Brief Answer:
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Detailed Answer:
Hello and welcome,

I can only give you a speculative answer and I doubt that any of the other practitioners on this site know more definitively as this is a somewhat academic and possibly political topic.

Changes in the practice of medicine happen over time and are (nowadays) predominantly based on large objective (double blind, meta-analysis) research studies and hopefully outcome studies. However, we don't always have outcome studies that are adequate. And studies can be interpreted differently and some are dismissed by some groups as flawed or having bias.

You will find, even in this country, differences in standards on criteria for screening of diseases. For example, there are differences between the XXXXXXX College of Obstetrics vs XXXXXXX College of Pediatrics vs Amercican College of Family Medicine on guidelines for preventive screening.

It's possible that Canada, having socialized medicine that decides for all, has chosen guidelines for their country that are less stringent because they do not recognize the studies on which the XXXXXXX Diabetic Association sets their cut off for treating A1C.

And things change with newer research. For example, there is now some discussion that we should be trying to keep blood pressures even lower than the guidelines we have used in the past.

When I was a medical student, in newborn nursery we were vehemently instructed to keep the babies on their tummies (face down) because it was thought that if they were on their backs, they could aspirate their spit-up and this could cause SIDS. Just a few years later, with equal vehemence and confidence, we were instructed that we must keep newborns on their backs because if left on their tummies, they would spit up and not be able to turn their heads out of the vomit, aspirate and die.

So a considerable number of guidelines in medicine are best guesses and obviously the practice of medicine changes over time depending on which studies are recognized. The larger the studies, the better design of the studies, and the more they are based long-term on outcome of interventions, the better. But it is still considered a "practice" because we don't have all of the answers.

I hope this information helps.

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Brief Answer:
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Detailed Answer:
I thought you would find the following discussion on HbA1C interesting as to why in some populations 7.0 might be a better standard than 6.5. It is from the following article. It won't "link" if you click on it so you will need to copy and paste it into your address bar to see the whole article: https://www.yyyyy.yyyyy.yyh.gov/yyyy/yyyyyyyy/yyy0000/

But here is the part I thought you might find interesting:


"Targets for HbA1c in clinical practice are recommended by official organizations,[14,15] and these guidelines generally suggest either <6.5% or <7.0%, with a number of caveats. In fact, either of those levels of HbA1c do signal a low risk of developing progressive microvascular complications. There is only a minor difference in risk status between long-term control at the level of 6.5% or 7.0%, but the individualization of targets can make a considerable difference.

It has been suggested, for example, that in the elderly patient with multiple comorbid conditions, glycemic control has little benefit.[16,17] It also makes clinical sense to relax glycemic control for people with hypoglycemia unawareness or a history of severe hypoglycemia. A younger, more stable person with diabetes and good self-care, on the other hand, may be able to achieve even better glycemic control. We are believers in individualizing targets for HbA1c."

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Brief Answer:
Thoughts on this

Detailed Answer:
It may not be genetically related, and even if it is, you would have 50% chance of this genetic influence from your mother. Also, environmental factors and dietary related factors other than blood glucose levels can have an effect on the heart. In particular, blood pressure, smoking, weight, and possibly elevated blood lipids could have an effect.

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