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Death Risk Rises With Blood Sugar

Even Without Diabetes, High Blood Sugar Ups Death, Heart Disease Risk

3 Most Important Things in Diabetes: Control, Control, Control continued...

People with diabetes already know they're supposed to keep their blood sugar under control. Now that advice is even more urgent. After all, Selvin notes, heart disease accounts for 70% to 80% of deaths in people with diabetes.

"The important question is whether HbA1c levels predict heart disease in diabetes. Our study says this is the case," Selvin says. "So if you keep good blood sugar control -- with good diet, proper exercise, and effective medication -- this can reduce your risk of heart disease."

High HbA1c Risky for Everybody

If you don't have diabetes, your blood sugar is still an issue. A huge issue, find Kay-Tee Khaw, MD, and colleagues at the University of Cambridge School of Clinical Medicine, England.

Khaw's team checked HbA1c levels in more than 10,000 45- to 79-year-old men and women for six years. Their findings:

  • 72% of deaths were in people with HbA1c levels between 5% and 6.9%.
  • The lowest rates of heart disease and death were among those with HbA1c levels under 5%.
  • For men, every 1% increase in HbA1c beyond 5% meant a 24% increase in risk of death from all causes.
  • For women, every 1% increase in HbA1c beyond 5% meant a 28% increase in risk of death from all causes.
  • Even after taking into account traditional risk factors for heart disease, like high blood pressure, cholesterol, and previous heart attacks, there was a 21% increased risk of cardiovascular disease for every 1% increase in HbA1c beyond 5%.

"About 4% of the population have diabetes and [only] 27% of the population have HbA1c levels less than 5% -- so the majority of the population have HbA1c levels that are less than optimal," Khaw tells WebMD in an email interview.

Some people without diabetes are at higher risk than some people with diabetes, notes Hertzel C. Gerstein, MD, of McMaster University in Hamilton, Ontario.

"An HbA1c level of 6.59% in a non-diabetic individual predicts a higher cardiovascular risk than an HbA1c level of 5.5% in a well-controlled diabetic individual," Gerstein writes in an editorial accompanying the Khaw and Selvin studies.

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