Table 2.
Guideline recommendations for key clinical outcomes for older people with diabetes
ADA51 | ES30 | DC48 | IDF49 | European47 | Japan46 |
Healthy (few coexisting chronic illnesses, intact cognitive and functional status) | Good health (no comorbidity or 1–2 comorbidities and no ADL impairments) |
Functionally independent | Functionally independent (no impairments of ADLs, and receiving none or minimal caregiver support) |
Free of other major comorbidities | Intact/mild cognition and functionality |
7.0%–7.5% | <7.5%* | ≤7.0% | 7.0%–7.5% | 7%–7.5% | 7%–8%* |
Complex (multiple coexisting chronic illnesses, cognitive or functional impairment) |
Intermediate health (>3 comorbidities and mild cognitive or ADL impairment) |
Functionally dependent | Functionally dependent (impairments of ADL, and requiring additional medical and social care) |
Dependent; multisystem disease, care home residency, and including dementia | Significant cognitive, presence of multiple comorbidities & functional impairment |
8.0%–8.5% | <8%* | 7.1%–8.0% | 7.0%–8.0% | 7.6%–8.5% | 8.0%–8.5%* |
Poor health (end-stage medical condition, moderate to severe dementia, or long-term care facility resident) |
Frail and/or dementia | Sublevel frail or dementia | |||
<8.5%* | 7.1%–8.5% | <8.5% |
*The A1C targets varies among older adults who are using medications known to cause hypoglycemia (eg, insulin and sulfonylureas).
ADA, American Diabetes Association; ADLs, activities of daily living; DC, Diabetes Canada; ES, Endocrine Society; IDF, International Diabetes Federation.