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- Title
Association of HbA1c With All-cause Mortality Across Varying Degrees of Glycemic Variability in Type 2 Diabetes.
- Authors
Jingyi Lu; Chunfang Wang; Jinghao Cai; Yun Shen; Lei Chen; Lei Zhang; Wei Lu; Wei Zhu; Gang Hu; Tian Xia; Jian Zhou; Lu, Jingyi; Wang, Chunfang; Cai, Jinghao; Shen, Yun; Chen, Lei; Zhang, Lei; Lu, Wei; Zhu, Wei; Hu, Gang
- Abstract
<bold>Context: </bold>The interaction of glycated hemoglobin A1c (HbA1c) and glycemic variability in relation to diabetes-related outcomes remains unknown.<bold>Objective: </bold>To evaluate the relationship between HbA1c and all-cause mortality across varying degrees of glycemic variability in patients with type 2 diabetes.<bold>Design, Setting, and Patients: </bold>This was a prospective study conducted in a single referral center. Data of 6090 hospitalized patients with type 2 diabetes was analyzed. Glucose coefficient of variation [coefficient of variation (CV)] was obtained as the measure of glycemic variability by using continuous glucose monitoring for 3 days. Cox proportional hazards regression models were used to estimate hazard ratios and 95% CIs for all-cause mortality.<bold>Results: </bold>During a median follow-up of 6.8 years, 815 patients died. In patients with the lowest and middle tertiles of glucose CV, HbA1c ≥ 8.0% was associated with 136% (95% CI 1.46-3.81) and 92% (95% CI 1.22-3.03) higher risks of all-cause mortality, respectively, as compared with HbA1c 6.0%-6.9%, after adjusting for confounders. However, a null association of HbA1c with mortality was found in patients with the highest tertile of glucose CV.<bold>Conclusions: </bold>HbA1c may not be a robust marker of all-cause mortality in patients with high degree of glycemic variability. New metrics of glycemic control may be needed in these individuals to achieve better diabetes management.
- Subjects
GLYCEMIC control; DIABETES; PROPORTIONAL hazards models; BLOOD sugar analysis; RESEARCH; BLOOD sugar monitoring; RESEARCH methodology; PROGNOSIS; MEDICAL cooperation; EVALUATION research; GLYCEMIC index; TYPE 2 diabetes; COMPARATIVE studies; RESEARCH funding; LONGITUDINAL method
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 11, p3160
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab532