To the Editor: In their Commentary on balancing hypoglycemia and glycemia, Drs Pogach and Aron1 addressed the dangers of hypoglycemia, which occur more often among people with diabetes who have stringent hemoglobin A1c goals. They also discussed the importance of guidelines, stating that, “Although guidelines are meant to inform and not mandate specific clinical decisions, they are also cited as definitive source documents for performance measurement development by those who may not be familiar with the primary data and any associated limitations.” They share their concern that despite dangers of hypoglycemia, the American Diabetes Association (ADA) guidelines “highlight targets of less than 7% hemoglobin A1c ‘in general.’”
Skolnik N. Guidelines for Glycemic Control and Individualized Targets. JAMA. 2010;304(10):1069–1070. doi:10.1001/jama.2010.1257
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