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T2 HbA1c guidelines (in the US)

The American College of Physicians (ACP) has published new guidelines regarding bloodglucose control levels for people with Type 2 diabetes. Reported in the American website Medical News Today by Ana Sandoiu in an article entitled, Type 2 diabetes: New guidelines lower blood sugar control levels, reference was made to some studies that seem to show that the HbA1c test may currently be overused in the US, and suggest that such over-testing may lead to over-treating patients with hypoglycemic drugs.

The ACP set out to examine the existing guidelines from several organizations and the evidence available in an effort to help physicians make better, more informed decisions about treating people with Type 2.

The current rationale behind the existing recommendations of a score of 6.5% is that keeping blood sugar this low decreases the risk of microvascular complications over time. However, the ACP found that the evidence for such a reduction was ‘inconsistent’.

Dr Jack Ende, the president of ACP, says: “The evidence shows that for most people with Type 2 diabetes, achieving an HbA1c between 7-8% will best balance long-term benefits with harms such as low blood sugar, medication burden, and costs.”

Additionally, the ACP recommend that patients who are older that 80 years or who live with chronic illnesses such as cancer or congestive heart failure, receive a treatment that focuses on reducing high blood sugar-related symptoms instead of lowering HbA1c levels. The reason for this is that for patients in this category, the potential side effects of hypoglycemic drugs outweigh the advantages.

The American Diabetes Association argued that this advice consider other factors. Read more HERE.

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