Type 2 Diabetes Adult Outpatient Insulin Guidelines - CMA Foundation

Achieving Glycemic Control
A1c Recommendations
Studies have demonstrated that A1c is a strong predictor of future diabetes complications.
Recent studies confirm that the A1c closely represents the average glucose over the last 3
months. The table below correlates A1c with estimated average glucose. A calculator can
be used to covert A1c results into estimated average glucose (eAG) at http://professional.
diabetes.org/GlucoseCalculator.aspx.
Note that the A1c can be affected by conditions that affect red blood cell turnover (such
as anemia and hemoglobinopathies like sickle cell disease), which needs to taken into
consideration especially when the A1c result does not correlate with the patient’s clinical
situation or home monitored glucose levels.
TAbLe 14 Correlation of A1c to Mean blood Glucose Values
Table 14: Correlation of A1c to mean Blood Glucose Values
A1c % estimated Average Glucose (eAG)
mg/dL
6 126
7 154
8 183
9 212
10 240
11 269
12 298
The American Diabetes Association recommends that patients have A1c done at least every 6
months if they have stable glucose levels that are at goal, and every 3 months in patients who are
not at goal or who are changing therapy.
Blood Glucose Level Goals
The A1c goal for most adult patients with diabetes should be < 7.0%, in order to decrease the long
term risk of complications.
Some patients with long life expectancy, and no significant CVD may benefit from an even lower
A1c goal (such as < 6.5%) due to evidence of a small incremental
improvement of microvascular outcomes. 8
22 CMA FoundAtion . diAbetes And CArdiovAsCulAr diseAse Provider reFerenCe guide . july 2011