Youtube Account: Dr Rob Cywes

CRITICAL SCIENCE: Your A1C Is ‘Normal’ — But Your Arteries May Already Be Building Plaque

What if your hemoglobin A1C is considered “normal,” but it is already signaling atherosclerosis years before diabetes develops? In the PESA (Progression of Early Subclinical Atherosclerosis) study, investigators evaluated 3,973 asymptomatic middle-aged adults without diabetes or known cardiovascular disease and compared HbA1c with directly imaged atherosclerosis in the coronary, carotid, aortic, and iliofemoral arteries. Even after adjustment for age, blood pressure, smoking, LDL, HDL, BMI, sex, and family history, progressively higher HbA1c within the **non-diabetic range** was associated with progressively greater multiterritorial atherosclerotic burden. Compared with HbA1c ≤4.8%, an HbA1c of **5.5–5.6% was already associated with 36% higher odds of more extensive subclinical atheroscler…