17
Table 10. Summary of Recommendations for Glycemic,
Blood Pressure and Lipid Control for Most Adults
with Diabetes
Test Goal
A1c <7.0%
a
Blood pressure <140/80 mmHg
b
Lipids LDL-C <100 mg/dL (<2.6 mmol/L)
c
a
More or less stringent glycemic goals may be appropriate for individual patients. Goals should be
individualized based on duration of diabetes, age/life expectancy, comorbid conditions, known
CVD or advanced microvascular complications, hypoglycemia unawareness, and individual patient
considerations.
b
Based on patient characteristics and response to therapy, higher or lower systolic blood pressure
targets may be appropriate.
c
In individuals with overt CVD, a lower LDL-C goal of <70 mg/dL (1.8 mmol/L), using a high dose
of a statin, is an option.
Antiplatelet Agents
Î Consider aspirin therapy (75-162 mg/day) as a primary prevention
strategy in those with type 1 or type 2 diabetes at increased
cardiovascular (CV) risk (10-year risk >10%). (C)
Note: This includes most men >50 years of age or women >60 years of age who have at
least one additional majr risk factor ( family history of CVD, hypertension, smoking,
dyslipidemia, or albuminuria).
Î Aspirin should NOT be recommended for CVD prevention for adults
with diabetes at low CVD risk (10-year CVD risk <5%, such as in men
<50 and women <60 years of age with no major additional CVD risk
factors), since the potential adverse effects from bleeding likely offset
the potential benefits. (C)
Î In patients in these age groups with multiple other risk factors
(eg, 10-year risk 5%-10%), clinical judgment is required. (E)
Î Use aspirin therapy (75-162 mg/day) as a secondary prevention
strategy in those with diabetes with a history of CVD. (A)
Î For patients with CVD and documented aspirin allergy, clopidogrel
(75 mg/day) should be used. (B)
Î Dual antiplatelet therapy is reasonable for up to a year after an acute
coronary syndrome. (B)
