The glycaemic sixer [glycaemic hexad]
1Department of Endocrinology, Bharti Hospital, Karnal, India.
Insights
The Glycaemic Sixer is a new diabetes care model focusing on six key glucose targets. Achieving these targets helps improve cardiovascular outcomes and promotes personalized, safe diabetes management.
Area of Science:
- Endocrinology
- Cardiology
- Metabolic Diseases
Background:
- Diabetes mellitus significantly increases cardiovascular risk.
- Current diabetes management often focuses on limited glycaemic parameters.
- Suboptimal glycaemic control contributes to adverse cardiovascular events.
Purpose of the Study:
- To introduce the Glycaemic Sixer, a novel framework for comprehensive diabetes care.
- To highlight the importance of targeting six specific glycaemic parameters for cardiovascular health.
- To advocate for a patient-centered approach in diabetes management.
Main Methods:
- Conceptual framework development based on existing evidence.
- Identification of six critical glycaemic parameters impacting cardiovascular outcomes.
- Discussion of therapeutic strategies for achieving optimal control of these parameters.
Main Results:
- The Glycaemic Sixer encompasses fasting glucose, post-prandial glucose, glycosylated haemoglobin, avoidance of hypoglycemia, avoidance of nocturnal hypoglycemia, and glycemic variability.
- All six parameters are independently associated with cardiovascular outcomes.
- Balancing these six parameters is crucial for effective diabetes management.
Conclusions:
- The Glycaemic Sixer provides a holistic approach to diabetes care, emphasizing both efficacy and safety.
- Individualized, patient-centered strategies are essential for optimal diabetes management.
- Evidence-based therapeutic agents should be utilized to target all six glycaemic parameters.
Abstract:
This opinion piece describes a cricket-based analogy, the Glycaemic Sixer, for diabetes care. The hexad lists six glycaemic parameters which must be targeted to achieve optimal cardiovascular outcomes. All six parameters, i.e., fasting glucose, post prandial glucose, glycosylated haemoglobin, avoidance of hypoglycaemia, avoidance of nocturnal hypoglycaemia, and minimization of glycaemic variability, are associated with cardiovascular outcomes. Hence, equal attention must be paid to all these while planning strategies and choosing drugs for diabetes management. The Glycaemic Sixer promotes safety along with efficacy, and supports institution of individualized, patient centred care, using evidence-based therapeutic agents.
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Glucose Transporters
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:


