Treatment Targets and Goals

Question 1

ADA Target HbA1c for Adults

Answer 1

Goal HbA1c less than 7%

Question 2

AACE target HbA1c for Adults

Answer 2

Goal HbA1c ≤ 6.5% (without concurrent serious illness and at low hypoglycemia risk)
Goal HbA1c greater than 6.5% if serious illness/hypoglycemia risk

Question 3

ADA target HbA1c for pregnant women with T1 or T2DM

Answer 3

Goal HbA1c less than 6% (if achievable without significant hypoglycemia; goal lower d/t alterations in red cell turnover)

Question 4

ADA - Outpatient goal (adult) preprandial capillary plasma glucose range
ADA - Outpatient goal (adult) postprandial capillary plasma glucose range

Answer 4

• 80 - 130 mg/dL

- Less than 180 mg/dL

Question 5

AACE - Outpatient goal (adult) fasting capillary plasma glucose range
ACCE - Outpatient goal (adult) 2 hour post prandial glucose goal range

Answer 5

• Less than 110 mg/dL

- Less than 140 mg/dL

Question 6

ADA - Glucose targets for inpatient critically ill patients

Answer 6

Goal 140 - 180 mg/dL

Question 7

ADA - Glucose targets for inpatient, non-critically ill patients

Answer 7

• Preprandial glucose less than 140 mg/dL

- Random blood glucose less than 180 mg/dL

Question 8

ADA target HbA1c for pediatric patients

Answer 8

Goal HbA1c less than 7.5% for all pediatric age groups (new recommendation for 2015)

Question 9

ADA - Glycemic targets in pregnancy for T1DM and T2DM

Answer 9

• Premeal, HS ,and overnight goal 60 - 99 mg/dL
• Peak postprandial goal 100 - 129 mg/dL
• HbA1c less than 6%

Question 10

ADA - Glycemic targets for GDM

Answer 10

Preprandial goal ≤ 95 mg/dL and either:
- One hour post meal ≤ 140 mg/dL or
- Two hour post meal ≤ 120
(ADA and AACE are the same)

Question 11

ADA - Target HbA1c in T1DM/T2DM prior to conception

Answer 11

HbA1c less than 7% (to reduce the risk of congenital anomalies)

Question 12

AACE - Inpatient non pregnant adult intensive care goal glucose range

Answer 12

140 - 180 mg/dL (as long as this can be achieved safely)

Question 13

AACE - Inpatient non pregnant adult non-critically ill goal glucose range (medicine and surgery patients)

Answer 13

• Pre-meal glucose less than 140 mg/dL

- Random blood glucose less than 180 mg/dL

Question 14

AACE - Glycemic targets for GDM

Answer 14

Preprandial goal ≤ 95 mg/dL and either:
- One hour post meal ≤ 140 mg/dL or
- Two hour post meal ≤ 120
(ADA and AACE are the same)

Question 15

AACE - Glycemic targets in pregnancy for T1DM and T2DM

Answer 15

• Premeal, HS ,and overnight goal 60 - 99 mg/dL
• Peak postprandial goal 100 - 129 mg/dL
• HbA1c ≤ 6%
• Only if these can be safely achieved
  (ADA and AACE are the same)

Question 16

AACE - Target HbA1c in T1DM/T2DM prior to conception

Answer 16

Less than 6.5%

Question 17

How often should A1C be measured?

Answer 17

• At least two times a year in patients meeting treatment goals
• Quarterly in patients whose therapy has changed or are not meeting glycemic goals

Question 18

How often should A1C be measured?

Answer 18

• At least two times a year in patients meeting treatment goals
• Quarterly in patients whose therapy has changed or are not meeting glycemic goals

Question 19

What are the recommendations for weight gain in diabetic women during pregnancy based on BMI?

Answer 19

Recommended weight gain in diabetic pregnant women is the same as non-DM patients.

PrePregnancy BMI —- Recommended Weight Gain

• BMI less than 18.5 = 28 - 40 lbs
• BMI 18.5 - 24.5 = 25 - 35 lbs
• Overwt BMI 25 - 29.9 = 15 - 25 lbs
• Obese BMI > 30 = 11 - 20 lbs