International Diabetes Guidelines Face to Face

Mini Review

Abstract

Diabetes mellitus is diagnosed by HbA1c ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, 2-hour oral glucose tolerance test glucose ≥ 200 mg/dL, or random plasma glucose ≥ 200 mg/dL with symptoms. Prediabetes is defined by HbA1c 5.7–6.4%, fasting glucose 100–125 mg/dL, or 2-hour oral glucose tolerance test glucose 140–199 mg/dL. Glycemic targets generally aim for HbA1c < 7%, with individualized goals based on age, comorbidities, and hypoglycemia risk. Recommended glucose targets include fasting levels of 80-130 mg/dL and postprandial levels < 180 mg/dL. Lifestyle management emphasizes at least 150 minutes of weekly physical activity, 5-10% weight loss, healthy dietary patterns, adequate sleep, and stress control. Metformin remains first-line therapy for type 2 diabetes, with Sodium-Glucose Cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists preferred in patients with cardiovascular disease, heart failure, chronic kidney disease, or weight-loss goals. Insulin is indicated for severe hyperglycemia or treatment failure. Comprehensive care includes blood pressure control (<130/80 mmHg), statin therapy based on cardiovascular risk, routine screening for kidney disease, retinopathy, neuropathy, and foot complications, and adherence to adult vaccination schedules. Continuous glucose monitoring is increasingly recommended, and special populations such as pregnancy and type 1 diabetes require tailored glycemic targets and insulin-based management.