Mean Blood Glucose Better Than A1c In Predicting Cardiovascular Disease

A group of researchers at theHull Royal Infirmary, Hull, UK, compared the use of measurements of mean blood glucose (MBG) and of HbA1c to predict macrovascular complications in patients with type 1 diabetes.

Data were analyzed from 1,441 participants in the Diabetes Control and Complications Trial (DCCT), during which pre- and postprandial 7-point glucose profiles were collected quarterly for a 10-year period. After adjusting for known macrovascular disease risk factors and the treatment groups of the patients, Cox regression analysis was used to identify any relationship between MBG or HbA1c, and time to first cardiovascular event.

The researchers found that MBG was predictive of a cardiovascular event (p = 0.019), but not HbA1c (p = 0.858), with a 18mg/dL.(1 mmol/L) rise in MBG being associated with an 11% increase in cardiovascular risk. Even after adjustment for HbA1c values and glucose variability, MBC remained highly predictive of cardiovascular risk (p = 0.015).

The researchers concluded that the risk of macrovascular complications associated with hyperglycemia was evident within the time period of the DCCT study, and that measurement of MBG was a better means of predicting cardiovascular risk than measurement of HbA1c.

Diabetologia. 2008;51:365-71.