Updated HbA1c Goal in ISCHEMIA
The hemoglobin A1c goal in ISCHEMIA has been relaxed to <8%. This was done because there is no evidence that tighter glycemic control reduces macrovascular events in type 2 diabetes, and since patients recruited into ISCHEMIA will fit the description below from the latest American Diabetes Association guidelines. This is consistent with the latest guidelines from virtually all professional societies.
ADA 2013 Glycemic Goal in Adults:
Less stringent A1C goals (such as <8%) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid conditions, and those with long-standing diabetes in whom the general goal is difficult to attain despite diabetes self-management education (DSME), appropriate glucose monitoring, and effective doses of multiple glucose-lowering agents including insulin.