Setting the hemoglobin A1c target in type 2 diabetes: a priori, a posteriori, or neither?

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• 作者：Dario Giugliano ; Maria Ida Maiorino ; Giuseppe Bellastella ; Michela Petrizzo…
• 关键词：HbA1c target ; Type 2 diabetes ; A priori ; A posteriori
• 刊名：Endocrine
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：50
• 期：1
• 页码：56-60
• 全文大小：340 KB
• 参考文献：1.Standards of Medical Care in Diabetes-2014, Diabetes Care 37(Supplement 1), S14–S80 (2014)
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• 作者单位：Dario Giugliano (1)
  Maria Ida Maiorino (1)
  Giuseppe Bellastella (1)
  Michela Petrizzo (2)
  Antonio Ceriello (3)
  Stefano Genovese (4)
  Katherine Esposito (5)
  
  1. Department of Medical, Surgical, Neurological, Metabolic Sciences and Geriatrics, Second University of Naples, Naples, Italy
  2. IOS and Coleman -Medicina Futura Medical Center, Centro Direzionale, Naples, Italy
  3. Institut d’Investigations Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
  4. Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni, MI, Italy
  5. Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
  
• 刊物主题：Endocrinology; Diabetes; Internal Medicine; Science, general;
• 出版者：Springer US
• ISSN：1559-0100

文摘

Current guidelines specify hemoglobin A1c (HbA1c) targets around or less than 7.0 %, with more (<6.5 %) or less (<8 %) stringent goals being appropriate for selected patients. The difficulty in setting a precise HbA1c target depends, at least in part, on the physician perception of the relative importance of the parameters to be considered when determining the target. Using the “a priori-approach, physicians set the HbA1c target first, then prescribe the appropriate antidiabetic drug in order to cover the distance from the target, i.e., the difference between the current HbA1c value of the patient and the individualized HbA1c target: calculating the distance from the target may also be useful as a predictor of therapeutic success. In the “a posteriori-approach, physicians first prescribe, then decide if the achieved HbA1c is an appropriate level for that patient. Attainment of the HbA1c target ultimately depends on which target the physician set: both approaches (“a priori-and “a posteriori- may be useful for both physicians to make appropriate therapeutic decisions and patients to adhere to the best possible treatment. All this presumably will avoid unnecessary therapeutic inertia. Keywords HbA1c target Type 2 diabetes A priori A posteriori