What is A1C and why is it important for diabetics. How often should A1C be tested. What are the target A1C levels for diabetics. How can diabetics lower their A1C. What factors can affect A1C test results. How does A1C relate to daily blood glucose monitoring. What are the risks of high A1C levels.

Understanding A1C: The Key to Long-Term Diabetes Management

A1C, also known as glycated hemoglobin or HbA1c, is a crucial measure for diabetics to understand and monitor their blood glucose control over time. But what exactly is A1C, and why is it so important?

A1C reflects the average blood glucose levels over the past 2-3 months. It provides a more comprehensive picture of glucose control compared to daily blood sugar readings. As glucose circulates in the bloodstream, it attaches to hemoglobin in red blood cells. The higher the blood glucose levels, the more glucose binds to hemoglobin, resulting in a higher A1C percentage.

How is A1C measured?

A1C is measured through a simple blood test that can be done at any time of day, without the need for fasting. The result is expressed as a percentage, representing the portion of hemoglobin that has glucose attached.

Why is A1C important for diabetics?

• Provides a long-term view of glucose control
• Helps predict the risk of diabetes complications
• Guides treatment decisions and medication adjustments
• Serves as a benchmark for evaluating diabetes management strategies

Target A1C Levels: What Should a Diabetic’s A1C Be?

Determining the ideal A1C target for diabetics is not a one-size-fits-all approach. Different organizations provide slightly varying recommendations, and individual factors play a significant role in setting personalized goals.

General A1C targets for diabetics:

• American Diabetes Association (ADA): Less than 7%
• American College of Endocrinology: Less than 6.5%
• For some individuals: Less than 6% (with proper medical guidance)

Is a lower A1C always better for diabetics? While lower A1C levels generally indicate better glucose control, extremely low levels may increase the risk of hypoglycemia in some individuals. It’s crucial to work with a healthcare provider to determine the most appropriate A1C target based on factors such as age, overall health, risk of complications, and lifestyle.

Interpreting A1C Results: What Do the Numbers Mean?

Understanding A1C results is essential for effective diabetes management. Here’s a breakdown of what different A1C percentages indicate:

• 4-5.6%: Normal (non-diabetic) range
• 5.7-6.4%: Prediabetes
• 6.5% and above: Diabetes

To better understand how A1C relates to average blood glucose levels, consider this conversion chart:

Strategies for Lowering A1C in Diabetics

Achieving and maintaining target A1C levels is a primary goal for diabetics. Here are some effective strategies to help lower A1C:

1. Consistent blood glucose monitoring
2. Balanced diet and meal planning
3. Regular physical activity
4. Medication adherence
5. Stress management
6. Adequate sleep
7. Regular check-ups with healthcare providers

Can lifestyle changes significantly impact A1C levels? Absolutely. Many diabetics have successfully lowered their A1C through dedicated lifestyle modifications. However, it’s essential to remember that sustainable changes often yield the best long-term results.

The Relationship Between A1C and Daily Blood Glucose Monitoring

While A1C provides valuable information about long-term glucose control, it doesn’t replace the need for daily blood glucose monitoring. Both measures serve important but distinct purposes in diabetes management.

A1C vs. Daily Blood Glucose Monitoring:

• A1C: Reflects average glucose levels over 2-3 months
• Daily monitoring: Provides real-time glucose information

Why is daily monitoring still crucial despite A1C tests? Daily glucose checks help identify immediate fluctuations, guide insulin dosing, and detect patterns that may not be evident from A1C alone. For example, two individuals with the same A1C might have vastly different daily glucose patterns, highlighting the importance of both measures.

Factors Affecting A1C Test Accuracy

While A1C is generally a reliable indicator of glucose control, certain factors can influence its accuracy. Understanding these potential confounding factors is crucial for proper interpretation of A1C results.

