“New Blood Test Advised for Diabetes Patients“. Quite a headline. This is the media’s interpretation of an article in this week’s Annals of Internal Medicine. This “new” test is in fact, the hemoglobin A1c – which is a standard test in monitoring diabetes control. The title should have been “A new use for an old test”.

The study suggests that cardiovascular (CV) disease increases with sugar levels not at the level of diabetes. A typical “well-controlled” diabetic has an A1c of less than 7.0%. It is now noted that increased CV risk occurs with levels of 5 to 6.9%. An increase in hemoglobin A1c of 1 percentage point was associated with an increased risk for death from any cause by 24% in men and 28% in women. Certainly more studies are needed to see if controlling the A1c has mortality benefit in those without the diagnosis of diabetes (i.e. less than 7.0%).