Beatriz Hemo1, Dikla Geva2, Danit R Shahar3, Rachel Golan4, Anthony D Heymann5. 1. Maccabi Healthcare Services, 27 HaMered St., Tel Aviv 6812509, Israel; The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8410501, Israel. Electronic address: Hemo_b@mac.org.il. 2. The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8410501, Israel. 3. The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8410501, Israel. Electronic address: dshahar@bgu.ac.il. 4. The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8410501, Israel. Electronic address: golanra@bgu.ac.il. 5. Maccabi Healthcare Services, 27 HaMered St., Tel Aviv 6812509, Israel; The Department of Family Medicine, The Sackler Faculty of Medicine, University of Tel Aviv, Tel-Aviv, Israel. Electronic address: heymann_t@mac.org.il.
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.
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.
Authors: Piia Lavikainen; Emma Aarnio; Miika Linna; Kari Jalkanen; Hilkka Tirkkonen; Päivi Rautiainen; Tiina Laatikainen; Janne Martikainen Journal: PLoS One Date: 2022-06-01 Impact factor: 3.752
Authors: Yuan Wang; Eric Yuk Fai Wan; Ivy Lynn Mak; Margaret Kay Ho; Weng Yee Chin; Esther Yee Tak Yu; Cindy Lo Kuen Lam Journal: PLoS One Date: 2022-01-27 Impact factor: 3.240