Conditions that may affect A1C accuracy:

• Hemoglobin variants
• Anemia
• Iron deficiency
• Recent blood transfusions
• Certain medications

When might alternative tests be necessary? If there’s a significant discrepancy between A1C results and daily blood glucose patterns, healthcare providers may recommend alternative tests like fructosamine or glycated albumin to assess glucose control.

The Impact of High A1C on Long-Term Health

Consistently elevated A1C levels can have serious implications for long-term health in diabetics. Understanding these risks can serve as a powerful motivator for maintaining good glucose control.

Potential complications associated with high A1C:

• Cardiovascular disease
• Kidney damage (nephropathy)
• Eye damage (retinopathy)
• Nerve damage (neuropathy)
• Increased risk of infections
• Slower wound healing

How quickly can lowering A1C reduce complication risks? Research suggests that even modest improvements in A1C can significantly reduce the risk of diabetes-related complications. However, the full benefits of improved glucose control may take years to manifest, emphasizing the importance of consistent long-term management.

Frequency of A1C Testing: How Often Should Diabetics Get Checked?

Regular A1C testing is an essential component of diabetes management. The frequency of testing may vary depending on individual circumstances and the stability of glucose control.

General recommendations for A1C testing frequency:

• For well-controlled diabetes: At least twice a year
• For uncontrolled diabetes or recent treatment changes: Every three months
• During pregnancy with diabetes: More frequent testing may be necessary

Should A1C testing frequency change over time? As diabetes management improves and A1C levels stabilize, some healthcare providers may recommend less frequent testing. However, it’s crucial to maintain regular check-ups and adjust testing frequency based on individual needs and circumstances.

In conclusion, understanding and managing A1C levels is a critical aspect of diabetes care. By working closely with healthcare providers, setting appropriate targets, and implementing effective management strategies, diabetics can optimize their glucose control and reduce the risk of long-term complications. Remember, A1C is just one piece of the diabetes management puzzle – a comprehensive approach that includes daily monitoring, lifestyle modifications, and regular medical care is key to achieving optimal health outcomes.

Understanding Your Average Blood Sugar :: Diabetes Education Online

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A1c is an average of all your blood sugars.

It does not tell you your blood sugar patterns. Use it only as yet another indicator of how well you’re doing.

Glysolated Hemoglobin (or A1c) is a measure of your average blood glucose control over the previous three months.

Glucose attaches to hemoglobin the oxygen carrying molecule in red blood cells. The glucose-hemoglobin unit is called glycosolated hemoglobin. As red blood cells live an average of three months, the glycosolated hemoglobin reflects the sugar exposure to the cells over that time.

The higher the amount of glucose in the blood, the higher the percentage of hemoglobin molecules that will have glucose attached. Think of the A1c as a long-term blood glucose measure that changes very gradually as red blood cells die and are replaced by new cells.

The A1c doesn’t replace self blood-glucose monitoring. Because the A1c is an average of all your blood sugars, it does not tell you your blood sugar patterns. For example, one person with frequent highs and lows can have the same A1c as another person with very stable blood sugars that don’t vary too much.

So what’s the point?

A1c is yet another indicator of how well you’re doing.

• An A1c measurement between 4-6% is considered the range that someone without diabetes will have.
• The American Diabetes Association goal is an A1c less than 7%. Research has shown that an A1c less than 7% lowers risk for complications.
• The American College of Endocrinology goal is an A1c less than 6.5%.
• For some people with diabetes an A1c goal of less than 6% is appropriate.
• Talk with your doctor about your A1c goal.

Use this chart to view A1c values and comparable blood glucose values:

A note of caution: the A1c measurement is not always accurate. For example, if someone has certain type of hemoglobin mutations (variation in the hemoglobin structure), is severely anemic (low red blood cell count), iron deficient or is being treated blood transfusions or medications to increase the production of new red blood cells, the A1c test may not be accurate.

If your finger-stick blood tests give an average blood sugar that is much higher or lower than your A1c test, ask your doctor if the A1c is the right test for you. An alternative test to the A1c is a fructosamine test. Unfortunately, the fructosamine test and the A1c are not interchangeable because they are measuring different things. The fructosamine test reflects the average blood sugars only over a 2-3 week period.

