An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure

Impact of Hyperglycemic Control on Left Ventricular Myocardium A Molecular and Cellular Basic Study in a Diabetic Rat Model

“…[10][11][12] Moreover, the effectiveness of blood sugar control has been found to be inversely proportional to the increase in risks of coronary artery disease, new onset of CHF, and also the associated mortality. 10,13,14) Consistently, the present study demonstrated significant elevation in MMP-9 gene expression and ROS generation in rats with poor hyperglycemic control compared to those under satisfactory control which in turn showed significantly higher levels of these two parameters as compared with those in the healthy rats. Therefore, the link between increased HbA 1C level and an increased intensity of inflammatory response in this investigation further reinforces the clinical observations from previous studies.…”

“…4,5,8,9) A high hemoglobin A 1C (HbA 1C ) level, which reflects poor glycemic control, not only is more predictive of the development of atherosclerosis [10][11][12] compared to the diagnosis of DM per se, it has also been shown to be associated with an increased risk of obstructive coronary artery disease, new onset of heart failure, and the associated mortality. 10,13,14) Furthermore, studies have previously indicated that nearly 20% of DM patients have been given the diagnosis of diabetic cardiomyopathy because of their myocardial dysfunction and congestive heart failure (CHF) in the absence of coronary artery disease. 15,16) However, the relationship among inflammatory activity, circulating level of HbA 1C , and the mechanistic basis of myocardial dysfunction has not been fully addressed.…”

Glycosylated Haemoglobin (HbA 1 c) - A Marker of Circulating Lipids in Type 2 Diabetic Patients

“…However these patients had a lower level of HDL cholesterol when compared to patients with good glycemic control. It has been reported that HDL cholesterol is inversely, and non-HDL cholesterol directly, associated with CAD risk in diabetes patients [23]. The cause of dyslipidaemia in type 2 diabetes mellitus may be due to impaired liver apolipoprotein production which in turn regulates the enzymatic activity of lipoprotein lipase and cholesterol ester transport protein [24].…”

Do We Need A Wider Therapeutic Paradigm For Heart Failure With Comorbidities?: A Remote Australian Perspective

“…Diuretics effect on extracellular K+ and non-selective ββ effect on glycemic control are concerns. Combination of calcium blocker e.g amlodipine or vasodilating ββ or lower strength diuretic with potent RAAS blockade can negate this risk [6,21,29,31,[62][63][64][65][66][67][68][69]. Finally, cashing in on post-op weight loss with extended rehab and support are factors to discuss at unit case conferences, and when all options fail bariatric surgery in selected patients [15,70,71].…”