by Dr. Alba
Quick Answer
The ADA updates its Standards of Care every year. In 2026, an HbA1c below 7% remains appropriate for many nonpregnant adults, but goals must be individualized. Blood pressure generally should be below 130/80 mmHg when safely attainable. Cholesterol targets depend on cardiovascular risk, and gestational diabetes may be diagnosed using either a one-step or two-step strategy. Modern care also emphasizes continuous glucose monitoring, weight management, and medicines that protect the heart and kidneys.
The original page used 2011–2012 recommendations. This update highlights the ADA Standards of Care in Diabetes—2026.
Important: These are general targets, not personal prescriptions. Diabetes type, age, pregnancy, complications, treatment burden and hypoglycemia risk can change the safest goal.
For many nonpregnant adults without severe hypoglycemia, an HbA1c below 7% is appropriate. A lower goal may be reasonable when reached safely; a less stringent goal may suit people with frailty, serious illness, advanced complications or high hypoglycemia risk.
An HbA1c of 7.5% or 8% should not automatically be called “normal.” It may be an individualized treatment goal, but it remains above the nondiabetes range. Review our HbA1c guide.
HbA1c does not show daily highs or lows. CGM improves safety and time-in-range information, especially with insulin, and is standard care for most people with type 1 diabetes.
Glucose goals should be considered alongside hypoglycemia, symptoms and quality of life. See blood sugar levels by time of day.
The goal is generally below 130/80 mmHg when safely attainable. Systolic pressure below 120 may suit selected people at high cardiovascular or kidney risk.
Frail older adults or people with limited life expectancy may need a less intensive goal, such as below 140/90 mmHg. Proper repeated measurements are more useful than one isolated result.
The old universal LDL targets are no longer the complete approach. Current treatment depends on age and cardiovascular risk:
Ezetimibe or a PCSK9 inhibitor may be added when appropriate. Read about LDL cholesterol and diabetes.
Medicine selection now considers heart and kidney disease, obesity, hypoglycemia, cost and preferences—not only HbA1c. SGLT2 inhibitors or GLP-1 receptor agonists may provide organ protection in suitable patients.
Weight management may include nutrition, activity, behavioral support, medicine or metabolic surgery. See our type 2 diabetes treatment overview.
People with type 2 diabetes should generally have eGFR and urine albumin-to-creatinine ratio checked from diagnosis and at least yearly. In type 1 diabetes, annual screening generally begins after about five years.
ACE inhibitors or ARBs, SGLT2 inhibitors and other kidney-protective treatments may be appropriate according to blood pressure, albuminuria and eGFR. See diabetes and kidney disease.
People without previously diagnosed diabetes should be screened at 24–28 weeks. The ADA discusses two accepted approaches:
The old page was incorrect to say that the 50-g and 100-g approach was no longer accepted. The method depends on local practice. After gestational diabetes, the ADA recommends a fasting 75-g OGTT at 4–12 weeks postpartum and lifelong screening every one to three years. See our gestational diabetes guide.
Healthy older adults may use similar goals, while frailty, cognitive impairment or serious illness may require simpler treatment and less stringent targets.
Written by Dr. Albana Greca Sejdini, MD, MMedSc
Medically reviewed by Dr. Ruden Cakoni, MD, Endocrinologist
Last reviewed: August 2026
This summary does not replace individualized medical care.
Click here to post comments or follow up
Ask the Doctor now? Simply click here to return to Contribute to All About Beating Diabetes.