Diabetes: Hence the 7.0 A1c ADA guidance

One problem is that we know if you have elevated BG, you will have all sorts of damage long term (diabetic retinopathy, vessel disease, kidney damage, neuropathy, and on and on). However, it is not so clear how much the last incremental improvement really helps (hence the 7.0 A1c ADA guidance). I have been screamed at in here before, since getting that ever lower A1c is thought of as almost a religious fervor by some diabetics (if 7.0 is decent, then 6.0 just has to be better and impart more protection against side effects, but there may be a point of diminishing returns).

Personally, my concern is hypo episodes since I have CAD and CHF. The risk of arrhythmias is very real with hypoglycemia, Besides, I have never been fond of sweating profusely and passing out. I will always trade reasonable control for a lessened chance of heart attack. In my own case, I never like to see my BG go much below 100.