Goyal MK, Hatwal J, Desai R, Sehgal T, Batta A. Glycated hemoglobin and cardiovascular risk in diabetes mellitus: Evolving evidence beyond glycemic control. World J Diabetes 2026; 17(6): 115820 [DOI: 10.4239/wjd.115820]
Reader's ID:
02715271
Submitted on:
June 20, 2026, 05:38
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Reader Comments:
This review provides a timely and clinically relevant discussion on the evolving role of HbA1c in cardiovascular risk assessment among patients with diabetes mellitus. The article appropriately emphasizes that HbA1c remains an important marker of long-term glycemic exposure, but should not be interpreted as the sole determinant of cardiovascular risk. In particular, the discussion of HbA1c variability, individualized glycemic targets, and the cardiovascular benefits of SGLT2 inhibitors and GLP-1 receptor agonists highlights the need to move beyond a glucose-centric framework. From a clinical perspective, cardiovascular risk in diabetes should be assessed through an integrated approach that considers glycemic burden, glycemic variability, hypoglycemia risk, renal function, obesity, blood pressure, lipid profile, and established cardiovascular disease. This perspective is important because intensive HbA1c reduction may not uniformly translate into cardiovascular benefit across different patient populations, especially in those with long-standing diabetes or multiple comorbidities. Overall, the article offers a balanced and meaningful interpretation of current evidence and supports a more individualized, outcome-oriented strategy for diabetes managemen.