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Question #840

Jul 2, 2016

More stringent hyperglycemia management (target A1C 6-6.5%) in type 2 diabetes might be supported by which one of the following factors:


Answer: D. Absent-few comorbidities

In 2008, the American Diabetes Association, the American Heart Association and the American College of Cardiology released a joint position statement providing clarified guidance for determining individualized A1C targets based upon analysis of findings from the ACCORD, ADVANCE and VADT studies. Ismail-Beigi, et al. further reiterated the importance of utilizing these elements of decision-making when determining appropriate individualized glycemic targets. Some factors favor more stringent efforts to lower A1C, while others favor less stringent efforts. Patient elements that favor more stringent pursuit of lower A1C are: high motivation, excellent self-care capabilities, and adherent patient attitudes and efforts; low potential for risks associated with hypoglycemia or other adverse effects; newly diagnosed disease stage; long life expectancy; absent-few/mild important comorbidities; absent-few-mild established vascular complication; and readily available resources and support system.