Hemoglobin Reduction Treatment May Lower CV Risk in Type 2 Diabetes Patients
Patients with type 2 diabetes who reduce their hemoglobin A1c (HbA1c) levels via metformin treatment can lower their risk of cardiovascular (CV) events and death, a recent study showed.
A Northern Denmark population-based cohort study conducted from 2000 to 2012 assessed 24,752 patients who initiated metformin in their treatment plan for type 2 diabetes. Participants’ median age was 62.5 years, and 55% were male.
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Median follow-up after baseline was 2.6 years, and Cox regression analysis was used to examine post-treatment rates of acute myocardial infarction, stroke, or death, controlling for baseline HbA1c and other confounding factors. Six months after metformin initiation, the researchers categorized patients by HbA1c achieved (higher or lower than 6.5%) and by magnitude of HbA1c change from baseline.
Results showed that patients with higher HbA1c levels had an increased risk of a CV event or death compared with those who achieved target HbA1c levels of less than 6.5%. The risk gradually increased with rising HbA1c levels.
The researchers noted that results were consistent for myocardial infarction, stroke, and mortality, and were also consistent within different age groups and among other patient characteristics, such as the presence or absence of comorbidities at baseline.
Higher HbA1c levels tended to produce worse outcomes in patients aged 70 years or older.
“A large initial HbA1c reduction and achievement of low HbA1c levels within 6 months after metformin initiation are associated with a lower risk of cardiovascular events and death in patients with type 2 diabetes,” the researchers concluded.
—Christina Vogt
Reference:
Svensson 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. Diabetes Care. 2017;40(6). https://doi.org/10.2337/dc16-2271.