Victor W Zhong1, Juhaeri Juhaeri2, Stephen R Cole3, Christina M Shay4, Penny Gordon-Larsen5, Evangelos Kontopantelis6, Elizabeth J Mayer-Davis7. 1. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 2. Global Pharmacovigilance and Epidemiology, Sanofi, Bridgewater, NJ, USA. 3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. 4. Center for Health Metrics and Evaluation, the American Heart Association, Dallas, TX, USA. 5. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA. 6. Farr Institute for Health Informatics Research, University of Manchester, Manchester, UK. 7. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA. Electronic address: mayerdav@email.unc.edu.
Abstract
AIMS: To determine association between HbA1C variability and hypoglycemia requiring hospitalization (HH) in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS: Using nested case-control design in electronic health record data in England, one case with first or recurrent HH was matched to one control who had not experienced HH in incident T1D and T2D adults. HbA1C variability was determined by standard deviation of ≥3 HbA1C results. Conditional logistic models were applied to determine association of HbA1C variability with first and recurrent HH. RESULTS: In T1D, every 1.0% increase in HbA1C variability was associated with 90% higher first HH risk (95% CI, 1.25-2.89) and 392% higher recurrent HH risk (95% CI, 1.17-20.61). In T2D, a 1.0% increase in HbA1C variability was associated with 556% higher first HH risk (95% CI, 3.88-11.08) and 573% higher recurrent HH risk (95% CI,1.59-28.51). In T2D for first HH, the association was the strongest in non-insulin non-sulfonylurea users (P<0.0001); for recurrent HH, the association was stronger in insulin users than sulfonylurea users (P=0.07). The HbA1C variability-HH association was stronger in more recent years in T2D (P≤0.004). CONCLUSIONS: HbA1C variability is a strong predictor for HH in T1D and T2D.
AIMS: To determine association between HbA1C variability and hypoglycemia requiring hospitalization (HH) in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS: Using nested case-control design in electronic health record data in England, one case with first or recurrent HH was matched to one control who had not experienced HH in incident T1D and T2D adults. HbA1C variability was determined by standard deviation of ≥3 HbA1C results. Conditional logistic models were applied to determine association of HbA1C variability with first and recurrent HH. RESULTS: In T1D, every 1.0% increase in HbA1C variability was associated with 90% higher first HH risk (95% CI, 1.25-2.89) and 392% higher recurrent HH risk (95% CI, 1.17-20.61). In T2D, a 1.0% increase in HbA1C variability was associated with 556% higher first HH risk (95% CI, 3.88-11.08) and 573% higher recurrent HH risk (95% CI,1.59-28.51). In T2D for first HH, the association was the strongest in non-insulin non-sulfonylurea users (P<0.0001); for recurrent HH, the association was stronger in insulin users than sulfonylurea users (P=0.07). The HbA1C variability-HH association was stronger in more recent years in T2D (P≤0.004). CONCLUSIONS: HbA1C variability is a strong predictor for HH in T1D and T2D.
Authors: David Metcalfe; James Masters; Antonella Delmestri; Andrew Judge; Daniel Perry; Cheryl Zogg; Belinda Gabbe; Matthew Costa Journal: BMC Med Res Methodol Date: 2019-06-06 Impact factor: 4.615
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
Authors: Julia C Prentice; David C Mohr; Libin Zhang; Donglin Li; Aaron Legler; Richard E Nelson; Paul R Conlin Journal: Diabetes Care Date: 2021-06-14 Impact factor: 17.152