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HbA1c ‘best kept between 6% and 8%’ in older patients

By Christian Duffin

The life expectancy of older patients with type 2 diabetes is optimised by achieving HbA1c levels of between 6% and 8%, a new US study concludes.

The research follows much discussion over whether reducing HbA1c too low might actually push up mortality. It examined the relationship between the level of glycaemic control and major adverse outcomes among 71,000 people aged 60 and above linked to the Kaiser Permanent North California healthcare organisation in the US, enrolled between 2004 and 2008.

Compared with patients with an HbA1c of less than 6.0, the risks of major adverse events – including death, acute metabolic and cardiovascular events – was 17% less for patients with an HbA1c of between 6.0 and 9.0, but 31% higher for patients with HbA1c levels of 11.0% and above. Risk of any complication or death became significantly higher at 8.0% or above.

Study researcher Professor Elbert Huang, assistant professor of medicine at the University of Chicago, said: 'dditional research is needed to evaluated the low HbA1c-mortality relationship, as well as protocols for individualising diabetes care.'

Diabetes Care 2011 online 19 April

HbA1c 'best kept between 6% and 8%'