What Are the Management Targets for Diabetes?

Author：Dr.Liu Haixia

The morbidity of diabetes is increasing year by year in the world, and it is the third disease threating life and health after cardiovascular and cerebrovascular diseases and malignant tumors. Diabetes can cause a variety of chronic complications, such as diabetic nephropathy, atherosclerosis, retinal microangiopathy, which increases the mortality of patients. Targets achieved management of diabetes are the basis for preventing diabetes complications and reducing mortality.  The management targets of diabetes mainly include blood glucose, blood lipids, blood pressure, kidney function and body weight.  

1. Blood Sugar  

1)Fasting blood glucose (FBG) refers to blood glucose with fasting for about 8 to 10 hours, which is a main standard of the diagnosis of diabetes and reflecting the patient's basic insulin level and whether the medication dose of the previous night is appropriate.  The refer range of fasting blood glucose is 4.4 to 7.0 mmol/L .  

2)Non-fasting blood glucose is recommended to be under 10.0mmol /L at any time.  

3) Glycosylated hemoglobin A1C ( HbA1C ), reflecting the average level of blood sugar in the past 2 to 3 months, is not affected by occasionally rise and fall of blood sugar, and reflecting the average blood glucose levelfor a period of time effectively. Hb A1c is recommended to be under 7%if there is no chance of low blood sugar in patient with diabetes. 

2. Blood Lipids

Diabetes is a metabolic disorder syndrome. In addition to hyperglycemia, patients with diabetes are often accompanied by dyslipidemia, a high risk factor for chronic complications of diabetes.  The targets of blood lipid management in diabetic patients are required as total cholesterol < 4.5mmol /L, high-density lipoprotein cholesterol > 1.0mmol /L in male and 1.3mmol /L in female, and triglyceride < 1.7mmol /L;  Low density lipoprotein cholesterol < 2.6 mmol/Lor < 1.8 mmol/L for patients with coronary heart disease.  

3. Blood Pressure (BP)

BP is recommended under130/80 mmHg for patient with diabetes.

4. Kidney Function

The early changes of diabetic nephropathy are the thickening of glomerular basement membrane, the enlargement of filtration pores and the disappearance of charge barrier, which make the plasma albumin with low molecular weight easily filter into urine.  Therefore, urinary albumin excretion rate is an important index in the diagnosis of early diabetic nephropathy. Normally,The ratio of urinary albumin/ creatine should be under 2.5 mg/mmol (22.0 mg/g) for males and 3.5 mg/mmol (30.0 mg/g) for females.  

5. Body Weight

It is recommended to control body mass index (BMI) between 18.5to 24.0 kg/m2.