Guidelines for individualised HbA1c targets to be released soon

LONG-AWAITED individualised HbA_1c target guidelines, developed by the Australian Diabetes Society (ADS), will soon be published in the MJA, according to one of the guidelines’ authors.

The development of the guidelines was prompted by a rethink of aggressive HbA_1c lowering in the wake of three recent trials showing negligible benefits, and some serious adverse events, from intensive glycaemic lowering (Medical Observer, 29 May).

Associate Professor Wah Cheung, co-director of the Centre for Diabetes and Endocrinology Research at Westmead Hospital, Sydney, told the recent annual scientific meeting of the ADS and the Australian Diabetes Educators Association (ADEA) in Adelaide that the guidelines would continue to recommend a general target of ≤7.0%, which was suitable for most patients.

However, he said, in some cases, more relaxed HbA_1c targets would be recommended. These would include patients with hypoglycaemia problems, for whom a target of less than or equal to 8.0% was advised, and patients with severe co-morbidities.

“If there are co-morbidities limiting life expectancy, I don’t think you even need to bother about HbA_1c, and the aim would be to keep the patient symptom free,” he said.

A document detailing the rationale behind the guidelines will appear on the ADS website in late September.

More from the ADS/ADEA annual scientific meeting: Illicit drug use common among young with diabetes; Fibrate's CVD benefit in type 2 diabetes underestimated; Dopplers useful for detecting PVD in diabetes