Comment on Pantalone et al. The Probability of A1C Goal Attainment in Patients With Uncontrolled Type 2 Diabetes in a Large Integrated Delivery System: A Prediction Model. Diabetes Care 2020;43:1910–1919

We were interested in the recent article from Pantalone et al. (1), who reported that 23.7% of 6,973 subjects with poorly controlled type 2 diabetes (HbA1c >9%) attained HbA1c below 8% within 1 year, based on the electronic health record at Cleveland Clinic. Although the 6,973 participants represented only 6.7% of the 103,969 encountered patients in the database, their fate is a matter of concern, as high rates of vascular and infectious complications have been related to HbA1c above 9%. The follow-up of HbA1c trajectories has shown that high HbA1c usually remains stable or ascending for years, and long-term frank reductions are uncommon, only occurring for 3–4% of the patients (2). Real improvement of …