This blog tracks updates to the Blood Sugar 101 Web site.

Sunday, May 9, 2010

More Data Links A1c But Not Fasting Glucose to Cardiac Risk

Page Changed: A1c and High Post-Meal Blood Sugars Predict Heart Attack

Risk Quantified For Non-Diabetic A1cs and Heart Attack Risk

The Atherosclerosis Risk in Communities study tracked 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease. for 15 years. It found no association between fasting blood sugar and risk of heart disease, but A1c was a different story. The The table below summarizes the correlation of baseline A1c with the risk of developing cardiovascular disease.

Multivariate-Adjusted Hazard Ratio

5%:              0.96 (0.74-1.24)
5% to < 5.5%:       1.00 (reference)
5.5% to < 6%:      1.23 (1.07-1.41)
6% to < 6.5%:      1.78 (1.48-2.15)
≥ 6.5%:             1.95 (1.53-2.48)

Glycated Hemoglobin, Diabetes, and Cardiovascular Risk in Nondiabetic Adults. Elizabeth Selvin et al.NEJMVolume 362:800-811. March 4, 2010 Number 9.

Keep in mind that because these subjects were probably diagnosed as "non-diabetic" using a fasting glucose test many of those with the higher A1cs probably were diabetic at the study outset based on post-meal values. If you are recently diagnosed with diabetes and have no signs of heart disease, your risk/A1c ratio should be similar if not identical to those shown here.