A glycated
hemoglobin (HbA1c) target value of <6.5 percent does not offer additional protection against organ complications for patients with type 1 diabetes compared with a target of 6.5 to 6.9 percent.

In their
study just published in The BMJ, Marcus Lind, M.D., Ph.D., of the
University of Gothenburg in Sweden, and colleagues report that they assessed
10,398 children and adults with type 1 diabetes who were recorded in the
Swedish National Diabetes Registry during 1998 to 2017.

Patients
were followed from first observation until the first incidence of retinopathy
or nephropathy, the last follow-up, or the end of data collection on Dec. 31,
2017.

The
researchers observed no additional reduction in the risk for retinopathy and
nephropathy for HbA1c levels of <6.5 percent. However, the lower HbA1c target increased risk for severe hypoglycemia compared with 6.5 to 6.9 percent (relative risk, 1.34).

At HbA1c
levels of 7.0 to 7.4 percent, there was an increased risk for any retinopathy (odds
ratio, 1.31) and microalbuminuria (odds ratio, 1.55). At HbA1c levels of
>8.6 percent, there was a higher risk for proliferative retinopathy (odds
ratio, 5.98) and macroalbuminuria (odds ratio, 3.43).

“The
current findings support a general target of HbA1c <7.0 percent in people with type 1 diabetes," the authors wrote.

“People
who achieve HbA1c levels <6.5 percent should be vigilant about not spending too much time in hypoglycemia and achieve a good diabetes-related quality of life."

SOURCE: https://www.practiceupdate.com/C/90856/56?elsca1=emc_enews_topic-alert

REFERENCE:
Lind et al: HbA1c level as a risk factor for retinopathy and nephropathy
in children and adults with type 1 diabetes: Swedish population based cohort
study; 
https://www.bmj.com/content/366/bmj.l4894