Maintaining Target Hemoglobin A1c Less than 6% May Increase Mortality in Patients with Type 2 Diabetes?

science
diabetes
hba1c
(Steve B) #1

I want to begin this post by saying that as of this posting, I have not had an opportunity to read the studies referenced, nor am I suggesting they are even good science.

I happened to do a quick search on cvs.com to see what options they had for a home A1C test. Curiously, I saw a link in their Health Resources section to this article: Maintaining Target Hemoglobin A1c Less than 6% May Increase Mortality in Patients with Type 2 Diabetes. I’ve bookmarked this link and plan to read the referenced studies more thoroughly. My first thought, however, is that members of this forum would want to know about this and take a look for themselves.

In addition to just putting it out there to make the community aware, I’m always interested in what members of the forum think of the article itself, and the studies referenced. Have fun reading and commenting!

(Chris W) #2

It wouldn’t surprise me if the data showed that sugar burning T2s showed an increase mortality with a low a1c, since the BG roller coaster that they experience exposes them to hypoglycemic periods if they are attempting to keep the average BG that low. Fat burning (keto) T2s shouldn’t have any problems with hypoglycemic episodes as long as they are not taking BG lowering medications.
A quick read of the summary of study shows that the lower a1c group was all taking aggressive BG lowering medications. The mortality is likely more related to the over use of meds to try and acheive an a1c, rather than using proper diet. This would expose the group to a much higher chance of hypoglycemic episodes.

(Steve B) #3

Again, without having read the studies yet.

My first reaction was that this would be more likely due to aggressive medication and the manner in which the lower HBA1C was achieved than the lower average itself.

(Ethan) #4

My first and only reaction to this story is that it is only valid for those who receive, " Intensive blood glucose-lowering treatment." I assume this means multiple crappy medications or even insulin.

#5

Have not read the study but have an older relative who is T2. Was visiting family including my cousin who is a very well respected internist in a major city. When she asked about my older relative, I said I was annoyed that he cannot seem to get his A1C under 6. She practically went apoplectic that it was a bad idea to go so low. Until I mentioned that due to partial compliance with his mostly but not entirely LC diet, he is no longer medicated. Then she lost interest and said that was ok. My hunch is as others have said, this is for medicated patients

As I recall now, there was a whole program in the early 2000s that focused on controlling BG with medications. The trial was stopped early because there was higher mortality with medicated blood sugar control that was too low

(Ethan) #6

The sad part is that blood glucose is only part of the problem. Hyperinsulinemia is the real issue, but most medications don’t treat that.

(You've tried everything else; why not try bacon?) #7

I take the wonder drug known as :bacon:. Safe and effective, and impossible to overdose!

(Ethan) #8

I don’t eat pork, but there are plenty of foods that fit the bill for me! Im particularly fond of liver right now.

(You've tried everything else; why not try bacon?) #9

And I had to go mentioning it at the high holy days, too! Sorry—no offense intended.

(Ethan) #10

No offense to me. Everybody has the freedom to do what they choose! That’s the beauty of us all being individuals and freedom itself!