians should treat patients with type 2 diabetes to minimize symptoms related to hyperglycemia and avoid targeting an HbA1c level in patients with a life expectancy less than 10 years due to advanced age (80 years or older), residence in a nursing home, or chronic conditions (such as dementia, cancer, end-stage kidney disease, or severe chronic obstructive pulmonary disease or congestive heart failure) because the harms outweigh the benefits in this population.

About Annals Article

Many articles published in the Annals of Internal Medicine (annals.org) offer CME credit and MOC points, earned by reading the articles and subsequently completing a multiple-choice quiz to demonstrate knowledge. Note that CME and MOC availability typically expires 3 years after article publication, but quizzes remain available to allow learners to test their knowledge.


Details

CME/MOC:

Up to 1 AMA PRA Category 1 Credits ™ and MOC Points
Expires March 6, 2021   active

Cost:

Free to Members

Format:

Journal-Based Article

Product:

Annals Article

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