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ADA: Lower Glucose Levels May Not Explain Excess Mortality

New analysis of ACCORD trial suggests converse; that higher A1C levels predict higher mortality

TUESDAY, June 9 (HealthDay News) -- A new analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, which reported that intensive treatment strategy to lower blood glucose was associated with an increased risk of death, shows that lower glucose levels alone might not be the cause, according to a report presented at the American Diabetes Association's 69th Scientific Sessions, held from June 5 to 9 in New Orleans.

Matthew C. Riddle, M.D., of the Oregon Health Science University in Portland, and a member of the Glycemia Management Group of ACCORD, confirmed the trial's estimate that intensive treatment was associated with a 20 percent increased risk of death.

However, Riddle said that the data also show that for every 1 percent higher A1C level above 6 percent, there is a 20 percent increased risk of death. In addition, he said that this increased risk remains constant even after adjusting for age, diabetes duration, or previous cardiovascular events.

"An A1C below 7 percent alone does not appear to explain the excess deaths in the ACCORD trial and is not necessarily a predictor of mortality risk," Riddle said in a statement. "Further, the rate of one-year change in A1C showed that a greater decline in A1C was associated with a lower risk of death."

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