In conclusion , polyphenols can successfully reduce HbA1c in T2DM without any intervention at glycemia , and could contribute to the prevention of diabetes complications
ABSTRACT Polyphenols have been extensively studied for their antioxidant and anti-inflammatory properties .
Recently , their antiglycative actions by oxidative stress modulation have been linked to the prevention of diabetes and associated complications .
This article assesses the evidence for polyphenol interventions on glycohemoglobin ( HbA1c ) in non-diabetic , pre-diabetic , and type 2 diabetes mellitus ( T2DM ) subjects .
Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds
Aims /hypothesisThere is conflicting evidence regarding appropriate glycaemic targets for patients with type 2 diabetes . Here , we investigate the relationship between HbA1c and the risks of vascular complications and death in such patients . Methods Eleven thous and one hundred and forty patients were r and omised to intensive or st and ard glucose control in the Action in Diabetes and Vascular disease : Preterax and Diamicron Modified Release Controlled Evaluation ( ADVANCE ) trial . Glycaemic exposure was assessed as the mean of HbA1c measurements during follow-up and prior to the first event . Adjusted risks for each HbA1c decile were estimated using Cox models . Possible differences in the association between HbA1c and risks at different levels of HbA1c were explored using linear spline models . Results There was a non-linear relationship between mean HbA1c during follow-up and the risks of macrovascular events , microvascular events and death . Within the range of HbA1c studied ( 5.5–10.5 % ) , there was evidence of ‘ thresholds ’ , such that below HbA1c levels of 7.0 % for macrovascular events and death , and 6.5 % for microvascular events , there was no significant change in risks ( all p > 0.8 ) . Above these thresholds , the risks increased significantly : every 1 % higher HbA1c level was associated with a 38 % higher risk of a macrovascular event , a 40 % higher risk of a microvascular event and a 38 % higher risk of death ( all p < 0.0001 ) . Conclusions /interpretationIn patients with type 2 diabetes , HbA1c levels were associated with lower risks of macrovascular events and death down to a threshold of 7.0 % and microvascular events down to a threshold of 6.5 % . There was no evidence of lower risks below these levels but neither was there clear evidence of harm . Trial Registration : Clinical Trial.gov NCT00145925 Funding : Servier and the National Health and Medical Research Council of Australia ( project grant ID 211086 and programme grant IDs 358395 and 571281
In conclusion , polyphenols can successfully reduce HbA1c in T2DM without any intervention at glycemia , and could contribute to the prevention of diabetes complications
ABSTRACT Polyphenols have been extensively studied for their antioxidant and anti-inflammatory properties .
Recently , their antiglycative actions by oxidative stress modulation have been linked to the prevention of diabetes and associated complications .
This article assesses the evidence for polyphenol interventions on glycohemoglobin ( HbA1c ) in non-diabetic , pre-diabetic , and type 2 diabetes mellitus ( T2DM ) subjects .