Type 2 diabetes: Goals for optimum management
| Parameter | Goals/Recommendations |
|---|---|
| Diet | – Follow Australian dietary guidelines with attention to quantity and type of food. – If CVD risk is a concern, recommend an individual dietary review. |
| Body Mass Index (BMI) | – Therapeutic goal: 5-10% weight loss for people who are overweight or obese with type 2 diabetes. – For BMI >35 kg/m² (with comorbidities) or BMI >40 kg/m², consider more aggressive weight loss measures. – BMI may vary between population groups, so interpretation should be individualized.  |
| Physical Activity | – At least 30 minutes of moderate physical activity on most, if not all, days of the week. – Target: ≥150 minutes/week. |
| Cigarette Consumption | – 0 cigarettes per day. |
| Alcohol Consumption | – ≤2 standard drinks (20 g) per day for both men and women. |
| Blood Glucose Level (BGL) | – Fasting BGL: 6–8 mmol/L. – Postprandial BGL: 8–10 mmol/L. – Recommend self-monitoring for those on insulin, sulphonylureas, with hyperglycemia, haemoglobinopathies, or pregnancy. – Routine self-monitoring is not recommended for low-risk patients using oral glucose-lowering drugs (except sulphonylureas). |
| Glycated Haemoglobin (HbA1c) | – Individualized based on patient circumstances. – General target: ≤53 mmol/mol (48–58 mmol/mol) or ≤7% (6.5–7.5%). |
| Total Cholesterol | – <4.0 mmol/L. – Pharmacotherapy initiation is based on absolute CVD risk using multiple factors. – Use targets as a guide to treatment, not mandatory benchmarks. |
| High-Density Lipoprotein Cholesterol (HDL-C) | – ≥1.0 mmol/L. |
| Low-Density Lipoprotein Cholesterol (LDL-C) | – <2.0 mmol/L. |
| Non–HDL Cholesterol | – <2.5 mmol/L. |
| Triglycerides | – <2.0 mmol/L. |
| Blood Pressure (BP) | – ≤140/90 mmHg – Consider lower targets for younger individuals and those at high risk of stroke, as long as treatment doesn’t increase the risk. – Target BP for those with diabetes and albuminuria/proteinuria: <130/80 mmHg – Individualize treatment and monitor for medication side effects |
| Urine Albumin Excretion | – Urine albumin-to-creatinine ratio (UACR): <3.5 mg/mmol (women) <2.5 mg/mmol (men) – Timed overnight collection: <20 mcg/min. – Spot collection: <20 mg/L. |
| Vaccination | – Consider immunization against influenza, pneumococcal disease, and diphtheria-tetanus-acellular pertussis (dTpa) vaccine. |
This table pr