Medical associations fight American College of Physicians HBA1c recommendations

Diabetes and endocrinology associations pushed back against a recent American College of Physicians recommendation to raise the target level of hemoglobin A_1c in patients with type 2 diabetes to between 7% and 8% in a statement released Friday, March 9.

The new guideline, which was published in the Annals of Internal Medicine on March 5 “could prevent many patients from receiving the full benefits of long-term glucose control,” according to a joint statement from the Endocrine Society, American Diabetes Association, American Association of Diabetes Educators, and American Association of Clinical Endocrinologists.

“The main concern here is this statement is too large to apply to most people with type 2 diabetes,” Grazia Aleppo, MD, chair of the Endocrine Society’s Clinical Affairs Core Committee, said in an interview. “We are all in agreement among the societies to include the ACP’s recommendation on individualizing treatment, but there is a big difference in a 1% HbA_1c increase.

“A 7% HbA_1c reflects the average of about 154 mg/dL on average, but 8% reflects the average of about 183 mg/dL.”