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Managing A1C in Adults with Type 2 Diabetes

Your body needs insulin to use sugar for energy

The hormone insulin helps your body use or store the blood sugar it gets from food. Read more about type 2 diabetes below or go to the
American Diabetes Association (ADA) website for more information.

If you have type 2 diabetes:

Your body doesn’t make enough insulin, doesn’t use insulin well, or both.

Since the sugar is not being used for energy, it stays in your blood.

This leads to high blood sugar. Over time, this could hurt your eyes, kidneys, nerves, heart, and blood vessels.

A normal level for A1C is at 5.7% or below. Prediabetes A1C levels are 5.7% to 6.4%. Type 2 diabetes A1C levels are 6.5% and above.

What the A1C test does

The A1C test measures your average blood sugar level over the past 2 to 3 months. The higher your blood sugar or A1C level, the higher your risk of developing diabetes-related problems. Usually, people with type 2 diabetes get an A1C test at least twice a year.

What the results mean

A1C levels are numbers in the form of a percentage. A high percentage means a high blood sugar level. According to the ADA, the goal for most adults with type 2 diabetes is an A1C level that is less than 7%.

Your doctor will help you set your individual goal.

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What does weight have to do with type 2 diabetes?

One thing that can increase the risk of type 2 diabetes is being overweight. It can lead to your body having a harder time using the insulin it makes because it has trouble using sugar in the blood.

Your pancreas keeps making insulin, but your body doesn’t respond to insulin like it used to.

Losing weight could help improve how your body responds to the insulin it makes and help lower blood sugar.

According to the American Diabetes Association (ADA), sometimes, losing just 5%-7% of your body weight is enough to improve diabetes control. For someone who weighs 200 lb, this is a weight loss of just 10-15 lb.

How can I manage my type 2 diabetes?

You and your doctor will work together to make an appropriate treatment plan for your type 2 diabetes. This can include eating healthy, exercising more, and possibly taking a diabetes medication. These changes may help you reach a healthier blood-sugar level and weight.

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SAFETY SUMMARY WITH WARNINGS

Warnings –

Mounjaro may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. If you have any of these symptoms, tell your healthcare provider.

• Do not use Mounjaro if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
• Do not use Mounjaro if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Do not use Mounjaro if you are allergic to it or any of the ingredients in Mounjaro.

Mounjaro may cause serious side effects, including:

Inflammation of the pancreas (pancreatitis). Stop using Mounjaro and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.

Low blood sugar (hypoglycemia). Your risk for getting low blood sugar may be higher if you use Mounjaro with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood sugar may include dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, or mood changes, hunger, weakness and feeling jittery.

Serious allergic reactions. Stop using Mounjaro and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, and very rapid heartbeat.

Kidney problems (kidney failure). In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems to get worse. It is important for you to drink fluids to help reduce your chance of dehydration.

Severe stomach problems. Stomach problems, sometimes severe, have been reported in people who use Mounjaro. Tell your healthcare provider if you have stomach problems that are severe or will not go away.

Changes in vision. Tell your healthcare provider if you have changes in vision during treatment with Mounjaro.

Gallbladder problems. Gallbladder problems have happened in some people who use Mounjaro. Tell your healthcare provider right away if you get symptoms of gallbladder problems, which may include pain in your upper stomach (abdomen), fever, yellowing of skin or eyes (jaundice), and clay-colored stools.

Common side effects

The most common side effects of Mounjaro include nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach (abdominal) pain. These are not all the possible side effects of Mounjaro. Talk to your healthcare provider about any side effect that bothers you or doesn’t go away.

Tell your healthcare provider if you have any side effects. You can report side effects at 1-800-FDA-1088 or
www.fda.gov/medwatch
.

