Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus
Abstract Glycated hemoglobin (HbA1c) is widely accepted as the most reliable measure of long‐term glycemia. However, there is disagreement among professional medical societies on a proper glycemic target for long‐term benefits in type 2 diabetes (T2D). The use of some glucose‐lowering drugs was asso...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-07-01
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| Series: | Journal of General and Family Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgf2.244 |
| _version_ | 1818300060921757696 |
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| author | Masayuki Ikeda Rumiko Shimazawa |
| author_facet | Masayuki Ikeda Rumiko Shimazawa |
| author_sort | Masayuki Ikeda |
| collection | DOAJ |
| description | Abstract Glycated hemoglobin (HbA1c) is widely accepted as the most reliable measure of long‐term glycemia. However, there is disagreement among professional medical societies on a proper glycemic target for long‐term benefits in type 2 diabetes (T2D). The use of some glucose‐lowering drugs was associated with heart failure despite substantial lowering of HbA1c. The failure of intensive glycemic control to reduce cardiovascular risk in some trials again brought into question the usefulness of HbA1c as a therapeutic target in T2D. In large cardiovascular outcome trials, some newer glucose‐lowering drugs were associated with higher risks of heart failure or amputation despite comparable glycemic control between the test and placebo groups. Here, we provide evidence that variation in hemoglobin glycation between individuals is responsible for these inconsistencies. We suggest that further research be conducted in this area and that the findings be applied to clinical trials and practice. |
| first_indexed | 2024-12-13T05:01:07Z |
| format | Article |
| id | doaj.art-13798f6c2e7f4c118f300abff129a300 |
| institution | Directory Open Access Journal |
| issn | 2189-7948 |
| language | English |
| last_indexed | 2024-12-13T05:01:07Z |
| publishDate | 2019-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of General and Family Medicine |
| spelling | doaj.art-13798f6c2e7f4c118f300abff129a3002022-12-21T23:58:46ZengWileyJournal of General and Family Medicine2189-79482019-07-0120412913810.1002/jgf2.244Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitusMasayuki Ikeda0Rumiko Shimazawa1Department of Medical Informatics Kagawa University Hospital Kagawa JapanDepartment of Clinical Pharmacology Tokai University School of Medicine Kanagawa JapanAbstract Glycated hemoglobin (HbA1c) is widely accepted as the most reliable measure of long‐term glycemia. However, there is disagreement among professional medical societies on a proper glycemic target for long‐term benefits in type 2 diabetes (T2D). The use of some glucose‐lowering drugs was associated with heart failure despite substantial lowering of HbA1c. The failure of intensive glycemic control to reduce cardiovascular risk in some trials again brought into question the usefulness of HbA1c as a therapeutic target in T2D. In large cardiovascular outcome trials, some newer glucose‐lowering drugs were associated with higher risks of heart failure or amputation despite comparable glycemic control between the test and placebo groups. Here, we provide evidence that variation in hemoglobin glycation between individuals is responsible for these inconsistencies. We suggest that further research be conducted in this area and that the findings be applied to clinical trials and practice.https://doi.org/10.1002/jgf2.244cardiovascular diseasesclinical trialsglycated hemoglobinhypoglycemic agentsoutcome assessmenttype 2 diabetes mellitus |
| spellingShingle | Masayuki Ikeda Rumiko Shimazawa Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus Journal of General and Family Medicine cardiovascular diseases clinical trials glycated hemoglobin hypoglycemic agents outcome assessment type 2 diabetes mellitus |
| title | Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus |
| title_full | Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus |
| title_fullStr | Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus |
| title_full_unstemmed | Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus |
| title_short | Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus |
| title_sort | challenges to hemoglobin a1c as a therapeutic target for type 2 diabetes mellitus |
| topic | cardiovascular diseases clinical trials glycated hemoglobin hypoglycemic agents outcome assessment type 2 diabetes mellitus |
| url | https://doi.org/10.1002/jgf2.244 |
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