The Effect of HbA1c Variability on Cardiovascular Disease

Lowering blood glucose is, of course, important; so is how glucose is lowered. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was terminated early due to increased mortality. The authors of this study interpret this as meaning that normalization of blood glucose levels should not be the only target of diabetes treatment. They believe that glycemic variability may be a factor that could be used to explain differences in cardiovascular outcomes between studies. Glycemic variability can be either glucose fluctuation during the day or over a long-term period, with the latter being more studied. Most of those studies evaluated HbA1c variability using the standard deviation or coefficient of variation. Those studies suggested an association with all-cause mortality. Recently, a new scale, the HbA1c variability score (HVS), was developed to allow HbA1c variability to be more easily and consistently studied....

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