Before using Mounjaro

• Your healthcare provider should show you how to use Mounjaro before you use it for the first time.
• Talk to your healthcare provider about low blood sugar and how to manage it.
• If you take birth control pills by mouth, talk to your healthcare provider before you use Mounjaro. Birth control pills may not work as well while using Mounjaro. Your healthcare provider may recommend another type of birth control for 4 weeks after you start Mounjaro and for 4 weeks after each increase in your dose of Mounjaro.

Review these questions with your healthcare provider:

• Do you have other medical conditions, including problems with your pancreas or kidneys, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food?
• Do you take other diabetes medicines, such as insulin or sulfonylureas?
• Do you have a history of diabetic retinopathy?
• Are you pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed? It is not known if Mounjaro will harm your unborn baby or pass into your breast milk.
• Do you take any other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements?

How to take

• Read the Instructions for Use that come with Mounjaro.
• Use Mounjaro exactly as your healthcare provider says.
• Mounjaro is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm.
• Use Mounjaro 1 time each week, at any time of the day.
• Do not mix insulin and Mounjaro together in the same injection.
• You may give an injection of Mounjaro and insulin in the same body area (such as your stomach area), but not right next to each other.
• Change (rotate) your injection site with each weekly injection. Do not use the same site for each injection.
• If you take too much Mounjaro, call your healthcare provider or seek medical advice promptly.

Learn more

Mounjaro is a prescription medicine. For more information, call 1-833-807-MJRO (833-807-6576) or go to

www.mounjaro.com.

This summary provides basic information about Mounjaro but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your healthcare provider. Be sure to talk to your healthcare provider about Mounjaro and how to take it. Your healthcare provider is the best person to help you decide if Mounjaro is right for you.

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Mounjaro^® and its delivery device base are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

INDICATION

Mounjaro^® (mown-JAHR-OH) is an injectable medicine for adults with type 2 diabetes used along with diet and exercise to improve blood sugar (glucose).

• It is not known if Mounjaro can be used in people who have had inflammation of the pancreas (pancreatitis). Mounjaro is not for use in people with type 1 diabetes. It is not known if Mounjaro is safe and effective for use in children under 18 years of age.

Diabetes mellitus type 2

A number of measures will help you control your blood glucose levels as accurately as possible, which will help to avoid complications.

Healthy eating
Contrary to popular belief, there is no special diet for diabetics. You don’t have to eat bland, tasteless food all your life. On the contrary, he needs vegetables, fruits and whole grains – that is, nutritious, but low-calorie and low-fat foods.
The child, as well as the whole family, is advised to reduce the consumption of animal products and sweets.
Patients with diabetes are advised to consume foods with a low glycemic index. The glycemic index measures how quickly a food raises blood sugar after consumption. Foods with a low glycemic index help stabilize glucose levels. Usually these are foods that contain a large amount of fiber.
A certified dietitian can create a meal plan that will help control your disease and fit your tastes and lifestyle. It will also teach you how to count the amount of carbohydrates in your diet to keep your sugar levels stable.

Physical activity
Everyone needs aerobic exercise from time to time, and a type 2 diabetic is no exception. Consult your doctor before starting any sports activities. Choose your favorite activity – walking, swimming, cycling. Accustom yourself to regular physical activity.
Aim to practice at least 30 minutes a day almost every day of the week. Don’t forget about strength training and stretching. If you haven’t done anything in a while, start with low-intensity exercise.
A combination of different types of exercise – aerobic (walking, dancing) and developing endurance (yoga, exercise on machines) – reduces blood sugar levels more effectively than preferring only one type of exercise.
However, remember that physical activity lowers blood sugar levels. Check your glucose levels before exercising. You may need to snack to prevent a critical drop in blood sugar, especially if you are taking medication.

Measuring Your Blood Sugar
Depending on the type of insulin you are taking, you may need to measure and record your glucose readings only periodically, or vice versa, strictly several times a day. Ask your doctor how often you need to do this. Careful monitoring is the only way to make sure your glucose levels stay within the normal range. Blood sugar levels can fluctuate for no apparent reason. With the help of specialists, you will learn how to predict how glucose levels will change depending on food, exercise, alcohol, diseases, and drugs.

