29/10/2024
The American College of Physicians (ACP) guidelines for 2018 focus on managing type 2 diabetes. Here are the key takeaways:
- *Blood Sugar Control Targets*: The ACP recommends aiming for an A1C level between 7% and 8% for most patients with type 2 diabetes ¹. This is because treating to targets below 7% didn't show significant benefits in reducing deaths or macrovascular complications like heart attacks or strokes.
- *Personalized Goals*: Clinicians should set individualized blood sugar control goals based on patient preferences, overall health, life expectancy, treatment burden, and costs ¹.
- *De-Intensifying Treatment*: If patients achieve an A1C level below 6.5%, clinicians should consider reducing medication dosage or discontinuing treatment to minimize harm ¹.
- *Prioritizing Symptoms*: For patients with limited life expectancy (less than 10 years), focus on managing symptoms related to high blood sugar rather than targeting a specific A1C level ¹.
- *Performance Measures*: The ACP suggests that physician performance measures should not have A1C targets below 8% for any patient population, and no targets for older adults (80+ years) or those with limited life expectancy ¹.
These guidelines aim to balance the benefits and harms of treatment, emphasizing personalized care and minimizing unnecessary medication burdens.