Glycated hemoglobin and cardiovascular risk in diabetes mellitus: Evolving evidence beyond glycemic control

Table 2 Various guidelines and their summaries about glycated hemoglobin and cardiovascular risk

Guideline or consensus source	Glycaemic target statement	Cardiovascular implication
ADA standards 2025[51]	HbA1c < 7% is appropriate for many non-pregnant adults; targets should be individualised, with more stringent or less stringent goals according to safety and burden	HbA1c remains important, but glycaemic goals should not be pursued at the cost of severe hypoglycaemia or excessive treatment burden
ADA/European Association for the Study of Diabetes consensus 2022[47]	HbA1c remains central to monitoring, but target-setting should be person-centred and tailored to comorbidity, duration, patient preference, and treatment risk	In ASCVD, HF, or chronic kidney disease, drug selection should prioritise organ protection, not HbA1c lowering alone
European Society of Cardiology diabetes/CVD guideline 2023[57]	Glycaemic management should be personalised within comprehensive cardiovascular risk reduction	HbA1c should be interpreted within broader CVD prevention, with strong emphasis on therapies proven to reduce ASCVD, HF, and renal events

ADA: American Diabetes Association; CVD: Cardiovascular disease; HbA1c: Glycated hemoglobin; HF: Heart failure.