A1c's 6.0 Or Below Recommended In This Study

The following information comes from a study published in the July 27, 2009 issue of the Archives of Internal Medicine.

The percentages of complications in well controlled type 1s were very impressive.

“The demonstration that near-normal glucose control substantially lowers microvascular and cardiovascular complications has heralded a new era of Type 1 diabetes care,” says lead author David M. Nathan, M.D., of Massachusetts General Hospital. “The remarkable improvement in long-term outcomes achieved with intensive glucose control should encourage clinicians and patients alike to implement intensive therapy as early in the course of Type 1 diabetes as possible.”

The authors compared overall rates of eye, kidney, and cardiovascular complications in three groups of people diagnosed with Type 1 diabetes an average of 30 years earlier.

“After 30 years of diabetes, fewer than 1% of those receiving intensive glucose control in the DCCT had significantly impaired vision, kidney failure, or needed a limb amputation due to diabetes,” noted Saul Genuth, M.D., of Case Western University, who co-chairs the EDIC study. “Tight control is difficult to achieve and maintain, but its benefits have changed the course of diabetes.” Intensive treatment meant trying to keep hemoglobin A1c readings at 6% or less with at least three insulin injections a day or an insulin pump.


What’s really odd here is that the authors promote an A1c of 6% or less, but make no mention of the fact that the average A1c of intensively controlled DCCT subjects was 7%. And when the DCCT ended, the average A1c in the intensively controlled group increased. So where did the 6% figure come from if it didn’t occur in the DCCT?

That said, I am a total believer in good control.

These are such promising results. Not that I needed an incentive to keep my A1C below 6%, but I think I’ll continue to do it anyway.

The authors had a group that consisted of good (6% or less) and less good controlled subjects. Then they compared the outcome. They analysed the correlation between complications and A1c and what a miracle it was around 6% where the number of complications was significantly lower. A healthy human being has an A1c ranging from 5 to 5.5% so the border must have been around 6%. In Germany this is common knowledge for more than 10 years and not even my family doctor promoted the 7% rule. Sadly this knowledge has not ‘heralded a new era of Type 1 diabetes care’ in Germany. The problem still prevails: how to motivate the patients?