[HbA1c: target value should remain 7%].
The treatment of diabetes mellitus is focused on the prevention of micro- and macrovascular complications. The target HbA(1c) should therefore be 7% or lower. However, a recent study advised a HbA(1c) of 7.5%, since it was found that mortality increased with an HbA(1c) below 7.5%. This was probably caused by hypoglycaemia. A higher mortality in patients with a low HbA(1c) has been described before, but the causes were never understood. It is true that a lower HbA(1c) leads to more hypoglycaemia, but there are no indications that this is the cause of the increased mortality. Changing the target HbA(1c) based on one epidemiological retrospective study is unwise. Taking into account historic prospective studies such as the United Kingdom Prospective Diabetes Study, we think the target HbA(1c) should remain 7% or lower in the treatment of diabetes mellitus.
Soeters
Maarten R
MR
Academisch Medisch Centrum, afd. Inwendige Geneeskunde, Amsterdam, the Netherlands. m.r.soeters@amc.uva.nl
Hoekstra
Joost B
JB
de Vries
J H Hans
JH
D048909:Diabetes Complications / Q000097:blood / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000097:blood* / Q000401:mortality / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000517:prevention & control
D006442:Glycated Hemoglobin