[Diabetes: time to redefine goals?]

The aim of this study was to assess if the A1c goals from the Brazilian Diabetes Society (SBD) were compatible with their goals for blood glucose.

An online simulation (AIDA) was used to simulate a hypothetical patient with blood glucose values similar to the SBD's goals. Average glucose was calculated from generated blood glucose values, and then converted to the corresponding A1c value, using the ADA online calculator. Other glycemic profiles, using different levels of blood glucose, were also simulated in order to assess which would be the A1c value associated with each profile.

Glycemic goals proposed by the SBD (fasting glucose < 100 mg/dL, preprandial < 110 mg/dL, and postprandial < 140 mg/dL), were associated with an A1c of 5.9%, much lower than the goal of 7% recommended by the SBD. This demonstrates incompatibility among A1c and blood glucose goals proposed by the SBD. Such A1c levels are associated with increased mortality among high-risk patients.

Besides recommending different A1c goals for different patients, the SBD should probably review its recommendations and adopt different blood glucose goals that are compatible with the proposed A1c goals, making therapeutic targets clearer.