Appropriate target for HbA1c

ACCORD Trial: Intensive Glucose Control and Mortality
In the ACCORD trial, the intensive-therapy group (targeting glycated hemoglobin to less than 6.0%) as compared to the standard-therapy group, had a relative increase in mortality of 22% and an absolute increase of 1.0% during the follow-up period, with similar differences in death from cardiovascular causes. This increase in mortality is equivalent to one extra death for every 95 patients who were treated for 3.5 years. The cause for the rise in the rate of these unexpected, excess deaths in the ACCORD trial is not certain.

Q: What is the most appropriate target for glycated hemoglobin level in a diabetic?
A: The most appropriate target for glycated hemoglobin level is 7%. Both editorials published in this latest issue of the Journal, include discussion suggesting that the benefits of achieving glycemic targets below 7% in patients with type 2 diabetes remain uncertain.