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HbA1c variability predicts cardiovascular complications in type 2 diabetes

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The incidence of cardiovascular disease (CVD) in people with type 2 diabetes mellitus is very high. It is common knowledge that, to stop them, the HbA1c levels of people suffering from type 2 diabetes mellitus should be controlled, since elevated levels of HbA1c increase the risk of suffering from these diseases. However, several studies suggest that HbA1c fluctuations over time may increase the development of cardiovascular complications.

The objective of this study was to determine the impact of HbA1c fluctuations on the development of CVD in people with type 2 diabetes mellitus, who had HbA1c levels ≤ 7%, and did not have established CVD. The study analyzed data from 101,533 patients from the Swedish National Diabetes Registry.

The study divided the patients into 4 groups, where the variations experienced in HbA1c in each group were 1.3%, 1.7%, 2.3% and 3.5%, respectively. Group 4, which experienced greater HbA1c variability with a variation of 3.5%, had a 41% higher risk of CVD than group 1, which had experienced an HbA1c variability of 1.3%. This showed that the risk of CVD increased significantly with increasing HbA1c variability (p<0.004).

Thus, this study shows the importance of achieving and maintaining constant HbA1c ≤ 7% over time, to prevent future cardiovascular complications in patients with type 2 diabetes mellitus.

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