Glycemic Control Predicts CVD Outcomes in Diabetes Patients Taking Metformin
Early and rapid glycemic control following initiation of metformin therapy was associated with reduced cardiovascular events in patients with type 2 diabetes, according to the results of a new study.
The population-based cohort study included 24,752 Danish patients with diabetes who initiated metformin for the first time (median age 62.5 years, 55% males). Researchers followed participants for a median of 2.6 years. They classified the participants by HbA1c levels achieved and the magnitude of changes from baseline, and documented incidents of acute myocardial infarction, stroke, or death.
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In comparison with participants who achieved a target HbA1c below 6.5%, the researchers found that the risk for combined cardiovascular outcomes gradually increased with rising HbA1c levels achieved. The association remained consistent after researchers adjusted for age and other patient characteristics, as well as for individual outcomes.
In addition, a rapid reduction in HbA1c levels within 6 months of starting metformin was associated with a lower risk of cardiovascular events and death.
“Whereas causality is difficult to prove in our observational study design, these results provide an early prediction tool for identification of patient subgroups with type 2 diabetes that have increased risk for cardiovascular complications and death,” the researchers concluded.
—Melissa Weiss
Reference:
Svennsson E, Baggesen LM, Johnsen SP, et al. Early glycemic control and magnitude of HbA1c reduction predict cardiovascular events and mortality: population-based cohort study of 24,752 metformin initiators [published online April 12, 2017]. Diabetes Care. https://doi.org/10.2337/dc16-2271.