Dr. Rahul Baxi Profile picture
Consultant Diabetologist | Bombay Hospital | @OffCMCVellore @NUSingapore | Singapore Instagramer of the year 2018 | @Tedx speaker | Views are personal |

Jan 17, 2022, 11 tweets

“Doctor, what should be my targets for Hba1c, Fasting and Post meal (PP) glucose?”

Many of our friends with Diabetes have this question. I will try to explain in the thread below.

#Diabetes #GlycemicTargets #HbA1c (1/n)

HbA1c should be done at least 2 times a year if goals are met and glucose control is stable,

Done more often if goals not met or there is change in the medicines.

A1c goal for many non pregnant adults is < 7% without any significant hypoglycaemia.

#Diabetes #HbA1c (2/n)

Tighter HbA1c goals ( less than 7%) may be considered in some.

Less stringent goals (less than 8%) may be appropriate in pts with limited life expectancy or side effect of drugs.

Individualisation of glycemic targets is a must. It’s not a one size fits all criteria.

(3/n)

These are the glycemic recommendations for many non pregnant adults with Diabetes. Preprandial- before meals.
Postprandial- after meals

#Diabetes (4/n)

During pregnancy, the glycemic targets are as follows.

Fasting plasma glucose <95 mg%

1 hr post prandial glucose <140 mg%

2 hr post prandial glucose <120 mg%

#Diabetes #GDM #Pregnancy (5/n)

Glycemic targets for the elderly population differ depending on multiple factors. Below table summarises them.

#Diabetes (6/n)

Continuous Glucose Monitoring (CGM)

Time in range can be a useful tool for assessment of glucose control. A goal of 70 % TIR aligns with A1C of ~ 7%

Time above target (TAR) and time below target (TBR) are also useful parameters.

#Diabetes #CGM (7/n)

Hypoglycaemia (low glucose levels)

Symptoms: shakiness, irritability, confusion, hunger, excessive perspiration, palpitations, etc.

Recurrent low glucose levels require medical attention & medication dose adjustments. It’s preventn is an imp part of DM mgmt (8/n)

All above information is for education purpose only.

Remember, Type 2 Diabetes is primarily a lifestyle Disease.

Do take good care of your health, eat a balanced diet and walk/ exercise regularly. 💐

#Diabetes #Lifestyle (9/9)

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