Highlights
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes, accounting for 90 - 95% of cases. In type 2 diabetes, the body does not respond properly to insulin, a condition known as insulin resistance. Insulin is a hormone produced by the pancreas that regulates how the body converts sugar (glucose) into energy.
New Recommendations for Blood Sugar (Glucose) Control and Heart Disease Prevention
In December 2008, the American College of Cardiology (ACC), the American Diabetes Association (ADA), and the American Heart Association (AHA) issued revised recommendations for target goals for blood glucose control. Major recent studies of people with longstanding type 2 diabetes and high risk for heart disease have indicated that intensive blood glucose control may not have much benefit and may carry some increased risks. (However, one study did find that intensive glucose control can help prevent heart disease in people who have had diabetes for a short period of time.)
Based on the results of these trials, the ACC, ADA, and AHA recommend:
- Most people with type 2 diabetes should continue to aim for HbA1c levels at or below 7%. (HbA1c is a test that is performed at regular intervals to evaluate a patient’s average blood glucose level.) There is strong evidence that achieving this goal can help prevent many diabetes complications, including eye, kidney, and nerve disease.
- Patients with certain factors may need less stringent HbA1c goals. These factors include longstanding diabetes, a history of severe low blood sugar (hypoglycemia), limited life expectancy, advanced vascular complications, and the presence of other diseases.
- All patients with type 2 diabetes should continue to follow proven measures for heart disease prevention. These include blood pressure control, lipid-lowering statin drug therapy, and lifestyle changes such as weight loss, proper nutrition, and increased physical activity.