Normal mortality in the elderly with diabetes under strict glycemic and blood pressure control: Outcome of 6-year prospective study

V-shaped relationship between HbA1c and all-cause mortality in the elderly with type 2 diabetes

“…The current group was comprised of patients admitted for control of hyperglycemia and diabetic education and the mean HbA1c was as high as 9.9% at baseline. In this regard, patients of the current study were significantly different from those in the previous studies in which the degree of hyperglycemia was mild [2,[4][5][6]. Nevertheless, our finding of a V-shaped relationship between baseline HbA1c and risk of all-cause mortality is reminiscent of the U-shaped relationship in one study [4].…”

“…This was found together with the fact that glycemic control was relatively good upon follow-up irrespective of baseline HbA1c. The follow-up HbA1c was not significantly related to mortality as reported [5,6]. Importantly, the V-shaped relationship between HbA1c and the mortality hazard was similar when the participants were divided by absolute value of baseline HbA1c (data not shown).…”

“…Previously, a linear increase in mortality as a function of baseline HbA1c was reported in the frail [3] but not in elderly patients with diabetes at large [2,[4][5][6] (Supplemental Table). The current group was comprised of patients admitted for control of hyperglycemia and diabetic education and the mean HbA1c was as high as 9.9% at baseline.…”

“…In a randomized trial in which intervention had a minimal effect on glycemia, no differences in mortality or cardiovascular events were found [2]. The results of observational studies have been inconclusive [3][4][5][6]. One study disclosed that the relationship between baseline hemoglobin A1c (HbA1c) and the follow-up mortality was linear [3] but it was significantly U-shaped in the other [4].…”

“…One study disclosed that the relationship between baseline hemoglobin A1c (HbA1c) and the follow-up mortality was linear [3] but it was significantly U-shaped in the other [4]. Katakura and colleagues [5,6], including three of the A B S T R A C T Purpose: The optimal glycemic target for elderly patients with diabetes has not been established. The purpose of this study was to elucidate relationship between HbA1c and mortality in elderly patients with diabetes.…”