Studies show that lowering HbA1c by 1% (11 mmol/mol) in patients with type 2 diabetes and an HbA1c of above 8%, significantly reduced rates of heart problems and stroke.
Researchers from the UK and France reviewed people with type 2 diabetes that had participated in the CREDIT (Cardiovascular Risk Evaluation in People with Type 2 Diabetes on Insulin Therapy) study.
2,999 patients, which had been living with diabetes for around 9 years and had high HbA1c results, were reviewed over 54 months (4 and a half years). The mean average HbA1c levels were 9.3% (78 mmol/mol) and the majority of participants had an HbA1c reading between 8 and 11% (64 and 97 mmol/mol). The mean age of patients was 61 years old, mean BMI (body mass index) was 28.6 there was a roughly equal split of men and women.
The patients received treatment with insulin which reduced the mean HbA1c from 9.3% (78 mmol/mol) to 7.4% (57 mmol/mol). The results showed that participants with an HbA1c 1% (11 mmol/mol) higher than the mean had a 25% increased risk of a major heart problem (major adverse cardiac event) and a 36% increased risk of stroke.
Lead author of the study, Dr Nick Freemantle stated: “The results confirm that people with better blood glucose control have better cardiovascular outcomes, adding to the view that maintaining good blood glucose control when using insulin therapy may be of advantage in the medium term.”
The research adds another side to the debate that has opened this week, following the news that intensive treatment with insulin of type 2 diabetes in older patients, without high HbA1c levels, may do more harm than good.

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