Diabetes Care: Is your glycation okay?

Early, a United Kingdom Prospective Diabetes Study (UKPDS) showed that intensive glycemic control, compared with conventional glycemic control, HbA1c levels averaged 0.
9% lower, reducing the micro type 2 diabetes (T2D) patients with vascular risk of complications
.

The risk of all-cause death (ACM) and myocardial infarction (MI) did not decrease, although the 16% reduction in MI risk was statistically marginal (P = 0.

Diabetes and blood sugar control compared to conventional, HbA1c levels averaged 0.

When cardiovascular HbA1c is reduced by 0.

At present, the legacy effect is considered to be a bridge between diabetes and its complications, as well as a challenge for blood sugar management

In order to explore the relationship between the blood glucose legacy effect and the previous HbA1c value, and to explore the potential effects of early hypoglycemic treatment and delayed hypoglycemic treatment, experts from the Institute of Medicine of Sahlgrenska College, University of Gothenburg in Sweden carried out related research, and the results were published in the journal Diabetes Care On
.

The researchers started with the T2D diagnosis of 3802 participants in the UK Prospective Diabetes Study (UKPDS 88) and estimated the risk functions of ACM and MI for 20 years
.

According to the HbA1c value, the influence of downstream ACM and MI risk is weighted and analyzed

diagnosis

The results showed that for every percentage point increase in HbA1c, the risk of ACM at 5, 10, and 20 years increased by 8%, 18%, and 36%, respectively (HR=1.
08, 95% CI 1.
07-1.
09; 1.
18, 1.
15-1.
21; 1.
36 , 1.
30-1.
42); The risk of MI increased by 13% (HR=1.
13, 1.
11-1.
15) in 5 years and 31% in 20 years (HR=1.
31, 1.
25-1.
36)
.

The results showed that for every percentage point increase in HbA1c, the risk of ACM at 5, 10, and 20 years increased by 8%, 18%, and 36%, respectively (HR=1.
08, 95% CI 1.
07-1.
09; 1.
18, 1.
15-1.
21; 1.
36 , 1.
30-1.
42); The risk of MI increased by 13% (HR=1.
13, 1.
11-1.
15) in 5 years and 31% in 20 years (HR=1.
31, 1.
25-1.
36)
.

The results showed that for every percentage point increase in HbA1c, the risk of ACM at 5, 10, and 20 years increased by 8%, 18%, and 36%, respectively (HR=1.

Time-dependent HR of death from all causes (left) and myocardial infarction (right) from 0 to 20 years after the diagnosis of type 2 diabetes
.

On the other hand, reducing HbA1c by one percentage point from the beginning of diagnosis will reduce the risk of ACM by 18.
8% (95% CI 21.
1-16.
0) after 10-15 years, and postpone this reduction to 10 years after diagnosis, the risk is only 1/7 , Which is 2.
7% (3.
1-2.
3)
.

Reducing HbA1c at the time of diagnosis, the corresponding MI risk was reduced by 19.

On the other hand, reducing HbA1c by one percentage point from the beginning of diagnosis will reduce the risk of ACM by 18.

In summary, early detection of diabetes and begin intensive glucose control from the time of diagnosis, to maximize the reduction of hypoglycemia long-term risk of complications is essential

references:

Historical HbA1c Values ​​May Explain the Type 2 Diabetes Legacy Effect: UKPDS 88.

Historical HbA1c Values ​​May Explain the Type 2 Diabetes Legacy Effect: UKPDS 88.
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