Intensive glucose control in Type 2 diabetes
Why flagged
T2DM patient age 68 on insulin/sulfonylurea with HbA1c 6.4 < 7.0%; intensive control in elderly reversed by ACCORD 2008 (increased mortality).
Universal tight glycemic control targeting HbA1c < 7.0% o…
Intensive target (< 6.0%) increased all-cause mortality (HR 1.22; 95% CI 1.01-1.46) and cardiovascular mortality (HR 1.35; 95% CI 1.04-1.76) compared to standard control (7.0-7.9%).
Guidelines updated
ADA (Current Standards of Care): Individualized HbA1c goa…
- Prior guidance2008
Universal tight glycemic control targeting HbA1c < 7.0% or < 6.0% for macrovascular risk reduction (ADA, pre-2008).
- ACCORD2008
Intensive target (< 6.0%) increased all-cause mortality (HR 1.22; 95% CI 1.01-1.46) and cardiovascular mortality (HR 1.35; 95% CI 1.04-1.76) compared to standard control (7.0-7.9%).
- Reversal2025
Guidelines updated
- Current recommendation
ADA (Current Standards of Care): Individualized HbA1c goals. Generally < 7.0%, but less stringent targets (< 8.0%) strictly recommended for older adults with extensive comorbidities or high hypoglycemic risk.