Association of treatment-achieved HbA 1c with incidence of coronary artery disease and severe eye disease in diabetes patients.

Aim. - To examine the association between treatment-achieved HbA(1c) values and incidence of both coronary artery disease (CAD) and severe eye disease with different diabetes treatments. Methods. - Associations of treatment-achieved HbA(1c) were investigated in various treatment groups [diet only; insulin; sulphonylurea (SU) alone; SU with glinides; and antihyperglycaemic agents other than glinides, SU or insulin] taken from a nationwide claims database of 14,633 Japanese diabetes patients. Cox's regression analysis examined risks over a 5.1-year follow-up. Results. - A significant linear trend was associated with HbA(1c) levels and CAD events in the diet-only group, and CAD risks were significantly higher in insulin and SU groups with HbA(1c) <= 7.0% and > 8.0% than in the diet-only group with HbA(1c) <= 7.0%. In contrast to CAD, a linear association was observed regardless of treatment modality between achieved HbA(1c) levels and risk of severe diabetic eye disease, but with no significant difference in eye disease risk between groups with HbA(1c) <= 7.0% and 7.1-8.0% in those treated with either SU alone, SU with glinides, or insulin. Conclusion. - These findings suggest that the relationship between treatment-achieved HbA(1c) and incidence of both CAD and severe diabetic eye disease differed according to treatment, based on a large-scale real-life database. More research is now needed to confirm these findings and to further investigate the underlying mechanisms. (C) 2018 Elsevier Masson SAS. All rights reserved.