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Diabetes Groups Issue New Guidelines on Blood Sugar
Date:4/19/2012

C, often just referred to as A1C, is a measure of long-term blood sugar control. It gives an estimate of what the average blood sugar level has been for the past two to three months. A1C is expressed as a percentage, and in general, the goal for people with type 2 diabetes is to lower their A1C levels below 7 percent. Someone without diabetes generally has levels below 5.6 percent, according to the American Diabetes Association.

In the past, the below-7-percent goal was applied to most people with type 2 diabetes. But, the new guidelines note that more stringent goals, such as keeping A1C between 6 and 6.5 percent, might be appropriate for someone who has a long life expectancy, no history of heart disease and who hasn't experienced significant low blood sugar levels (hypoglycemia). Low blood sugar levels can be a potentially dangerous side effect of many diabetes treatments.

The new guidelines suggest that blood sugar targets should be looser (A1C between 7.5 and 8 percent) for people who are older than 65 or 70, because they're more at risk of having complications from hypoglycemia, as well as being more at risk of side effects from taking multiple medications.

Lifestyle changes remain an important part of any type 2 diabetes management plan in the new guidelines. The recommendations are to lose 5 percent to 10 percent of body weight, and to participate in modest exercise for at least two-and-a-half hours each week.

The medication metformin is also recommended as a first-line treatment for people with type 2 diabetes. Metformin works by making the body more receptive to the hormone insulin. Metformin therapy should begin as soon as someone is diagnosed with type 2 diabetes, unless they have a near-normal A1C and are highly motivated to make lifestyle changes, according to the guidelines. In such a case, doctors may choose to follow up with the patient in three to six months to see if the lifestyle changes have been effective. If not, m
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