Table 1: Consensus framework for considering treatment goals for glycemia in older adults with diabetes. Adapted with permission from American Diabetes Association Older Adults. Section 10. In Standards of Medical Care in Diabetes - 2016. Diabetes Care 2016; 39 (Suppl. 1): S81-S85.


Patient characteristics/health status


Reasonable A1C goal

Fasting or pre-prandial glucose

Bedtime glucose

Healthy (few coexisting chronic illnesses, intact cognitive and functional status)

Longer remaining life expectancy

< 7.5%

90-130 mg/dL

90-150 mg/dL

Complex/intermediate (multiple coexisting chronic illnesses* or 2+ instrumental ADL impairments or mild-to-moderate cognitive impairment)

Intermediate remaining life expectancy, high treatment burden, hypoglycemia vulnerability, fall risk

< 8.0%

90-150 mg/dL

100-180 mg/dL

Very complex/poor health (LTC or end-stage chronic illnesses** or moderate-to-severe cognitive impairment or 2+ ADL dependencies)

Limited remaining life expectancy makes benefit uncertain

< 8.5%

100-180 mg/dL

110-200 mg/dL


*Coexisting chronic illnesses are conditions serious enough to require medications or lifestyle management and may include arthritis, cancer, congestive heart failure, depression, emphysema, falls, hypertension, incontinence, stage 3 or worse chronic kidney disease, myocardial infarction, and stroke. By “multiple,” the authors mean at least three, but many patients may have five or more.


**The presence of a single end-stage chronic illness, such as stage 3-4 congestive heart failure or oxygen-dependent lung disease, chronic kidney disease requiring dialysis, or uncontrolled metastatic cancer, may cause significant symptoms or impairment of functional status and significantly reduce life expectancy. Abbreviations: LTC: Long-term care; ADL: Activities of Daily Living.