Why Raise Your A1C?

According to this study from the University of California at San Francisco, Achieving lower A1C levels with oral hypoglycemic medications was not associated with more frequent falls, except, among those using insulin, an A1C less than or equal to 6% increased risk of falls. Below 6% is a pretty rare A1C for an older insulin-using adult. A large study at Yale University found that Contrary to conventional wisdom, hypoglycemia occurs just as frequently among those with poor glycemic control (higher A1C) as it does in those achieving near-normal glycemia. And in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the more people lowered their A1C, the fewer hypoglycemic episodes they had. So there is no reason to assume risk of falls or hypos from tight control. It should be an individual decision. Confusing tight control with control by drugs Three large studies are driving the diabetes establishment away from "tight control." These studies, ACCORD, the Action in Diabetes and Vascular Disease (ADVANCE) Trial, and the Veterans Affairs Diabetes Trial (VADT), showed no significant improvement in death, heart disease, or stroke rates for people with tighter control (lower A1Cs). So why bother with the risks, effort, and expense of tight control if there was no benefit? But the problem wasn’t the tight control. It was all the drugs doctors used to achieve the control. Those drugs, especially insulin, thiazolidinedioines (TZDs), and sulfonylureas, can have...
Source: Diabetes Self-Management - Category: Diabetes Authors: Source Type: blogs