In the article to which my editorial referred, Khaw and colleagues (1) reported that glycosylated hemoglobin is clearly associated with cardiovascular disease and that this relationship is independent of diabetes status. However, this prospective study also clearly showed that this relationship is independent of other cardiovascular risk factors, including age, body mass index, abdominal obesity, systolic blood pressure, cholesterol, smoking, and previous cardiovascular disease. At least 1 other large epidemiologic study also reported a similar independent relationship between markers of dysglycemia (including glycosylated hemoglobin) and incident cardiovascular events (2). Indeed, after the authors controlled for sex, age, total and high-density lipoprotein cholesterol level, systolic and diastolic blood pressure, diabetes, and smoking (that is, the factors included in the Framingham Risk Score), the risk for incident cardiovascular disease rose 1.15-fold (95% CI, 1.02-fold to 1.30-fold; P = 0.03) per 0.71% increase in hemoglobin A_1c level. This paper also suggested that post-load glucose levels may independently provide even more information about future cardiovascular risk than hemoglobin A_1c levels (2). Therefore, it is clear that glycemia is indeed an independent risk factor for future cardiovascular disease. However, I agree completely with Dr. Davidson that these data provide no information on whether it is also a responsive or modifiable risk factor; moreover, none of the clinical trials completed to date were designed to answer that question. Thus, we do not yet know with certainty if lowering glycosylated hemoglobin levels can prevent cardiovascular disease in people with diabetes or with lesser degrees of dysglycemia. However, the compelling epidemiologic data have led to tremendous interest in addressing this problem. As such, this question is currently being directly answered in several large clinical trials worldwide that should be completed within the next 5 years.