Blood sugar is typically defined as being under control for diabetic patients when it is below 7%, using a measure known as hemoglobin A1c, or HbA1c, according to the ADA. Under the new guidelines, that level is still desirable. But younger, newly diagnosed and well-motivated patients with a long life expectancy may want to aim for even lower levels, closer to 6%, according to the recommendations. Such aggressive therapy is expected to better keep the disease from progressing.
ADA称,糖化血红蛋白(HbA1c)水平低于7%的糖尿病患者通常会被认定血糖受到控制。新发布的指引也认为这一水平比较理想。但是,指引中还提到,年纪较轻、新近被诊断患并强烈希望自身长寿的患者可能要把血糖控制在接近6%的更低水平。这一比较激进的治疗方案可能会更好地防止糖尿病加重。
For older patients vulnerable to severe hypoglycemia or who may already have advanced cardiovascular disease, less stringent targets of up to 8% or even a little higher would be sufficient, the guidelines say. This also could reduce the burden of side effects from medications.
新指引称,对于易患严重低血糖症的老年患者或是可能已经患有心血管疾病的患者,目标可以放松一些,8%甚至是略高一些的血糖水平就足够了。这可能会减轻药物副作用带来的负担。
If patients fail to maintain control of their blood sugar with metformin plus diet and exercise, treatment guidelines call for them to add a second diabetes drug. This could include Januvia, made by Merck & Co.; Takeda Pharmaceuticals Co.'s Actos; NovoNordisk's Victoza and Sanofi's insulin drug Lantus.
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