Blood Sugar May Matter for Non-Diabetics

HbA1c levels associated with anemia and death risk in people without diabetes

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Even without diabetes, low blood sugar levels can lead to some serious risks and health problems. Researchers recently set out to see what these risks were.

In people without diabetes, low levels of HbA1c (a measure of blood sugar over time) were associated with an increased risk of death from all causes.

In addition, people with low HbA1c were more likely to have anemia - a condition in which the body does not have enough healthy red blood cells, which affects how much oxygen body tissues receive.

"Get blood sugar screening if you are overweight."

Elizabeth Selvin, PhD, MPH, of Johns Hopkins University, and colleagues wanted to better understand the relationship between low blood sugar and the risks of death and hospitalization for liver disease.

Compared to people with normal HbA1c levels, those with low HbA1c were younger, less likely to smoke and had a lower BMI - a measure of body fat using height and weight. In addition, participants with low HbA1c had lower levels of fibrinogen - a protein made by the liver that is sometimes measured to track the progression of liver disease.

Still, people with low HbA1c were more likely to have anemia and a higher mean corpuscular volume - a measure of average red blood cell size and indicator of anemia.

Furthermore, a low HbA1c was associated with an increased risk of death from all causes, with a hazard ratio 1.32, compared to HbA1c levels in the normal range. Low HbA1c was also associated with an increased risk of death from cancer, with a hazard ratio of 1.47.

A hazard ratio tells us how often one event happens in one group compared to how often it happens in another group. If a hazard ratio is more than one, it means that the event happens more often in one group than the other.

The researchers also found evidence that low HbA1c may increase the risk of death from heart-related and lung-related causes. However, this relationship was small.

There was a "J-shaped" association between HbA1c and risk of hospitalization for liver disease.

For their research, Dr. Selvin and colleagues studied 13,288 participants in the Atherosclerosis Risk in Communities Study. An HbA1c of 5.0 to 5.7 percent was considered normal. An HbA1c below 5.0 percent was considered low.

The study was published August 1 in Diabetes Care, a journal of the American Diabetes Association.

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Review Date: 
July 31, 2012
Last Updated:
August 6, 2012