HbA1c Variability and Cardiovascular Events

• Published in: Current cardiovascular risk reports Vol. 10; no. 5; p. 18
• Main Authors: Mehring, Michael, Donnachie, Ewan, Schneider, Antonius
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2016; Springer Nature B.V
• Subjects: Cardiology; Cardiovascular disease; Developing countries; Diabetes; Diabetes + Insulin Resistance (M Rutter; Glucose; Health care expenditures; Health risks; LDCs; Lifestyles; Medicine; Medicine & Public Health; Patients; Section Editor; Signal transduction; Topical Collection on Diabetes and Insulin Resistance; Vein & artery diseases; Cardiovascular events; variability; HbA; Severe adverse events; Health services research
• ISSN: 1932-9520; 1932-9563
• DOI: 10.1007/s12170-016-0501-x

Due to its high and increasing prevalence, type 2 diabetes mellitus is becoming more and more of a global public health burden. Effective measures are required to prevent diabetes-related morbidity and the resulting premature death. The effect of long-term glycemic fluctuations in patients with diabetes mellitus, referred to as HbA1c variability, has been the subject of intensive discussion. Whereas the mean HbA1c value is already established as a risk factor for vascular complications, an accumulation of findings makes a compelling case that HbA 1c variability adds further predictive value. Recent studies raise the possibility that a reduced HbA 1c variability may inhibit hyperglycemia-related diseases without increasing the risk of hypoglycemia. Taken as a whole, the present evidence demonstrates a clear association between HbA 1c variability and cardiovascular events in patients with type 1 and type 2 diabetes. Nevertheless, there exists to date no standardized definition or method of measuring HbA 1c variability. To advance further research, it would be helpful to reach consensus on a precise definition of HbA 1c variability.