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There is currently no international consensus on optimal blood glucose levels in people with diabetes. Published in the journal BMJ, the study looked at more than 10,000 children and adults with type 1 included in the Swedish Diabetes Register, evaluating risks for a variety of conditions in people with various A1C levels (a measure of glucose control over the previous 2–3 months).
In Sweden, target A1C levels are 6.9% or lower for adults and 6.5% or lower in children. (The American Diabetes Association recommends an A1C level of less than 7.0% for most people with diabetes.) The researchers found that an A1C level above 6.9% was associated with increased risk of “mild changes” in the eyes and kidneys, with vision-threatening damage occurring primarily at much higher levels. Staying below an A1C of 6.5% was found to show no further reduction in risk.
“We were unable to see that fewer instances of organ damage occurred at these lower levels. As for loss of consciousness and cramp, which are unusual, low blood glucose caused a 30% rise in risk. Patients with low HbA1c need to make sure they don’t have excessively low glucose levels, fluctuations or efforts in managing their diabetes,” says Marcus Lind, professor of diabetology and first author of the study.
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Senior Digital Editor for DiabetesSelfManagement.com, Fennell has 16 years’ experience specializing in diabetes and related health conditions. Based in New York City, she has a degree from Columbia University.