Targets

The management of a patient with diabetes can be focused on key areas. These have been outlined recently in the Diabetes National Service Framework, and are known as targets. Patient care and disease management is guided by achieving the targets listed below.

Targets

HbA1c - below 6.5% (but 7.5% or below for those at risk of severe hypoglycaemia)
Blood glucose - 4 - 6 mmol/l pre meals; less than 10mmol/l 2 hours after a meal
Blood pressure - 130/80 or less
Blood lipids
Total Cholesterol - below 4 mmol/l
LDL - below 2mmol/l
HDL - 1.0 mmol/l or above for men, 1.2 mmol/l or above for women
Triglycerides - 1.7mmol/l or below
Waist circumference - less than 94cm for men (caucasian and black), less than 80cm for women (caucasian and black), less than 90cm for men (south asian) and less than 80cm for women (south asian)
Body mass index (BMI) average, Caucasian - 18.5 – 24.9kg/m2
BMI average, Asian origin - 18.5 –22.9kg/m2

These targets are based on guidelines from NICE, the International Diabetes Federation (PDF, 720 KB), and the Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice.

Adult NSF targets

The DH Illustrative targets for local priorities (PDF, 29KB) is available to download.

Failure in realising optimum targets in disease management can lead to significant change to patient well being, increasing the complications that a patient may experience. Co-morbidities (other conditions) listed below are commonly seen in the patient with diabetes, and will often first present with the patient experiencing a new symptom, such as worsening vision (retinopathy).