The importance of glycemic control: how low should we go with HbA1c? Start early, go safe, go low

(A) Relationship between updated mean HbA1c and risk for diabetic complications in patients with newly diagnosed Type 2 diabetes in the prospective observational UKPDS-35 study. Each 1% decrease in mean HbA1c was associated with risk reductions of 21% for any diabetes endpoint (P<.0001), 21% for diabetes-related mortality (P<0.0001), 14% for myocardial infarction (MI) (P<.0001) and 37% for microvascular complications (P<.0001) (Stratton et al., 2000). (B) Association between a 1% increase in HbA1c and risk for coronary heart disease, cardiovascular death and all-cause mortality among more than 10,000 men and women aged 45–79 years from the general population in the European Prospective Investigation into Cancer in Norfolk study (Khaw et al., 2004).

Adjusted rates of diabetes-related morbidity and mortality, all-cause mortality, myocardial infarction (MI), stroke, and microvascular disease according to HbA1c strata in the UKPDS-35 study in Type 2 diabetes. (Stratton et al., 2000)