A new study suggests that keeping blood sugars balanced while adapting drug treatments could help lower the incidence of heart failure among people with type 2 diabetes.
Previous research suggested that people with type 2 diabetes are more likely to develop heart complications than people without diabetes. It is also thought that poorer blood glucose control can increase the risk of heart disease.
This new observational study looked at the impact of different HbA1c levels and drug treatment regimen on the risk of first hospitalisation for heart failure and death in people with and without type 2 diabetes.
Researchers from the University of Leicester and the University of Keele, in the UK, have looked at 48,000 heart failure patients and investigated what levels of blood glucose control and drug treatment intensity appeared to confer more risks.
The participants’ HbA1c levels and drug treatment information were tracked six months before hospitalisatio, or one year before death, and compared between people with or without type 2 diabetes over a 12-year time period.
After controlling for other factors that may influence heart risk, they found that people with type 2 diabetes had a higher risk of hospitalisation for heart failure compared to those without diabetes.
Of all participants with and without type 2 diabetes, those with HbA1c levels greater than 80 mmol/mol (9.5%) as well as those with HbA1c levels lower than 37 mmol/mol (5.5%) had higher risks of hospitalisation for heart failure.
Readers can note that if you can maintain a very good HbA1c level, below 37 mmol/mol (5.5%), without medication or on metformin alone, this should not present a greater risk for heart failure. The study did not attempt to specifically isolate and review people with very good control.
People with type 2 diabetes who experienced a greater than one per cent change in their HbA1c levels six months before hospitalisation had higher heart failure and death risks than those who saw smaller changes during that time.
Receiving few medications was associated with elevated risks of hospitalisation for heart failure and death among people with type 2 diabetes, with the highest risks being seen for those only on insulin or taking no treatment at all.
Researchers believe that the HbA1c targets for people with type 2 diabetes should be adapted according to the progression of symptoms of heart failure, as tighter control was associated with an increase in risk.
They also emphasise that achieving better blood glucose control through diet can lead to less heart complications, as suggested by previous studies they reviewed.
Overall, these findings suggest that changes in HbA1c levels can affect the risk of heart failure and highlight the importance of keeping blood sugar levels in a healthy range for reducing such complications.

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