One recent observational study of 123 patients with diabetes and advanced CHF compared the outcome of patients with HbA1c < 7 against those with HbA1c > 7 (Eshaghian etal., 2006). Surprisingly, those with HbA1c < 7 had an increased mortality rate (75% versus 50%, 2-year mortality, respectively). After multivariate adjustment HbA1c remained a significant independent predictor of mortality (HR 2.3, 95% CI 1.0-5.2). One possible explanation is that a low HbA1c reflects cachexia found in the sickest patients with CHF.
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