New ADA Diabetes Management Guidelines 2011- 2012

by Dr. Alba

I went through the new ADA

diabetes management guidelines for this year (2011), and I wanted to share with some interesting points:

1. The emphasis of ADA is put on "individualization" of treatment according to one patient conditions. Although there are some previous upper limits like A1C <7%; however, the judgement for changes in the individual treatment would depend also on person's age and if she/he is having hypoglycemia.

So, according to ADA, if one person is 40 or 50 years old, and the A1C is <6% without facing hypoglycemia; that means this is the target for that person.

However, if the person is older, or is experiencing hypoglymia, than the accepted A1C level would be higher (unless that will cause harm to that person).

In addition, even though a person is trying hard to get normal levels of A1C, but cannot obtain less than 7.5 or 8%, and not harm is caused to the patient; that is accepted as a normal level according to 2011 ADA recommendations.

2. With regards to other laboratory results, accepted LDL-cholesterol levels are 100 mg/dL, and blood pressure target is <130/80 mm Hg. However, if this person is already diagnosed with any cardiovascular disease, ADA acceptable upper limit of LDL levels is reduced to <70 mg/dL.

3. Gestational diabetes - Stricted follow-up of pregnant women in their 24 - 28 weeks of gestation is also advised from ADA. Actually, the old oral glucose tolerance test when 50-grams of glucose is given followed-up by other 100-grams is no longer accepted.

These women are directly asked to perform 75-gram glucose tolerance test, when 3 measurements of blood glucose will be applied (at baseline, after 1 hour and after 2 hours).

If blood sugar levels will be higher than: 92 mg/dL at baseline; or ≥180 mg/dL after 1 hour; or ≥153 mg/dL after 2 hours; that pregnant women is definetively diagnosed with gestational diabetes.

Attention is also recalled to the follow-up of a women after giving birth and had gestational diabetes. It is obligatory to screen for diabetes at least every 3 years.

So, dear diabetic and non-diabetic readers. It is important to discuss with your doctor what your or your diabetic beloved acceptable blood sugar levels are. So, your personal goal and treatment is achieved correctly.

All the best!

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