Authors :
Basil Chukwuma Ezeokpo; Chidiebere V. Ugwueze; Bede I. Nnolim; Emmanuel A. Agim; Nnamdi C. Anikpo; Kenechukwu E. Onyekachi
Volume/Issue :
Volume 5 - 2020, Issue 11 - November
Google Scholar :
http://bitly.ws/9nMw
Scribd :
https://bit.ly/32Va7xh
Abstract :
Haemoglobin A1c (HbA1c) offers a retrospective
analysis of patient’s glucose excursions and is used in
determining cardiovascular disease risks in diabetes
mellitus patients. The availability of drugs of the class,
Sodium-Glucose Co Transporter-2 inhibitors (SGLT),
and Glucagon-like –peptide -1 (GLP-1) receptor agonists
offer a proactive option to the management of
cardiovascular disease complications in diabetes mellitus
patients, despite failure to achieve HbA1c levels.
The lowest level of HbA1c associated with
increased cardiovascular risks varies between the young
and the old, and between races, as exemplified in the risk
of diabetic retinopathy. The Metabolic Memory has also
introduced the need to control hyperglycaemia as early
as in the pre-diabetes stage, and also to address the
factors that maintain the vicious circle of metabolic
dysfunction.
Pre-diabetes carries cardiovascular risk,
achievement and maintenance of HbA1c goals among
diabetes patients are poor, thus emphasising the
cardiovascular disease risks. This is pertinent in regions
where the burden of diabetes mellitus is high, and
frequent HbA1c monitoring cannot be achieved. The
different HbA1c indices have not been shown to prevent
stroke, diabetic foot ulcer syndrome and diabetic
retinopathy, which would soon become new targets as we
achieve greater reduction in the other cardiovascular
disease complications. We here offer a new perspective
for reasons to start/initiate treatments with lifestyle
modification, Metformin and GLP-1 or SGLT therapy.
Keywords :
Diabetes Mellitus, HbA1c, HbA1c Variability, Cardiovascular Disease Risk, Metabolic Memory.
Haemoglobin A1c (HbA1c) offers a retrospective
analysis of patient’s glucose excursions and is used in
determining cardiovascular disease risks in diabetes
mellitus patients. The availability of drugs of the class,
Sodium-Glucose Co Transporter-2 inhibitors (SGLT),
and Glucagon-like –peptide -1 (GLP-1) receptor agonists
offer a proactive option to the management of
cardiovascular disease complications in diabetes mellitus
patients, despite failure to achieve HbA1c levels.
The lowest level of HbA1c associated with
increased cardiovascular risks varies between the young
and the old, and between races, as exemplified in the risk
of diabetic retinopathy. The Metabolic Memory has also
introduced the need to control hyperglycaemia as early
as in the pre-diabetes stage, and also to address the
factors that maintain the vicious circle of metabolic
dysfunction.
Pre-diabetes carries cardiovascular risk,
achievement and maintenance of HbA1c goals among
diabetes patients are poor, thus emphasising the
cardiovascular disease risks. This is pertinent in regions
where the burden of diabetes mellitus is high, and
frequent HbA1c monitoring cannot be achieved. The
different HbA1c indices have not been shown to prevent
stroke, diabetic foot ulcer syndrome and diabetic
retinopathy, which would soon become new targets as we
achieve greater reduction in the other cardiovascular
disease complications. We here offer a new perspective
for reasons to start/initiate treatments with lifestyle
modification, Metformin and GLP-1 or SGLT therapy.
Keywords :
Diabetes Mellitus, HbA1c, HbA1c Variability, Cardiovascular Disease Risk, Metabolic Memory.
