The ADA's latest guidelines (2015) indicate that one of the criteria for screening to help diagnose diabetes is a Hb A1C level of ≥6.5%. Moreover, the ADA indicates that the glycemic target for nonpregnant adults with diabetes is <7.0% and lowering A1C below or around 7.0% has been shown to reduce microvascular complications and macrovascular disease. Therefore, a Hb A1C level that is < 7.0% indicates glycemic control for most adults with diabetes.
Providers might recommend even lower Hb A1C goals than the general goal of <7.0% for some patients (if this can be achieved without significant hypoglycemia or other adverse effects). This includes patients who have a short duration of diabetes (eg, gestational diabetes), long life expectancy, and no significant cardiovascular disease.
Less stringent Hb A1C goals than the general goal of <7.0% may also be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, and those individuals with longstanding diabetes who are not able to consistently achieve the general goal of <7.0%.
