Tsai-Chung Li1, Sharon L R Kardia2, Chia-Ing Li3, Ching-Chu Chen4, Chiu-Shong Liu5, Sing-Yu Yang6, Chin-Shin Muo7, Patricia A Peyser8, Cheng-Chieh Lin9. 1. Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan. 2. Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA. 3. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. 4. Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 5. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. 6. Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan. 7. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 8. Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA. 9. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. Electronic address: cclin@mail.cmuh.org.tw.
Abstract
OBJECTIVE: The relationship between glycemic control and adverse outcomes found in a population with diabetes has seldom been evaluated in patients with type 2 diabetes. We explored the association between hemoglobin A1c (HbA1c) and hospitalization risks within one-year and eight-year follow-up periods. METHODS: We conducted a retrospective cohort study on 57,061 patients with type 2 diabetes from National Diabetes Case Management Program during 2002-2004 in Taiwan. HbA1c at baseline and in-hospital mortality, all-cause and cause-specific hospitalization over one year and eight years were analyzed. RESULTS: After multivariate adjustment, one-year risk was higher for cases with HbA1c level <6%, 9-10%, ≥10% versus 6-7% for all-cause hospitalization (hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 1.03-1.20; 1.08, 1.01-1.16, and 1.19, 1.12-1.26, respectively) and for ≥10% for diabetes-related hospitalization (1.68, 1.46-1.92). Yet each 1-step increment in HbA1c category (<6.0, 6.0-6.9, 7.0-7.9, 8.0-8.9, 9.0-9.9 and ≥10.0%) showed linkage with lower risk of hypoglycemia hospitalization (0.81, 95% CI: 0.74-0.88). For eight-year risk, subjects with HbA1c level <6%, and ≥10% were more likely to have in-hospitality mortality (1.16, 1.03-1.31, and 1.23, 1.11-1.35, respectively). Each 1-step increment in HbA1c category showed an association with higher risks of all-cause and diabetes-related hospitalization (1.04, 1.03-1.05, and 1.15, 1.14-1.17, respectively). CONCLUSIONS: Higher HbA1c level correlated with lower one-year risk due to hypoglycemia hospitalization but increased one-year and eight-year risks due to all-cause and diabetes-specific hospitalization among Chinese people with type 2 diabetes in Taiwan. Future study must ascertain how to meet HbA1c targets and improve outcome without risk to this population.
OBJECTIVE: The relationship between glycemic control and adverse outcomes found in a population with diabetes has seldom been evaluated in patients with type 2 diabetes. We explored the association between hemoglobin A1c (HbA1c) and hospitalization risks within one-year and eight-year follow-up periods. METHODS: We conducted a retrospective cohort study on 57,061 patients with type 2 diabetes from National Diabetes Case Management Program during 2002-2004 in Taiwan. HbA1c at baseline and in-hospital mortality, all-cause and cause-specific hospitalization over one year and eight years were analyzed. RESULTS: After multivariate adjustment, one-year risk was higher for cases with HbA1c level <6%, 9-10%, ≥10% versus 6-7% for all-cause hospitalization (hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 1.03-1.20; 1.08, 1.01-1.16, and 1.19, 1.12-1.26, respectively) and for ≥10% for diabetes-related hospitalization (1.68, 1.46-1.92). Yet each 1-step increment in HbA1c category (<6.0, 6.0-6.9, 7.0-7.9, 8.0-8.9, 9.0-9.9 and ≥10.0%) showed linkage with lower risk of hypoglycemia hospitalization (0.81, 95% CI: 0.74-0.88). For eight-year risk, subjects with HbA1c level <6%, and ≥10% were more likely to have in-hospitality mortality (1.16, 1.03-1.31, and 1.23, 1.11-1.35, respectively). Each 1-step increment in HbA1c category showed an association with higher risks of all-cause and diabetes-related hospitalization (1.04, 1.03-1.05, and 1.15, 1.14-1.17, respectively). CONCLUSIONS: Higher HbA1c level correlated with lower one-year risk due to hypoglycemia hospitalization but increased one-year and eight-year risks due to all-cause and diabetes-specific hospitalization among Chinese people with type 2 diabetes in Taiwan. Future study must ascertain how to meet HbA1c targets and improve outcome without risk to this population.
Authors: Andrea L C Schneider; Rita R Kalyani; Sherita Golden; Sally C Stearns; Lisa Wruck; Hsin Chieh Yeh; Josef Coresh; Elizabeth Selvin Journal: Diabetes Care Date: 2016-03-07 Impact factor: 19.112
Authors: Antonio Ceriello; Giuseppe Lucisano; Francesco Prattichizzo; Rosalba La Grotta; Stefan Franzén; Ann-Marie Svensson; Björn Eliasson; Antonio Nicolucci Journal: Cardiovasc Diabetol Date: 2022-01-24 Impact factor: 9.951