Glycaemic Control
The management of blood glucose levels within acceptable ranges, assessed primarily through HbA1c. Glycaemic control is the primary therapeutic objective for diabetes management and a key outcome measure in GLP-1 receptor agonist trials for type 2 diabetes.
Technical Context
Glycaemic control targets: ADA/EASD recommend HbA1c <7.0% for most adults with diabetes (individualised: <6.5% for those at low hypoglycaemia risk, <8.0% for elderly/comorbid patients). Beyond HbA1c, contemporary glycaemic metrics include: time in range (TIR — percentage of time glucose is within 70-180 mg/dL target, measurable by CGM; target ≥70%), time below range (TBR — <70 mg/dL; target <4%), time above range (TAR — >180 mg/dL; target <25%), and glycaemic variability (coefficient of variation <36%). GLP-1 RAs improve glycaemic control through multiple mechanisms: potentiating glucose-stimulated insulin secretion (glucose-dependent — low hypoglycaemia risk), suppressing glucagon secretion, slowing gastric emptying (reducing postprandial glucose excursions), and promoting weight loss (improving insulin sensitivity).