title: Strict glycemic control and mortality risk among US adults with type 2 diabetes.
abstract: OBJECTIVE
  To assess the relationships between strict HbA1c levels and mortality risk among adults with type 2 diabetes by age, insulin therapy, and hypertension comorbidity.
  
  
  METHODS
  Data of adult participants with type 2 diabetes from the third National Health and Nutrition Examination Survey (1988-1994) and its linked mortality file (with follow-up death up to 2000) were used.
  
  
  RESULTS
  Having strict glycemic control (i.e., HbA1c ≤6.5%) was associated with a lower risk of mortality (hazards ratio=0.69; 95% confidence interval=0.48-0.98). However, among those with strict glycemic control levels, statistically significant results were not found.
  
  
  CONCLUSIONS
  Reaching strict glycemic control levels in the general US population with type 2 diabetes appears to be associated with lower mortality. Further research is needed as to how strict glycemic control affects certain diabetic groups.
authors.affiliation: Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA. iyl7@cdc.gov
authors.forename: Evelyn P
authors.initials: EP
authors.lastname: Davila
authors.forename: Hermes
authors.initials: H
authors.lastname: Florez
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Trepka
authors.forename: Lora E
authors.initials: LE
authors.lastname: Fleming
authors.forename: Theophile
authors.initials: T
authors.lastname: Niyonsenga
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.forename: Jai
authors.initials: J
authors.lastname: Parkash
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012306:Risk; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human