Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-

Establish target A1C based on individual characteristics (22) • A1C <6.5% (adults with type 2 diabetes if at low risk of hypoglycemia) O Rationale: to reduce the risk of CKD and retinopathy • A1C <7.0% (most people) O Rationale: Shown to reduce long-termmicrovascular complications in people newly diagnosed with type 2 diabetes.(3) o A1C 7.1-8.0%: Functionally dependent. o A1C 7.1-8.5%: Limited life expectancy, frail elderly and/or dementia. ▪ Pre-existing diabetes with history of recurrent severe hypoglycemia and/or hypoglycemia unawareness. o Goal: To strictly prevent hypoglycemia in these individuals (23). o Avoid higher A1C to minimize risk of symptomatic hyperglycemia and acute and chronic complications o Rationale: Potential risks outweigh the benefits of intensive glycemic control (limited life expectancy, multiple comorbidities, high risk of hypoglycemia or individual values/preference). • A1C up to 8.5%