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Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus.
- Source :
-
Diabetes, obesity & metabolism [Diabetes Obes Metab] 2024 Nov; Vol. 26 (11), pp. 5138-5146. Date of Electronic Publication: 2024 Aug 19. - Publication Year :
- 2024
-
Abstract
- Aim: To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients.<br />Method: We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c (<7%; 7%-7.9%; ≥8%) and age (<65; ≥65 years), and then clustered into classes by HbA1c trajectory and CVD incidence over the 12-year follow-up period using joint latent class mixture models. We explored the HbA1c trajectories and CVD incidences in each latent class. Multinomial logistic regression was used to compare the baseline characteristics among different latent classes.<br />Results: A total of 128 843 T2DM patients were included with a median follow-up period of 11.7 years. Ten latent classes were identified in patients with baseline HbA1c ≥ 8% and age <65 years, while seven classes were identified in the other five groups. Among all the identified latent classes, patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, had higher CVD incidences. Male patients, and patients with higher baseline HbA1c and use of antidiabetic drugs were more likely to have a fluctuating HbA1c trajectory. More specifically, patients aged < 65 years with younger age or a smoking habit, and patients aged ≥ 65 years with a longer duration of T2DM were more likely to have a fluctuating HbA1c trajectory.<br />Conclusion: We found that T2DM patients with fluctuating HbA1c trajectories could have a higher CVD risk. Different trajectory-associated characteristics in age subgroups highlight the need for individualized management of T2DM patients.<br /> (© 2024 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
- Subjects :
- Humans
Male
Female
Middle Aged
Incidence
Aged
Retrospective Studies
Follow-Up Studies
Diabetic Angiopathies epidemiology
Diabetic Angiopathies blood
Hypoglycemic Agents therapeutic use
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 epidemiology
Diabetes Mellitus, Type 2 complications
Glycated Hemoglobin analysis
Glycated Hemoglobin metabolism
Cardiovascular Diseases epidemiology
Cardiovascular Diseases etiology
Cardiovascular Diseases blood
Subjects
Details
- Language :
- English
- ISSN :
- 1463-1326
- Volume :
- 26
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Diabetes, obesity & metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 39161066
- Full Text :
- https://doi.org/10.1111/dom.15856