What is the target Hemoglobin A1c (HbA1c) level for an 82-year-old patient?

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Last updated: May 30, 2025 • View editorial policy

From the Guidelines

For an 82-year-old, the goal A1c should be less than 8%, as this target balances the benefits of glycemic control with the risks of hypoglycemia and other adverse effects, prioritizing safety and quality of life. According to the American College of Physicians guidance statement 1, clinicians should treat patients with type 2 diabetes to minimize symptoms related to hyperglycemia and avoid targeting an HbA1c level in patients with a life expectancy less than 10 years due to advanced age (80 years or older). This approach is supported by the most recent guidelines from Diabetes Care 2, which suggest less stringent A1C goals (such as <8% [64 mmol/mol]) may be appropriate for patients with limited life expectancy or where the harms of treatment are greater than the benefits.

Key Considerations

  • The risk of hypoglycemia is a significant concern in older adults, and treatment should focus on minimizing this risk.
  • Medications with lower hypoglycemia risk, such as metformin, DPP-4 inhibitors, or GLP-1 receptor agonists, are preferred over sulfonylureas or intensive insulin regimens.
  • Regular monitoring remains important, but the emphasis shifts to maintaining quality of life and preventing diabetes complications that could develop within the patient's life expectancy.
  • Individualization of the A1c target is crucial, taking into account the patient's overall health status, comorbidities, functional status, and life expectancy.

Guidance Statements

  • Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy, treatment burden, and costs of care 1.
  • Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes, but consider deintensifying pharmacologic therapy in patients who achieve HbA1c levels less than 6.5% 1.
  • Clinicians should treat patients with type 2 diabetes to minimize symptoms related to hyperglycemia and avoid targeting an HbA1c level in patients with a life expectancy less than 10 years due to advanced age (80 years or older) 1.

From the Research

Goal A1c for 82-year-old

  • The American Diabetes Association (ADA) recommends different A1C targets in older adults based on comorbid health status 3.
  • For older adults with diabetes, an A1C target of <7% is considered reasonable, but this may vary depending on the individual's health status and other factors 3.
  • A study of older adults with diabetes found that those with an A1C ≥8% had a higher risk of mortality and hospitalizations compared to those with an A1C <7% 3.
  • The choice of therapy for type 2 diabetes in older adults should take into account the individual's health status, cardiovascular risk, and risk of hypoglycemia 4, 5, 6.
  • Sulfonylureas may be associated with an increased risk of hypoglycemia and mortality in older adults with type 2 diabetes, especially when used as add-on therapy to metformin 6.
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors and other newer classes of medications may be considered as alternatives to sulfonylureas for second-line therapy in older adults with type 2 diabetes 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.