ARBs can be useful to prevent HF in patients at high risk for developing HF who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with asso- ciated cardiovascular risk factors (Class IIa; Level of Evidence B). Stages B and C HF Management of Hyperglycemia: Glycemic Goals in Patients With Diabetes Mellitus and HF Current American Diabetes Association (ADA) guide- and the AHA/ACC statement on intensive glycemic control and the prevention of cardiovascular events181 provide the following: The following recommendations are from the ADA Standards of Medical Care (2015)13 : (1) Lowering A1c to approximately 7% has been shown to reduce microvascular complications of diabetes, and if implemented soon after the diagnosis of diabetes, it is associated with long-term reduction in macrovascular dis- ease. Therefore, a reasonable A1c goal for many nonpregnant adults is <7%. (B)13,181 (2) Providers might reasonably suggest more strin- gent A1c goals (such as <6.5%) for selected individual patients, if this can be achieved with- out significant hypoglycemia or other adverse effects of treatment. Appropriate patients might include those with short duration of dia- betes, type 2 diabetes treated with lifestyle or metformin only, long life expectancy, and no significant CVD. (C)13,181 Less-stringent A1c goals (such as <8%) may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, extensive comorbid condi- tions, and those with longstanding diabetes in whom the general goal is difficult to attain despite diabetes self-management educa- tion, appropriate glucose monitoring, and effective doses of multiple glucose lowering agents including insulin. 