Medications and insulin therapy
Some people with type 2 diabetes successfully manage their glucose levels with diet and exercise, but some patients require medication. The choice of specific drugs depends on a number of factors, including the degree of increase in blood sugar levels and comorbidities. In some cases, the doctor may prescribe therapy in the form of a combination of drugs from different groups to more effectively control glucose. Below are the main drugs used in the treatment of type 2 diabetes.
Metformin (Glucophage and others) is usually the first drug given to all patients with type 2 diabetes. Metformin increases the sensitivity of cells to insulin, as a result of which this hormone works more efficiently.
It also reduces hepatic glucose excretion. However, metformin by itself does not cause a decrease in blood sugar levels. Along with its intake, it is recommended to increase physical activity and monitor nutrition.
Side effects of metformin include nausea and diarrhea. They usually go away when the body gets used to the drug. If metformin and lifestyle changes are not enough to control your blood sugar, your doctor will recommend adding other drugs by mouth or by injection.

• Sulfonylureas. This group of drugs stimulates the body to synthesize more insulin. These include preparations of glyburide, glipizide (Glucotrol), glimepiride (Amaryl). Possible side effects include low blood sugar levels and weight gain.
• Meglitinides. Drugs in this group are similar in action to sulfonylurea drugs, but their action develops faster and they are removed from the body earlier. They can also lead to a strong decrease in glucose levels, but to a lesser extent than sulfonylurea drugs. Side effects also include weight gain. The drugs in this group include repaglinide and nateglinide .
• Thiazolinediones . Like metformin, drugs in this group increase tissue sensitivity to insulin. However, this class of drugs can cause weight gain and other, more serious effects, such as an increased risk of heart disease and kidney failure . Because of these side effects, thiazolindiones are not first-line drugs. These include rosiglitazone . pioglitazone .
• Dipeptyl peptidase-4 inhibitors. These drugs help lower blood sugar but are only moderately effective. They do not lead to weight gain. Representatives – sitagliptin , saxagliptin , linagliptin.
• Glucan-like peptide-1 receptor agonists. These drugs slow digestion and lower glucose levels, but are not as effective as sulfonylurea drugs. The use of glucan-like peptide-1 receptor agonists is recommended only in combination with other drugs. Representatives: exenatide (Bieta), liraglutide (Victoza). Side effects include nausea and an increased risk of pancreatitis .
• Sodium glucose cotransporter inhibitors. This is one of the most advanced drugs for diabetes. They prevent the reabsorption of glucose in the kidneys, resulting in it being excreted in the urine. Representatives: canagliflozin (Invokana), dapagliflozin (Forksiga). Side effects include frequent fungal infections and urinary tract infections.

Insulin therapy
Some type 2 diabetics require insulin. Previously, insulin therapy was used only when all other methods failed, but now doctors prescribe it much earlier due to the number of advantages of such treatment.
In the stomach, insulin interacts with other substances, so it must be given as an injection. Depending on the individual case, the doctor may prescribe a combination of different insulin preparations to control blood sugar during the day and night. Often insulin therapy for type 2 diabetics begins with a single injection of long-acting insulin at night.
Insulin injections can be given through special syringes with fine needles or with a pen, a device that looks like a regular pen but contains an insulin cartridge instead of ink.

There are several types of insulin, each of which works differently. Isolate:

• Insulin glulisine
• Insulin lispro
• Insulin aspart
• Insulin glargine
• Insulin detemir
• Insulin isophane

The pros and cons of each can be discussed with your doctor. It will help you choose the best option for you based on many factors, including cost, comorbidities, and others.
In addition to sugar-lowering drugs, your doctor may prescribe low-dose aspirin , as well as drugs that lower cholesterol and blood pressure to reduce the risk of heart and vascular disease.

