1% Reduction in A1C- A “Big Deal”

1% Reduction in A1C- A “Big Deal”

We’ve heard a lot about “the 1%”, referring to the very wealthy, in the recent US political campaign, and opinions are divided. There’s another 1% in the field of diabetes care about which opinions are divided, and that relates to HbA1C. HbA1C, or simply A1C, is a measure which estimates average blood sugar levels over a period of a few months, and relevant organizations have set target values where the risk for diabetes complications is reduced. The American Diabetes Association, for instance, establishes an A1C target value of 7%, corresponding with average blood glucose levels of approximately 150 mg/dl (8.3 mmol/l).

The relationship of A1C to heart and cardiovascular diabetes complications has not been clear, however, with different studies showing different results. Recent “real world” data from a large Swedish observational study presented this Fall to the conference of the European Association for the Study of Diabetes by Dr. Katarina Eeg-Olofsson of the University of Gothenburg suggests that reducing A1C has a marked impact on the risk for heart and cardiovascular events. A study group of more than 12,000 patients selected from the Swedish National Diabetes Registry (with no history of heart disease) were followed by researchers who noted changes in A1C over time and correlated those changes to heart disease, cardiovascular disease and death. About 6800 subjects showed A1C reductions over the course of the study from an average of 7.8% to a final average of 7.0%. Conversely, about 5500 subjects showed stable or increasing A1C from an average of 7.8% to a final average of 8.4%.

The group where A1C values improved over the course of the study showed a more than 40% decreased risk for these common diabetes cardiovascular complications. It is important to note that the only variable between the two groups was the trajectory of the subjects’ A1C values over the course of the study period. However, other potentially confounding factors between the groups such as BMI, age, duration of diabetes, gender, etc. matched relatively closely. Further evaluation of these observations is ongoing, but the benefit of reduced average blood glucose was profound in the broad assessment.We’ve heard a lot about “the 1%”, referring to the very wealthy, in the recent US political campaign, and opinions are divided. There’s another 1% in the field of diabetes care about which opinions are divided, and that relates to HbA1C. HbA1C, or simply A1C, is a measure which estimates average blood sugar levels over a period of a few months, and relevant organizations have set target values where the risk for diabetes complications is reduced. The American Diabetes Association, for instance, establishes an A1C target value of 7%, corresponding with average blood glucose levels of approximately 150 mg/dl (8.3 mmol/l).

The relationship of A1C to heart and cardiovascular diabetes complications has not been clear, however, with different studies showing different results. Recent “real world” data from a large Swedish observational study presented this Fall to the conference of the European Association for the Study of Diabetes by Dr. Katarina Eeg-Olofsson of the University of Gothenburg suggests that reducing A1C has a marked impact on the risk for heart and cardiovascular events. A study group of more than 12,000 patients selected from the Swedish National Diabetes Registry (with no history of heart disease) were followed by researchers who noted changes in A1C over time and correlated those changes to heart disease, cardiovascular disease and death. About 6800 subjects showed A1C reductions over the course of the study from an average of 7.8% to a final average of 7.0%. Conversely, about 5500 subjects showed stable or increasing A1C from an average of 7.8% to a final average of 8.4%.

The group where A1C values improved over the course of the study showed a more than 40% decreased risk for these common diabetes cardiovascular complications. It is important to note that the only variable between the two groups was the trajectory of the subjects’ A1C values over the course of the study period. However, other potentially confounding factors between the groups such as BMI, age, duration of diabetes, gender, etc. matched relatively closely. Further evaluation of these observations is ongoing, but the benefit of reduced average blood glucose was profound in the broad assessment.

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