Change in Hemoglobin A1cand C-Reactive Protein Levels in Patients With Diabetes Mellitus

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Abstract
The authors studied the effects on C-reactive protein (CRP) levels of an intensive intervention to reduce hemoglobin A(1c) (HbA(1c)) among 58 veterans with type 2 diabetes. Weekly group sessions of behavioral and pharmacologic intervention were conducted for 4 weeks at Providence Veterans Affairs Medical Center. Change in cardiovascular risk factors and CRP levels were compared at baseline and 3 months postintervention. There was a significant decrease in HbA(1c) (-0.7%+/-1.9%, P<.01), total cholesterol (-20.3+/-41.1 mg/dL, P=.01), low-density lipoprotein cholesterol (-11.7+/-31.4 mg/dL, P=.05), systolic blood pressure (-6.9+/-21.2 mm Hg, P=.03), and diastolic blood pressure (-6.0+/-10.6 mm Hg, P<.01) over 4 months. There was no significant change in CRP levels (1.1+/-6.6 mg/L, P=.2). These results suggest that CRP effects may not be adequate to predict changes in cardiovascular risk among diabetic patients and should not be a surrogate for achieving evidence-based goals in traditional cardiovascular risk factors.

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