Obesity surgery
If you have type 2 diabetes and your body mass index is above 35, then you are advised to undergo weight loss surgery. The operation ensures the normalization of glucose levels in 55-95% of patients. The most effective are operations in which part of the small intestine is “turned off” from the digestion process.
However, surgical treatment has a number of disadvantages. This is an expensive method and has a number of risks, including death. Long-term adverse effects include osteoporosis and nutritional disorders

Pregnancy
Women with type 2 diabetes will need to change therapy during pregnancy. Many patients in this period use insulin preparations. Cholesterol-lowering drugs and some antihypertensive drugs should be avoided.
If you have diabetic retinopathy, it may get worse during pregnancy. Consult an ophthalmologist during the first trimester of pregnancy and one year after childbirth.

Warning Signs
Since many factors affect glucose levels, it is impossible to control all of them, which can lead to medical emergencies:
Hyperglycemia . Sugar levels rise for a number of reasons, including overeating, eating unrecommended foods, low insulin dose, illness.

Watch out for the following signs:

• Frequent urination
• Extreme thirst
• Dry mouth
• Blurred vision
• Fatigue
• Nausea

If hyperglycemia is suspected, measure blood glucose. You will have to change your meal plan and medication doses.
Hyperglycemic hyperosmolar non-ketone syndrome. Signs of this dangerous condition include a rise in sugar levels above 600 mg / dL (33.3 mmol / L), dry mouth, severe thirst, fever above 38 ° C, fatigue, confusion, blurred vision, hallucinations, dark urine. Not every glucometer is able to accurately assess the level of sugar in this condition, most likely it will show a “high” icon.
This syndrome occurs due to a critical increase in glucose levels, due to which the blood changes consistency, becomes thicker. It is more common in older people with type 2 diabetes who have recently had an infection or other illness. This syndrome usually develops over several days or weeks. Seek help immediately if you suspect you have this condition.

Increased urinary ketone levels (diabetic ketoacidosis). If the patient’s cells are in urgent need of energy, an increased breakdown of fats begins with the formation of toxic substances called ketones. Symptoms of this serious condition include:

• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dry, reddened skin
• Sweet, fruity breath 90 050
• Confusion
• Difficulty breathing
• Extreme fatigue

If ketoacidosis is suspected, test urine for elevated ketones using a kit available from a pharmacy. With a pronounced increase in ketones, contact your doctor or call an ambulance. This condition usually occurs in people with type 1 diabetes, but can also occur in type 2 diabetes.
Hypoglycemia . If the blood level falls below the values ​​recommended by the doctor, then it is considered low. Decreased glucose levels can occur for a number of reasons, including skipping meals and strenuous exercise. This condition usually occurs when taking drugs that stimulate insulin synthesis, or when insulin is administered

Have your blood tested regularly and carefully evaluate yourself for the following symptoms:

• Sweating
• Trembling of the limbs
• Drowsiness
• Hunger
• Dizziness

90 043 Irritability

• Headache
• Heart flutter
• Blurred vision
• Abrupt changes in behavior
• Speech disorders
• Agitation or confusion
• Convulsions

If hypoglycemia develops at night, the patient wakes up because the pajamas are wet or because of a headache. But due to the natural rebound effect, sugar levels rise in the morning.
If you have low blood sugar, drink fruit juice, glucose tablets, soda (not diet), candy, or any other source of sugar. Check your sugar levels again to make sure it has risen. If it has not reached the normal level, give the baby more sweets and measure the glucose after another 15 minutes. If its level has not risen, eat more sweets and take a second measurement after 15 minutes.
If unconsciousness occurs, the patient needs an immediate injection of glucagon , a hormone that stimulates the flow of sugar into the blood.

Therapists softened glucose norms for patients with type 2 diabetes!

News 04/11/2018

Therapists softened glucose for patients with diabetes 2 type

The American collegium of doctors (ATV) re -released the treatment of diabetes of the 2nd type, in which the strict norms of glycated hemoglobin A1s in the blood indicated not so strict norms of glycated hemoglobin were in the previous version.

