Summary :Patients with type 2 diabetes who had both the lowest and the highest mean HbA(1c) levels had a higher all-cause mortality rate. “If confirmed, diabetes guidelines might need revision to include a minimum HbA(1c) value.”
Basis for Study : “Results of intervention studies in patients with type 2 diabetes have led to concerns about the safety of aiming for normal blood glucose concentrations.” This British study investigated whether survival is affected by the HbA(1c) level.
Detailed Summary of Study : All-cause mortality was determined in two groups of patients age 50 with type 2 diabetes: "27,965 patients whose treatment had been intensified from oral monotherapy to combination therapy with oral blood-glucose lowering agents, and 20,005 who had changed to regimens that included insulin." Mortality was compared based on HbA(1c) level (stratified into 10 groups). Findings were adjusted for age, sex, smoking, cholesterol, cardiovascular risk and general morbidity.
Results/Body :Patients with the lowest all-cause mortality were those with HbA(1c) of 7.5%. Compared with that group, patients in the lowest and highest groups (HbA(1c) of 6.4% and 10.5% respectively) had a significantly higher risk of dying.
Sources & Other Links :Currie CJ, Peters JR, Tynan A, Evans M, Heine RJ, Bracco OL, Zagar T, Poole CD. Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study.Lancet. 2010 Jan 26.
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