Cardiovascular Disease, Neuropathy, and Retinopathy — Diabetes Care

In a study of 648 apparently healthy individuals, 12% had an elevated total A ₁ level (measured in that study) not explained by measurement error or glucose intolerance and remaining in the same range over 3.5 years in 90% of those initially with high and in 68% of those initially with low baseline levels (1). There was no correlation with glucose tolerance, with caloric intake, or with physical activity, but A ₁ level was associated with cigarette use and with clinically overt atherosclerosis, leading Dekker to conclude that “factors unrelated to glucose metabolism are the main determinants of A ₁” in nondiabetic individuals, perhaps with bearing on risk of what are considered complications of diabetes.