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Diabetes

Low HbA1c levels and mortality in type 2 diabetes mellitus

A novel study published in The Lancet suggests a U-shaped association between HbA1c levels and mortality in patients with type 2 diabetes mellitus. But is a revision of current guidelines to include a minimum HbA1c target advisable on the basis of these findings?

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References

  1. Action to Control Cardiovascular Risk in Diabetes Study Group et al. Effects of intensive glucose lowering in type 2 diabetes. N. Engl. J. Med. 358, 2545–2559 (2008).

  2. Currie, C. J. et al. Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study. Lancet 375, 481–489 (2010).

    Article  CAS  PubMed  Google Scholar 

  3. Wannamethee, G., Shaper, A. G., Whincup, P. H. & Walker, M. Low serum total cholesterol concentrations and mortality in middle aged British men. BMJ 311, 409–413 (1995).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kosiborod, M. et al. Relationship between spontaneous and iatrogenic hypoglycemia and mortality in patients hospitalized with acute myocardial infarction. JAMA 301, 1556–1564 (2009).

    Article  CAS  PubMed  Google Scholar 

  5. Riddle, M. C. A1C and mortality risk in ACCORD. Presented at the American Diabetes Association 69th Scientific Sessions (2009).

  6. Engel-Nitz, N. M., Martin, S., Sun, P., Buesching, D. & Fonseca, V. Cardiovascular events and insulin therapy: a retrospective cohort analysis. Diabetes Res. Clin. Pract. 81, 97–104 (2008).

    Article  CAS  PubMed  Google Scholar 

  7. Kelly, T. N. et al. Systematic review: glucose control and cardiovascular disease in type 2 diabetes. Ann. Intern. Med. 151, 394–403 (2009).

    Article  PubMed  Google Scholar 

  8. Khaw, K. T. et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of european prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 322, 15–18 (2001).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Selvin, E. et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N. Engl. J. Med. 362, 800–811 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Skyler, J. S. et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. J. Am. Coll. Cardiol. 53, 298–304 (2009).

    Article  PubMed  Google Scholar 

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Correspondence to Vivian A. Fonseca.

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S. Ali declares no competing interests. V. A. Fonseca declares an association with the following companies: AstraZeneca (research support), Daiichi Sankyo (research support/honoraria for consulting and lectures), Eli Lilly (research support/honoraria for consulting and lectures), GlaxoSmithKline (research support/honoraria for consulting and lectures), Novartis (research support/honoraria for consulting and lectures), Novo Nordisk (research support/honoraria for consulting and lectures), Sanofi-Aventis (research support/honoraria for consulting and lectures), Takeda (research support/honoraria for consulting and lectures).

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Ali, S., Fonseca, V. Low HbA1c levels and mortality in type 2 diabetes mellitus. Nat Rev Endocrinol 6, 359–360 (2010). https://doi.org/10.1038/nrendo.2010.69

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