Immediate, intensive treatment for newly diagnosed patients with type 2 diabetes (T2D) may be necessary to avoid irreversible long-term risk for diabetic complications and mortality, a recent study found. The Diabetes & Aging Study examined the legacy effect in T2D and the impact of early glycemic control on future complications. In managed care patients with newly diagnosed T2D and 10 years of survival were evaluated, researchers evaluated associations between HbA1c <6.5%, 6.5% to <7.0%, 7.0% to <8.0%, 8.0% to <9.0%, or ≥9.0% for various periods of early exposure and incident future microvascular and macrovascular events and death. They found:

• The study cohort included 34,737 patients from 1997-2013; average follow-up 13.0 years.
• Compared with HbA1c <6.5% for the 0-1-year early exposure period, HbA1c levels ≥6.6% were associated with increased microvascular and macrovascular events, and HbA1c levels ≥7.0% were associated with increased mortality.
• Longer periods of exposure to HbA1c levels ≥8.0% were associated with increasing microvascular events and mortality risk.