Jeff Unger
The risk of developing long-term diabetes mellitus–related complications (retinopathy, nephropathy, neuropathy, cardiovascular disease, and stroke) increases as glycated hemoglobin (A1C) levels exceed 6.5%. All patients with diabetes should be provided with an individualized target A1C based on factors such as age, duration of disease, risk of hypoglycemia, existing comorbidities, available resources, life expectancy, and cardiovascular risk. A delay of therapeutic intensification of just 2 years from the time of diagnosis can expose a patient to “glycemic burden” and a 61% increased risk of cardiovascular complications.