Changes in A1C levels are significantly associated with changes in levels of the cardiovascular risk biomarker hs-CRP: results from the SteP study

Authors: Schnell, O., Amann-Zalan, I., Jelsovsky, Z., Moritz, A., Bermejo, JL., Parkin, CG., Schweitzer, MA., Fisher, L., Polonsky, WH.

Abstract

Objective: The effect of therapeutic strategies on cardiovascular (CV) disease can be evaluated by monitoring changes in CV risk biomarkers. This study investigated the effect of a structured self-monitoring of blood glucose (SMBG) protocol and the resulting improvements in glycemic control on changes in high-sensitivity C-reactive protein (hs-CRP) in insulin-naïve patients with type 2 diabetes.

Research design and methods: The Structured Testing Program (STeP) study was a prospective, cluster-randomized, multicenter trial in which 483 poorly controlled, insulin-naïve patients with type 2 diabetes were randomized to active control (ACG) or structured testing (STG) that included quarterly structured SMBG. Changes in A1C, hs-CRP, and glycemic variability (STG subjects only) were measured at baseline and quarterly.

Results: Reductions in geometric mean hs-CRP values were significantly greater in the STG group at months 3 (P = 0.005), 6 (P = 0.0003), and 12 (P = 0.04) than in the ACG group. STG patients at high CV risk (>3 mg/L) showed significantly greater reductions in hs-CRP levels than ACG patients at high CV risk: -3.64 mg/dL (95% CI -4.21 to -3.06) versus -2.18 mg/dL (-2.93 to -1.43), respectively (P = 0.002). There was a strong correlation between reductions in hs-CRP and A1C in both groups: standardized coefficient (β) was 0.25 for the entire cohort (P < 0.0001), 0.31 for STG (P < 0.0001), and 0.16 for ACG (P = 0.02).

Conclusions: Reductions in hs-CRP level are associated with reductions in A1C but not reductions in lipids or glycemic variability. Comprehensive structured SMBG-based interventions that lower A1C may translate into improvements in CV risk, as evidenced by levels of the biomarker hs-CRP.

Source: https://pubmed.ncbi.nlm.nih.gov/23435160/

Share the Post:

BDI Monthly Events

July 9Case Consultation
BDI hosts the San Diego-wide, monthly case consultation meeting (for mental health professionals working in the field of diabetes). Contact us at [email protected] if you are in the greater San Diego area and would like further information about this program.
July 18Grownup T1D
July 18: Time for another T1D meet-up! GrownupT1Ds, a wonderful nonprofit here in southern California, is teaming up with TCOYD and BDI for a special Friday afternoon (3 pm - 6 pm) you won’t want to miss. Dr. Edelman (famed endocrinologist, TCOYD Founder and living with T1D) and Dr. Polonsky (BDI President) will be speaking, and it will be a chance to hang out with other adults with T1D. The event will be held at TCOYD, 5720 Oberlin Drive, Suite 150, San Diego, CA 92121. While the event is free, space is limited, so please RSVP https://grownupt1ds.org/.
August 8-10TCOYD ONE
August 8 – 10. Taking Control of Your Diabetes (TCOYD) will be hosting the in-person ONE event, an amazing weekend experience here in San Diego for more than 500 people with type 1 diabetes and their loved ones. Dr. Polonsky is honored to be one of the presenters, and we will hope to see many of you there. There are still a few spaces left, so if you’d like to know more, please visit: https://tcoyd.org/one-2025/