Early, intensive glycemic control in T2D patients is associated with long-term benefits on cardiovascular disease (CVD) development. Evidence on benefits of achieving HbA1c targets close to normal values is scant. Subjects with newly-diagnosed T2D, without CVD at baseline, were identified in an Italian clinical registry (N=251,339). We adopted three definitions of early exposure periods (0–1, 0–2 and 0–3 years). Mean HbA1c was categorized into HbA1c < 5.7%, 5.7-6.4%, 6.5-7.0%, 7.1-8.0%, and >8.0%. The outcome was the incidence of major cardiovascular events. After a mean follow-up of 4.6±2.9 years, at multivariate Cox regression analysis, compared with mean HbA1c <5.7% during the first year after diagnosis, the increase in the risk of CVD was 24%, 42%, 49% and 56% for patients with HbA1c of 5.7%-6.4%, 6.5%-7.0%, 7.1%-8.0%, and >8.0%, respectively. The same trend was documented in all exposure periods. In conclusion, our data support that an early achievement of stringent targets of HbA1c <5.7% is worthy for CVD prevention.

中文翻译：

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代谢记忆什么时候开始？来自 AMD Annals Initiative 对严格的 HbA1c 目标的见解。


T2D 患者的早期强化血糖控制与心血管疾病 （CVD） 发展的长期益处相关。关于实现接近正常值的 HbA1c 目标的好处的证据很少。在意大利临床登记处确定了新诊断的 T2D 受试者，基线时没有 CVD （N=251,339）。我们采用了早期暴露期的三个定义 （0-1 、 0-2 和 0-3 年）。平均 HbA1c 分为 HbA1c < 5.7%、5.7-6.4%、6.5-7.0%、7.1-8.0% 和 >8.0%。结果是主要心血管事件的发生率。平均随访 4.6±2.9 年后，多变量 Cox 回归分析显示，与诊断后第一年的平均 HbA1c <5.7% 相比，HbA1c 分别为 5.7%-6.4%、6.5%-7.0%、7.1%-8.0% 和 >8.0% 的患者发生 CVD 风险增加 24% 、 42% 、 49% 和 56%。在所有暴露期都记录了相同的趋势。总之，我们的数据支持早期实现 HbA1c <5.7% 的严格目标是值得预防 CVD 的。