Fixation on HbA1C ‘fundamentally flawed’

It’s a “fundamentally flawed” strategy to fixate exclusively on HbA1C, according to US and UK researchers who say clinicians should consider patient preferences, quality of life and the “burden” of treatment.

The researchers, led by Dr Sandeep Vijan of the University of Michigan, draw on seminal studies such as the UKPDS and DCCT trials to establish the clinical benefits of lowering HbA1C from 8.5% to 7.5%. Their study then plots these against the number of quality-adjusted life years lost to side effects and the inconvenience of the therapy.

The tipping point between benefit and harm was found to vary widely according to patients’ age at diagnosis and pre-treatment HbA1C level, the researchers write in JAMA Internal Medicine.

However, the most “profound impact” comes