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A new blood glucose management algorithm for type 2 diabetes: a position statement of the Australian Diabetes Society

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Large randomised controlled trials (RCTs) have demonstrated that controlling blood glucose level (BGL) in people with type 2 diabetes (T2D) is important for preventing microvascular complications.1,2 Lowering BGL may also reduce myocardial infarction, though not necessarily stroke or all-cause mortality.3

In 2009, the Australian Diabetes Society (ADS) published a position statement recommending individualisation of glycaemic targets.4 The general glycated haemoglobin (HbA1c) target for most people with T2D is ≤ 53 mmol/mol (7%), however:

  • in people without known cardiovascular disease, a long duration of diabetes, severe hypoglycaemia or another contraindication,4 the target is ≤ 48 mmol/mol (6.5%);
  • in people with reduced hypoglycaemia awareness or major comorbidities, the target may increase to ≤ 64 mmol/mol (8%);
  • in people with limited life expectancy, aim for symptom control; and
  • in women planning a pregnancy, aim for the tightest achievable control without severe hypoglycaemia; preferably ≤ 42 mmol/mol (6.0%).

Despite the increasing range of therapies available, achieving glycaemic targets can be difficult. To assist with…