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In patients with type 2 diabetes, large fluctuations in blood sugar levels between doctor visits are associated with an increased risk of heart disease.
The study, published in the journal Diabetes, Obesity & Metabolism, examined more than 29,000 patients with type 2 diabetes over a period of two years. Patients who already had heart disease were excluded.
The American Diabetes Association recommends adults with diabetes maintain an A1c, average blood sugar level for the past two to three months, of less than 7 percent to reduce complications from diabetes such as heart disease. However, studies – including this one – have shown that large fluctuations in blood sugar levels can be a better predictor of diabetic complications than the A1c value at every single visit to the doctor.
“The underlying mechanism for the relationship between large fluctuations in blood sugar levels between doctor appointments and a high risk of heart disease in patients with type 2 diabetes is unclear,” said Dr. Gang Hu, Associate Professor and Director, Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center. “It’s possible that episodes of severely low blood sugar are the link.”
Research has shown that large fluctuations in blood sugar levels are linked to poor health outcomes and even death. A 2017 Johns Hopkins study found that a third of people with diabetes who were hospitalized for a severe episode of low blood sugar died within three years of the incident.
“We recommend that patients and their doctors undertake therapies that can reduce large fluctuations in blood sugar levels and the associated episodes of severe blood sugar levels,” said Dr. Hu. “Our results suggest that measuring the fluctuations in blood hemoglobin A1c levels over a period of time – say six months to a year – could serve as an additional blood glucose target,” he added.
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Yun Shen et al. Relationship between visit-to-visit HbA1c variability and risk of cardiovascular disease in patients with type 2 diabetes, diabetes, obesity, and metabolism (2020). DOI: 10.1111 / dom. 14201
Provided by the Pennington Biomedical Research Center
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