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Beyond the Guidelines - To What Target Hemoglobin A1c Level Would You Treat This Patient With Type 2 Diabetes? Grand Rounds Discussion From Beth Israel Deaconess Medical Center

Controversy surrounds the optimal glycemic target for treatment of patients with type 2 diabetes (T2D). In this multimedia feature, a general internist and a diabetologist debate how to apply recent divergent professional guideline recommendations to the care of Ms. K, a 60-year-old woman who fears the need for insulin therapy and wonders whether she would gain any benefits from tighter glycemic control.

Use this feature to:

  • Watch the video of Ms. K's interview.
  • Ask yourself what the risks and benefits are of aiming for tight glucose control in patients with T2D. What target hemoglobin A1c level should be used? When should one consider deintensifying hemoglobin A1c goals?
  • Watch the video of the Grand Rounds presentations.
  • What questions would you ask Ms. K? How might her answers influence what you recommend? How would you explain the risks and benefits of tighter or less intense glycemic control to Ms. K? Watch a short cartoon depicting patient worries about “going on the needle.”

Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.

Back to the November 2019 issue of ACP IMpact