Glycemic targets in diabetes

Target setting is an important strategy in diabetes. The commonly used glycemic targets are blood glucose and HbA1c. The target values can be fixed based upon normative data or outcome data. Individualization of glycemic targets is based upon age of patient, duration of diabetes, life expectancy, type of diabetes, type of therapy, presence of complications, propensity for hypoglycemia, hypoglycemia awareness, availability of family support, patient motivation, and patient education. Currently, the rate of attainment of glycemic target is improving, and almost 50 % of diabetics achieve HbA1C targets. In pregnancy, glycemic targets recommended are strict. Furthermore, the concept of individualization needs to be extended to the pregnant state. We propose that the glycemic targets in pregnancy with diabetes should be different in gestational diabetes, pre-gestational type 2 diabetes, and type 1 diabetes.