Glycemic Recommendations for Nonpregnant Adults with Diabetes (3)

Recommended glycemic goals for many nonpregnant adults (Table 9) are shown on three slides Slide 3 of 3 For individual patients, more or less stringent glycemic goals may be appropriate If A1C goals are not met despite reaching preprandial glucose goals, postprandial glucose may be targeted Postprandial hyperglycemia, like preprandial hyperglycemia, contributes to elevated A1C levels, with its relative contribution being higher at A1C levels that are closer to 7% However, outcome studies have clearly shown A1C to be the primary predictor of complications, and landmark trials such as the Diabetes Control and Complications Trial (DCCT) and the UK Prospective Diabetes Study (UKPDS) relied overwhelmingly on preprandial SMBG For individuals who have premeal glucose values within target but A1C values above target, monitoring postprandial plasma glucose 1-2 hours after the start of the meal and treatment aimed at reducing PPG values to <180 mg/dL may help lower A1C47Reference American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S21; Table 9.