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Early Glycemic Control May Cut CV Risk in Type 2 Diabetes

Greater glycemic variability is associated with increased risk for major adverse cardiovascular events

WEDNESDAY, May 18, 2022 (HealthDay News) — Early control of glycated hemoglobin (HbA1c) may improve cardiovascular outcomes in type 2 diabetes, according to a study published online April 4 in Diabetes, Obesity and Metabolism.

Martin B. Whyte, Ph.D., from University of Surrey in the United Kingdom, and colleagues examined whether achieving early glycemic control and any subsequent glycemic variability was associated with any change in the risk for major adverse cardiovascular events (MACE). The analysis included 26,180 newly diagnosed patients (aged 25 years or older) with type 2 diabetes on or after Jan. 1, 2005, with HbA1c measurements at both diagnosis and after one year.

The researchers found that compared with those with HbA1c <58 mmol/mol (<7.5 percent) over one year, those with HbA1c ≥75 mmol/mol (≥9.0 percent) who transitioned to HbA1c <58 mmol/mol (<7.5 percent) had a reduced risk for MACE. Those who maintained HbA1c ≥75 mmol/mol (≥9.0 percent) over the year had a higher risk for MACE. The greatest glycemic variability score was associated with an increased risk for MACE compared with the lowest glycemic variability score.

“Our findings support the concept that effort must be made to achieve rapid metabolic normalization after the diagnosis of diabetes in those with a low propensity to hypoglycemia,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Eli Lilly, which funded the study.

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