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TARGETS FOR CONTROL

All the target levels given below are generalisations and individual targets MUST be established. Laxity may be allowed in elderly patients; certain conditions require a much tighter control, e.g. pregnancy, maculopathy, etc.

Target Values
  mg/dl mmol/l
Venous Plasma Glucose (mg/100ml)    
Fasting 80-110 4.5 - 6.1
2 hours postprandial 120-140 6.7 - 7.8
Glycosylated hemoglobin (HbA1c)
(normal range 4-7)
<7.5 < 7.5
Blood pressure (mm/Hg) <130/85 < 130/85
Total Cholesterol < 180 < 4.66
HDL-Cholesterol (males) > 40 >1.03
HDL-Cholesterol (females) > 50 >1.3
LDL-Cholesterol < 100 <2.6
Triglycerides < 150 < 1.7


OPTIMAL WEIGHT


Ideally, Body Mass Index (BMI) should be used to calculate optimal weight using the following formula:

            Weight in Kg
BMI = -------------------------
            Height in meters2

> 23 = Overweight; > 27 = Obese ( for people from the Indian subcontinent)

Care must be taken that the weight is not decreased below the lower limits, as a BMI of 18.5 signifies low body weight.


For BMI Tables, see Appendix 2a


CENTRAL OBESITY


Recent evidence suggests that central or visceral obesity as measured by the waist circumference plays a key role in increasing the risk for T2DM as well as atherosclerotic cardiovascular disease (ASCVD).

The method to measure the waist circumference and Country/Ethnic group specific diagnostic waist circumference measures in given in Appendix 1c

IN ADDITION, OPTIMAL MANAGEMENT IMPLIES DIAGNOSIS FOR PRESENCE OF THE CHRONIC DIABETIC COMPLICATIONS IN THEIR EARLIEST STAGES, AS WELL AS OPTIMAL MANAGEMENT OF THE CO-MORBID RISK FACTORS ASSOCIATED WITH T2DM AND THE METABOLIC SYNDROME.


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