The actual guideline figures in the UK issued by NICE June 2009.
1.9.2.1
Adults with type 1 diabetes should be advised that
maintaining a DCCT-harmonised HbA1c below 7.5% is
likely to minimise their risk of developing diabetic eye,
kidney or nerve damage in the longer term.
1.9.2.2
Adults with diabetes who want to achieve an HbA1c down
to, or towards, 7.5% should be given all appropriate
support in their efforts to do so.
1.9.2.3
Where there is evidence of increased arterial risk
(identified by a raised albumin excretion rate, features
of the metabolic syndrome, or other arterial risk factors),
people with type 1 diabetes should be advised that
approaching lower HbA1c levels (for example, 6.5% or
lower) may be of benefit to them. Support should be
given to approaching this target if so wished.
1.9.2.4
Where target HbA1c levels are not reached in the
individual, adults with diabetes should be advised that
any improvement is beneficial in the medium and long
term, and that greater improvements towards the target
level lead to greater absolute gains.
1.9.2.5
Undetected hypoglycaemia and an attendant risk of
unexpected disabling hypoglycaemia or of hypoglycaemia
unawareness should be suspected in adults with
type 1 diabetes who have:
• lower HbA1c levels, in particular levels in or approaching
the normal reference range (DCCT harmonised < 6.1%)
• HbA1c levels lower than expected from self-monitoring
results.
1.9.2.6
Where experience or risk of hypoglycaemia is significant
to an individual, or the effort needed to achieve target
levels severely curtails other quality of life despite optimal
use of current diabetes technologies, tighter blood glucose
control should not be pursued without balanced discussion
of the advantages and disadvantages.