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HbA1c variability predicts cardiovascular complications in type 2 diabetes regardless of being at glycemic target
- Source :
- Cardiovascular Diabetology, Vol 21, Iss 1, Pp 1-9 (2022), Cardiovascular Diabetology
- Publication Year :
- 2022
- Publisher :
- BMC, 2022.
-
Abstract
- Background HbA1c variability has emerged as risk factor for cardiovascular diseases in diabetes. However, the impact of HbA1c variability on cardiovascular diseases in subjects within the recommended HbA1c target has been relatively unexplored. Methods Using data from a large database, we studied 101,533 people with type 2 diabetes without cardiovascular diseases. HbA1c variability was expressed as quartiles of the standard deviation of HbA1c during three years (exposure phase). The primary composite outcome included non-fatal myocardial infarction, non-fatal stroke, all-cause mortality and was assessed during five years following the first three years of exposure to HbA1c variability (longitudinal phase). An expanded composite outcome including non-fatal myocardial infarction, non-fatal stroke, coronary revascularization/reperfusion procedures, peripheral revascularization procedures, and all-cause mortality was also considered, as well as a series of specific cardiovascular complications. Cox models were adjusted for a large range of risk factors and results were expressed as adjusted hazard ratios. Results An association between HbA1c variability and all the outcomes considered was found. The correlation between HbA1c variability and cardiovascular complications development was confirmed in both the subgroups of subjects with a mean HbA1c ≤ 53 mmol/mol (recommended HbA1c target) or > 53 mmol/mol during the exposure phase. The risk related to HbA1c variability was higher in people with mean HbA1c ≤ 53 mmol/mol for the primary outcome (p for interaction 0.004), for the expanded secondary outcome (p for interaction 0.001) and for the stroke (p for interaction 0.001), even though HbA1c remained at the target during the follow-up. Conclusions These findings suggest that HbA1c variability may provide additional information for an optimized management of diabetes, particularly in people within the target of HbA1c.
- Subjects :
- Blood Glucose
Male
Time Factors
Databases, Factual
endocrine system diseases
Endocrinology, Diabetes and Metabolism
Glycemic Control
Risk Assessment
Diabetes complications
Predictive Value of Tests
Risk Factors
Prevalence
Humans
Hypoglycemic Agents
Diseases of the circulatory (Cardiovascular) system
Registries
Original Investigation
Aged
Glycated Hemoglobin
Sweden
HbA1c variability
nutritional and metabolic diseases
Type 2 diabetes
Middle Aged
Treatment Outcome
Cardiovascular diseases
Diabetes Mellitus, Type 2
RC666-701
Female
Cardiology and Cardiovascular Medicine
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 14752840
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Cardiovascular Diabetology
- Accession number :
- edsair.doi.dedup.....8f7e267b144c9fbaa239aadaef5c46f9