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- Title
Characteristics of people with high visit‐to‐visit glycaemic variability in Type 2 diabetes.
- Authors
Noyes, J. D.; Soto‐Pedre, E.; Donnelly, L. A.; Pearson, E. R.
- Abstract
Abstract: Aims: Increased visit‐to‐visit glycaemic variability is independently associated with adverse outcomes in Type 2 diabetes. Our aim was to identify the patient characteristics associated with raised visit‐to‐visit glycaemic variability in people with Type 2 diabetes. Methods: A case–control study was conducted to establish associations between HbA1c variability and clinical covariates in 10 130 people with Type 2 diabetes. Variability was calculated by two metrics [ sd and coefficient of variation (CV)] from a minimum of four HbA1c readings obtained over a 4‐year period. High and low variability groups were defined as the top and bottom tertile of the sd or CV, and used in logistic regression analyses including a number of clinical and biochemical covariates. The analyses were stratified into low mean (< 53 mmol/mol; 7%) and high mean (≥ 53 mmol/mol; 7%) HbA1c groups. Results: Findings were consistent across both HbA1c groups and variability metrics. Treatment, independent of other factors, was the most strongly associated covariate for the risk of high HbA1c variability. A six‐fold increased risk was observed in the low HbA1c group, between the most and least intense treatment regimens (<italic>P</italic> < 0.001). Similar findings were present in the high HbA1c group with a three‐fold increase in risk (<italic>P</italic> < 0.001). In addition, male gender, younger age, reduced HDL‐cholesterol and increased BMI were all found to be independently associated with raised visit‐to‐visit glycaemic variability. Conclusions: Intensive treatment resulting in low mean HbA1c was associated with marked increase in HbA1c variability. Irrespective of diabetes control, the greatest visit‐to‐visit variability was observed in young, insulin resistant men.
- Subjects
GLYCOSYLATED hemoglobin; TYPE 2 diabetes; DEMOGRAPHIC characteristics; CASE-control method; GLYCEMIC control
- Publication
Diabetic Medicine, 2018, Vol 35, Issue 2, p262
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.13435