Effect of Type 2 Diabetes Treatment Varies by Hemoglobin Glycation Index

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Effect of Type 2 Diabetes Treatment Varies by Hemoglobin Glycation Index
Effect of Type 2 Diabetes Treatment Varies by Hemoglobin Glycation Index

(HealthDay News) — The effect of intensive vs. standard type 2 diabetes treatment varies according to the hemoglobin glycation index (HGI: observed hemoglobin A1c [HbA1c] — predicted HbA1c), according to a study published in Diabetes Care.

James M. Hempe, PhD, from the Louisiana State University Health Sciences Center in New Orleans, and colleagues conducted an ancillary study using data from the Action to Control Cardiovascular Risk in Diabetes randomized trial involving 10,251 patients with type 2 diabetes. 

Participants were randomly assigned to standard or intensive treatment, with HbA1c goals of 7.0% to 7.9% and less than 6%, respectively. The effect of intensive treatment on outcomes was assessed in patients with low, moderate and high HGI.

The researchers found that the primary outcomes (composite of cardiovascular [CV] events) were improved with intensive treatment in the low (HR=0.75; 95% CI, 0.59-0.95) and moderate (HR=0.77; 95% CI, 0.61-0.97) HGI subgroups, but not in the high HGI subgroup (HR=1.14; 95% CI, 0.93-1.40). 

Only the high HGI subgroup had higher total mortality in intensively treated patients (HR=1.41; 95% CI, 1.10-.80). In standard and intensive treatment groups, high HGI correlated with increased risk for hypoglycemia.

"HbA1c is not a one-size-fits-all indicator of blood glucose concentration and suggest that failure to take this into account can result in suboptimal diabetes care," the researchers wrote.

Reference

  1. Hempe JM et al. Diabetes Care. 2015;doi:10.2337/dc14-1844.
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