Q: What do I need to know about the new diabetes recommendations?
A: Recently, the American College of Physicians released new guidelines on A1C, which is among the tests used to diagnose type 2 diabetes and prediabetes. If you are already diagnosed with diabetes, the test can also help your physician manage your treatment.
The test gives your physician an average level of your blood sugar over three months. The higher the percentage, the higher a person’s blood glucose levels are. The traditional number for A1C, determined by the American Diabetes Association, was 7 percent. Studies have shown that this level of A1C can help people with diabetes reduce the risk of diabetes complications.
However, the ACP is now suggesting patients and doctors aim for a goal of between 7 percent and 8 percent. Patients who are prone to hypoglycemia can benefit from this slightly less restrictive goal, such as patients over the age of 80, for whom low blood sugar is often less recognized and underreported.
The new recommendations may lead to less aggressive addition of new medications, or slower increase in dosage of existing medications that a patient may already be taking.
Further, the ACP suggests that adults whose A1C level dips below 6.5 percent may decrease their diabetes treatment to prevent that number from going too low, causing hypoglycemia (low blood sugar).
It’s important to remember that these recommendations are best utilized on a case-by-case basis, as many patients with diabetes may still benefit from tighter glucose or blood sugar control.
Patients should discuss these new recommendations with their doctor, especially if they are noticing frequent episodes of hypoglycemia.
Erik Polan, DO, is an internal medicine physician at Philadelphia College of Osteopathic Medicine.