Silbernagel G, Grammer TB, Winkelmann BR et al.
Ludwigshafen Risk and Cardiovascular Study non-profit LLC, Freiburg, Germany.
Diabetes Care 2011;34:1355–61.
Editor’s note: The ability of glycated hemoglobin (HbA1c) to predict micro-vascular outcomes in people with diabetes is well-established (Diabetes Care 2010;33[Suppl.]:62–9). Previous data from the ARIC (Atherosclerosis Risk in Communities) study suggested that in individuals who are not known to have diabetes, increasing levels of HbA1c was associated with an increased future risk of developing diabetes, cardiovascular disease, and cancer and all-cause mortality. Indeed, there was even a suggestion of a J-shaped curve in the relationship between HbA1c concentration and all-cause mortality (N Engl J Med 2010;362:800–11).