A1C-Derived Average Glucose (ADAG) study group recently published the average BG premeal, postmeal, and at bedtime to achieve a variety of HbA1c targets. These results, based on empirical data, will help patients and providers set realistic day-to-day SMBG targets to achieve individualized HbA1c goals. ADAG study cohort consisted of 507 nonpregnant adult individuals between 18 and 70 years old with stable HbA1c values for 3 months from 10 international centers: U.S. (6), Europe (3), and Africa.

The ADAG study was a multicenter observational study that used continuous glucose monitoring and SMBG testing to determine the relationship between mean average glucose and HbA1c. SMBG data from 470 of the ADAG study participants (237 with type 1 diabetes and 147 with type 2 diabetes) were used to determine the average fasting, premeal, 90-min postmeal, and bedtime blood glucose (BG) for predefined target HbA1c groups between 5.5 and 8.5%.

Mean fasting, premeal, 90-min postmeal, and bedtime BG in each HbA1c group are summarized in Table 1. There were significant differences in mean premeal and postmeal BG between specified breakfast, lunch, and supper meals, with the average prelunch BG significantly lower than the prebreakfast and supper averages in patients in the prespecified HbA1c groups (Table 2). The average postbreakfast BG was significantly higher than the postlunch and supper averages across nearly all HbA1c groups analyzed.

These data may be used by professional societies, clinicians, and patients to guide the appropriate choice of glucose targets and treatment to achieve their individualized HbA1c goal.

Table 1


Table 2