SOURCE: Svensson E, Baggesen LM, Johnsen SP, et al. Diabetes Care 2017;40:800-807.
Experts often opine that treatment of diabetes is “a marathon, not a sprint,” suggesting that careful, slow steps are wise. In reference to risk for hypoglycemia, this philosophy is likely to be particularly apt, and yet some data suggest that prompt control of type 2 diabetes (T2DM), with strong early reductions in A1c, may produce long-term benefits.
Svensson et al reported on a large population of T2DM patients (n = 24,752) in Denmark among whom baseline A1c and degree of A1c reduction within the first six months could be correlated with outcomes over the next 2.6 years (mean follow-up). The group was restricted to only those patients whose initial treatment had been metformin. The authors found that both the lowest six-month achieved A1c level and greatest absolute degree of A1c correlated with greatest risk reduction for cardiovascular outcomes.
Although the window of observation of these patients is only modest (< 3 years), these results encourage clinicians to pursue the best control of T2DM we can attain without incurring significant adverse events, such as hypoglycemia.