With patients without diabetes averaging between 70 and 99 mg/dL, a jump to 183 is concerning for Dr. Aleppo and her colleagues.
The ACP’s recommendations were determined from analysis of four drug therapy trials, which found aiming HbA1c levels at below 7% put patients at risk for hypoglycemia and cardiovascular events.
While the trials themselves were approved by the ADA, AADE, and AACE, associations expressed concern with the exclusion of important data, including the addition of newly diagnosed patients in the test population and more modern medications that reduce the adverse effects mentioned in the ACP’s reasoning for raising the target levels.
The patients participating in the trials were older and could have already had underlying cardiovascular disease, according to Dr. Aleppo. These factors plus a rapid change to their medication to get them below 6.5% could have instigated a cardiovascular response, which would not be as likely for patients in their 40s who are just being diagnosed.