A1c goals and cardiovascular disease

Experts in the care of patients with diabetes and cardiovascular disease recently re-evaluated the results from ACCORD, ADVANCE, and VADT and concluded that these studies did indicate a significant benefit of tight glycemic control in the primary prevention of cardiovascular events.

This group also reaffirmed an A1C < 7% as the treatment goal for patients with diabetes.

However, it was also noted that a higher goal may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced micro- or macrovascular complications, or extensive comorbid conditions, or for those with long-standing diabetes in whom a goal of < 7% would be difficult to attain despite appropriate monitoring and treatment.
References: Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association Diabetes Care. 2009;32:187-192.
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