CHF and HbA1C

According to a study published  in The American Journal of Cardiology, diabetic patients with heart failure who had lower levels of glycosylated hemoglobin were more likely to die or need urgent heart transplantation during two years of follow-up compared with those with higher HbA1c levels.  Yes, y0u read that right.    Who knows, maybe the study is flawed but one professor of cardiology said in the American Medical News that, “We may find that doctors who treat patients who have advanced heart failure and diabetes may not need to focus on aggressively lowering blood [glucose], but rather keep it under moderate control”.   So, once again, what about the quality indicators?   Sure the patient may die but at least their HbA1C is down.  Am I right?

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “CHF and HbA1C

  1. May 2, 2012 at 1:37 am

    Doctors have to deal with patients, none of which are standard. To that end we have guidelines to, well, guide us. Therein is the permanent trap in the system: a monkey can follow rules but with guidelines the practitioner can always be judged in the wrong depending on which way the winds are blowing.

    The government and lawyers will always encourage our following guidelines, to keep their profiting from their self-replenishing resource.

  2. April 30, 2012 at 4:08 pm

    imagine that, just like ACCORD said…and to think that had ACCORD been positive i would have an endocrinologist in my office right now telling me what a f*&^up and an a$$%^&* i am for not having everyone’s A1c’s <6, but since it was negative, we ignore it…

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