In a subset of individuals enrolled in the CHARM trial who had HbA1c available, the relationship between HbA1c and outcomes was assessed in 2412 participants (of whom 907 par- ticipants had known diabetes mellitus).126 In the total CHARM cohort, increasing levels of HbA1c were associ- ated with increased risk of total mortality, HF hospitaliza- tion, and a composite outcome of cardiovascular death or HF hospitalization. Of note, the graded relationship between HbA1c and mortality was more pronounced in the nondiabetic patients enrolled in CHARM and did not reach statistical significance for the outcomes of car- diovascular death (P for heterogeneity=0.04) and total mortality (P for heterogeneity=0.008) in the cohort of HF patient with diabetes mellitus.126 Among patients hospi- talized with HF, hyperglycemia is commonly observed in both patients with and those without recognized diabe- tes mellitus. In a large, nationally representative study of >50000 elderly patients hospitalized with HF, elevated glucose was found in nearly half of patients and was as- sociated with greater HF severity.127 However, in sharp contrast to patients hospitalized with acute coronary syndromes, there was no significant association be- tween glucose values on admission and either short- or long-term mortality, regardless of their diabetes mellitus status. Given these findings and the absence of data from clinical trials of targeted glucose control in this pa- tient population, there is insufficient evidence to recom- mend specific glucose thresholds or glucose treatment targets in patients hospitalized with HF. To date, no randomized, clinical trials of more versus less intensive glucose control have been performed spe- cifically in patients with HF. Until such trials are complet- ed, the ideal glucose targets in patients with established HF remain uncertain. Prospective data from subgroups of clinical trials assessing optimal glycemic targets in pa- tients with HF also are limited. 