Distinct trajectories in HbA1c are associated with different all-cause mortality and morbidity in newly diagnosed patients with type 2 diabetes.
Prim Care Diabetes
; 14(5): 413-419, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-31836307
ABSTRACT
AIMS:
To identify trajectories of long-term HbA1c levels and examine associations with subsequent risk for morbidity and mortality.METHODS:
We conducted a longitudinal follow-up among 27,724 patients, newly diagnosed with type 2 diabetes, in a large healthcare organization. We identified trajectories of long-term HbA1c levels during the first 5 years post diabetes onset to examine associations with subsequent risk for morbidity and all-cause mortality.RESULTS:
We identified two HbA1c trajectories; the "Steady-plateau HbA1c trajectory" in 93% of patients and a "Sharp-incline HbA1c trajectory" in 7% of patients. When compared to the steady-plateau group, patients in the sharp-incline group were younger, male, from a lower socio-economic background, and higher levels of HbA1c at baseline. Patients in the sharp-incline trajectory had a HR = 1.83 (95%CI 1.58-2.12) for all-cause mortality, HR = 1.99 (95%CI 1.74-2.27) for cardiovascular disease, and HR = 1.68 (95%CI 1.51-1.86) for renal disease, compared to patients in the steady-plateau trajectory.CONCLUSIONS:
Patients in the sharp-incline trajectory had a higher risk for all-cause mortality, cardiovascular disease, and renal disease, compared to patients in the steady-plateau trajectory. Estimation of HbA1c variability in the first years of diagnosis may be a useful indicator of those patients at high risk for diabetes related complications.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemoglobinas Glicadas
/
Diabetes Mellitus Tipo 2
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Prim Care Diabetes
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article