[Medical Q&A] What is the blood sugar control target for patients with type 2 diabetes?

Author: Liu Bing, deputy chief physician, Beijing Friendship Hospital, Capital Medical University

Reviewer: Yuan Mingxia, Chief Physician, Beijing Friendship Hospital, Capital Medical University

Patients with type 2 diabetes often have one or more components of metabolic syndrome, such as hypertension, dyslipidemia, obesity, etc., which significantly increase the risk, progression rate and harm of complications of type 2 diabetes. Therefore, the treatment of type 2 diabetes should be comprehensive, including the control of blood sugar, blood pressure, blood lipids and weight.

At present, the most important indicator reflecting the blood sugar control status in clinical practice is glycated hemoglobin (HbA1c), which represents the average blood sugar level of the patient in the last 3 months. The glycated hemoglobin control target should follow the principle of individualization, and stratified management should be implemented according to factors such as the patient's age, course of disease, health status, and risk of adverse drug reactions. The guidelines recommend that the glycated hemoglobin control target for most non-pregnant adult patients with type 2 diabetes is <7%. For type 2 diabetes patients who are younger, have a shorter course of disease, have a longer life expectancy, have no complications, and do not have cardiovascular disease, a stricter glycated hemoglobin control target, such as <6.5%; for patients who are older, have a longer course of disease, have a history of severe hypoglycemia, have a shorter life expectancy, and have significant microvascular or macrovascular complications or severe complications, a broader control target, such as 7.5% to 8.0%, is required. Of course, glycated hemoglobin is not a panacea. We also need daily self-blood sugar monitoring, that is, monitoring finger blood sugar through a blood glucose meter. The control target for fasting blood sugar is 4.4-7.0mmol/L, and the non-fasting blood sugar target is <10.0mmol/L. Like glycated hemoglobin, the control target for finger blood sugar also needs to be individualized.