What A1C level indicates that basal insulin should be started in diabetes management?

In diabetes management, an A1C level greater than 9% typically indicates that an individual’s blood glucose levels are not adequately controlled with oral medications or lifestyle changes alone, suggesting that insulin therapy, particularly basal insulin, may be necessary to improve glycemic control. An A1C above this threshold generally reflects a higher average blood glucose level and the increased risk of long-term complications associated with diabetes. Initiating basal insulin can help stabilize blood glucose levels throughout the day and reduce the high overall A1C level.

Choosing a level of greater than 9% aligns with clinical guidelines that advocate for insulin therapy when the A1C is significantly elevated, indicating the need for more intensive management strategies. A1C levels below this value may not warrant such an aggressive approach, as other management modalities might still be effective at controlling blood glucose levels.