Rec­om­men­da­tions

6.4 A rea­son­able A1C goal for many nonpreg­nant adults is <7% (53 mmol/‍mol). A

6.5 Providers might rea­son­ably sug­gest more strin­gent A1C goals (such as <6.5% [48 mmol/‍mol]) for se­lect­ed in­di­vid­u­al pa­tients if this can be achieved with­out significant hy­po­glycemia or other ad­verse ef­fects of treat­ment (i.e., polyphar­ma­cy). Ap­pro­pri­ate pa­tients might in­clude those with short du­ra­tion of di­a­betes, type 2 di­a­betes treat­ed with lifestyle or met­formin only, long life ex­pectan­cy, or no significant car­dio­vas­cu­lar dis­ease. C

6.6 Less strin­gent A1C goals (such as <8% [64 mmol/‍mol]) may be ap­pro­pri­ate for pa­tients with a his­to­ry of se­vere hy­po­glycemia, lim­it­ed life ex­pectan­cy, ad­vanced mi­crovas­cu­lar or macrovas­cu­lar com­pli­ca­tions, ex­ten­sive co­mor­bid con­di­tions, or long-‍stand­ing di­a­betes in whom the goal is difficult to achieve de­spite di­a­betes self-‍man­age­ment ed­u­ca­tion, ap­pro­pri­ate glu­cose mon­i­tor­ing, and ef­fec­tive doses of mul­ti­ple glu­cose-‍low­er­ing agents in­clud­ing in­sulin. B

6.7 Reas­sess glycemic tar­gets over time based on the cri­te­ria in Fig. 6.1 or, in older adults, Table 12.1. E