Early A1C control may improve cardiovascular outcomes in T2D, according to a study published in Diabetes, Obesity and Metabolism. Martin B. Whyte, PhD, 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 or older) with T2D on or after January 1, 2005, with A1C measurements at both diagnosis and after 1 year. Compared with those with an A1C less than 58 mmol/mol (<7.5%) over 1 year, those with an A1C of at least 75 mmol/ mol (≥9.0%) who transitioned to an A1C less than 58 mmol/mol (<7.5%) had a reduced MACE risk. Those who maintained an A1C of at least 75 mmol/mol (≥9.0%) over the year had a higher MACE risk. The greatest glycemic variability score was associated with an increased MACE risk compared with the lowest 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 wrote.