The A1C blood test allows doctors to determine a patient’s average blood sugar over the past 3 months. For most adults, the American Diabetes Association recommends keeping A1C blood levels below 7%. This target level may vary depending on the individual characteristics of the human body.

However, the new ACA guidelines state that the target level of A1C in the blood of patients with type 2 diabetes is 7-8%. In addition, according to the recommendations of the College of Physicians, it is necessary to suspend the treatment of those patients whose blood A1C level is below 6.5% in order to prevent a further decrease in this indicator.

The American College of Physicians, a national society of physicians, also believes that targets for monitoring patients with type 2 diabetes should be highly individualized based on the advantages and disadvantages of the patient’s medications, the individual’s personal preference, the patient’s overall health, and expected at this stage of development of the disease life expectancy.

The fact that the College of Physicians has relaxed the A1C does not mean that type 2 diabetes is not a serious health problem.

“The changes we have made to our recommendations should in no way be interpreted as indicating that the condition is not serious,” says Dr. Jack End, president of AKB.

More than 29 million Americans suffer from diabetes. As the disease progresses, high blood sugar levels can lead to vision loss, nerve problems, heart attacks, heart attacks, and kidney failure.

“Diabetes is a fairly common disease. There are many conflicting recommendations on how to treat this disease, so we set ourselves the goal of developing for ourselves the best measure for assessing the condition of patients with diabetes, ”says End. “In addition, the level of A1C is still used today as an indicator of the effectiveness of treatment.”

Insurance companies often believe that the level of A1C in the blood of patients must be reduced to some standard for all people. However, according to Dr. End, “the recommended level of A1C in the blood is not always a clear indication of the patient’s stable condition.”

For example, for an 80-year-old person with memory problems, the A1C norm in the blood will not always be equal to the norm for a 50-year-old person. Treatment for diabetes can also lead to critically low blood sugar levels, which can also be dangerous for the patient’s health.

The American Diabetes Association, according to Dr. William Cefalu, the association’s chief scientific and medical officer, also recognizes the importance of a strong individual approach to diabetes management. However, Dr. Chevalu expressed concern about the relaxation of the A1C guidelines proposed by the American College of Physicians.

“The American Diabetes Association believes that all people diagnosed with type 2 diabetes can be cured.

They need to be given carefully measured blood glucose levels so that they can recognize the approaching complications of the disease in time,” Cefalu says.

“Individualization is key in the treatment of diabetics,” he adds. “By stating that for most people the target blood level of A1C is 7-8%, the new AKV guidelines could potentially be dangerous for those patients who, for certain reasons, should stick to a much lower level.”

According to Cefalu, if a patient’s A1C level drops to 6.5%, he should not stop taking medications. If people have had periods of critically low blood sugar in the past, they may just need to adjust their medication dosage better. However, according to Cefalu, only the risk of lowering blood sugar to a critical minimum, and not the lower limit of the concentration of A1C in the blood, can cause drug withdrawal.

The new guidance also advises that practitioners should not set an A1C target for patients with a life expectancy of less than 10 years, as these are typically patients in their 80s who live in a nursing home or who have other chronic conditions. health problems. With such patients, the panel recommends that physicians take a course to reduce the symptoms of diabetes.

Dr. Cefalu says the American Diabetes Association recommends a highly individualized approach to dealing with these patients. He notes that the average life expectancy in patients aged 80 is 8 years for men and 10 for women.

“Each case must be assessed on a case-by-case basis, as a person living in a nursing home or with a serious chronic illness may only have a few years left to live, which they would obviously want to live without suffering from the complications of diabetes.” he adds.

Dr. End counters that the American College of Physicians does not downplay the importance of treating type 2 diabetes and recommends statins and careful blood pressure monitoring for all people with diabetes to reduce their risk of complications. However, he argues that, in fact, there is also evidence that too low levels of A1C can be dangerous for patients.

Dr. Cefalu believes that each practitioner should determine the target A1C level for himself.

“We all agree that treatment should be individualized and tailored to each patient,” he notes.