February 7, 2013

More is Less in High Risk T2D People


more_lessPicture people fully clothed on a sunny beach. Now picture the same sunny beach with scantily clad beach bunnies. Who’s better protected? Now translate the UV index to an HbA1c scale. Can more glucose in the blood be safer in Type 2 diabetes?

A study found that  patients with T2D had increased risk of death with lower HbA1c. The conventional wisdom for the HbA1c target is to remain between 4% and 6%  range.

However, a five-year follow-up data from the Accord trial confirms that it is better to target an HbAlc level between 7% and 7.5% rather than a lower value, in patients with T2D and a high risk of cardiovascular events.

For the record, it’s important to note that the patients in this study were at a high risk of cardiovascular events. The trial named ACCORD stands for “Action to Control Cardiovascular Risk in Diabetes”.

This article was based on the premise of a higher HbA1c for T2D glucose control in patients at high risk of cardiovascular events. In no way is this a hall pass for the bell curve of T2D people.

To describe the picture and parallel it to the story – leave the habit at home and slap on some SPF. Certain practices are more appropriate for certain people.

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