Glycaemic targets for adults with type 1 diabetes
Long-term optimisation of the glycaemic profile is important to minimise complications of diabetes, especially microvascular complications. The benefits of achieving and maintaining tight glycaemic targets must be weighed against the risk of hypoglycaemia.
|
glycated haemoglobin (HbA1c) target | |
|
Glycaemic parameter |
Target |
|
glycated haemoglobin (HbA1c) target | |
|
HbA1c [NB3] |
53 mmol/mol (7%) or less |
|
blood glucose concentration targets | |
|
fasting and preprandial |
4 to 7 mmol/L |
|
postprandial |
6 to 10 mmol/L |
|
interstitial glucose concentration targets [NB4] | |
|
interstitial glucose concentration range |
3.9 to 10 mmol/L |
|
time in range [NB5] |
more than 70% (16.8 hours) of the day |
|
time below range [NB5] |
less than 4% (60 minutes) of the day at less than 3.9 mmol/L AND less than 1% (15 minutes) of the day at less than 3.0 mmol/L |
|
glycaemic variability (%CV) [NB5] |
36% or less |
|
Note:
%CV = coefficient of variation; HbA1c = glycated haemoglobin NB1: These targets are a guide—individualise targets, aiming to avoid hypoglycaemia. NB2: For glycaemic targets in women who are planning pregnancy, see here and for glycaemic targets during pregnancy, see here. NB3: Caution is needed in interpreting HbA1c in patients with conditions that affect red blood cell turnover (see Limitations of HbA1c tests). NB4: Continuous glucose monitoring (CGM) and flash glucose monitoring systems measure the glucose concentration in interstitial fluid. See Interstitial fluid glucose monitoring systems for information about CGM and flash glucose monitoring. NB5: More conservative targets may be appropriate to minimise the risk of hypoglycaemia in older patients or those at higher risk for severe hypoglycaemia (see Common precipitants and patient risk factors for hypoglycaemia). | |