Diabetes Organizations Rebuke ACP’s Type 2 Guidelines

Grazia Aleppo, MD

Following the American College of Physician’s (ACP) announced change to their blood sugar control guidelines for patients with type 2 diabetes (T2D) last week, criticism from their peers came swiftly and wholly.A joint statement from the Endocrine Society, the American Diabetes Association (ADA), the American Association of Clinical Endocrinologists (AACE), and the American Association of Diabetes Educators (AADE) expressed strong disagreement with the ACP’s new guidelines, which raised goal A1C levels to between 7% and 8% for patients with T2D.

The change, an increase from the commonly advocated and practiced levels between 6.5% and 7%, came from lacking evidence that stricter treatment target levels equated to reductions in microvascular complications. Though diabetes is indicated in patients reporting blood sugar levels of at least 6.5%, the ACP now advises physicians provide personalized treatment and differing perception in an era of increasing diabetes rates.

 However, the dissenting endocrinology organizations have responded that lenient A1C target treatment levels could prevent patients from receiving thorough benefits from long-term glucose control.

“While ACP’s guidance is only 1 additional percentage point, this may equate to a difference of nearly 30 points when blood glucose is measured in mg/dl,” the organizations wrote in a statement. “This difference in the lower and higher A1Cs in the range ACP suggests also has been shown to have clear differences in microvascular complications from large, multicenter randomized trials of patients newly diagnosed with type 2 diabetes.”

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