Early glycemic control with metformin cuts CVD events
Elisabeth Svensson, Ph.D., from Aarhus University Hospital in Denmark, and colleagues conducted a population-based study involving 24,572 metformin initiators with HbA1c tests in Northern Denmark from 2000 to 2012 (median follow-up, 2.6 years). Patients were classified by HbA1c achieved at six months after metformin initiation and by the magnitude of change in HbA1c from the pretreatment base.
The researchers found that, compared with a target HbA1c of <6.5 percent, the risk of a combined outcome event (acute myocardial infarction, stroke, or death) increased gradually with increasing levels of HbA1c achieved (adjusted hazard ratios, 1.18 for 6.5 to 6.99 percent; 1.23 for 7.0 to 7.49 percent; 1.34 for 7.5 to 7.99 percent, and 1.59 for ≥8 percent). Outcome was also predicted by a large absolute HbA1c reduction from baseline (adjusted hazard ratio, 0.80 for Δ = −4, compared with no change [Δ = 0]).
"A large initial HbA1c reduction and achievement of low HbA1c levels within six months after metformin initiation are associated with a lower risk of cardiovascular events and death in patients with type 2 diabetes," the authors write.
Several authors disclosed financial ties to Novo Nordisk, which partially funded the study.
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