T2D: poor early glycaemic control linked to long-term complication risk

  • Rozing MP & al.
  • PLoS One
  • 1 Jan 2019

  • International Clinical Digest
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Takeaway

  • Increasing HbA1c levels in newly diagnosed patients with type 2 diabetes (T2D) are associated with a greater incidence of long-term microvascular complications.

Study design

  • Researchers studied patients with ≥3 HbA1c measurements during the first 6 years after T2D diagnosis (N=494; age, ≥40 years; 49.4% men), using adjusted Cox regression models to assess associations between early glycemic control and subsequent clinical outcomes over the course of 13 years of follow-up.
  • Funding: Danish Medical Research Council; Danish Research Foundation for General Practice; Danish Ministry of Health; Novo Nordisk.

Key results

  • Median HbA1c at 1 year after diagnosis was 60 mmol/mol (interquartile range [IQR], 52-71 mmol/mol) or 7.65% (IQR, 6.91%-8.62%).
  • High HbA1c was associated with a higher risk for later T2D-related morbidity and mortality (P<.05>
  • HbA1c increases within 6 years after diagnosis were associated with later microvascular complications (HR, 1.14; 95% CI, 1.05-1.24 per each 1.1 mmol/mol or 0.1% point increase), but not diabetes-related mortality, myocardial infarction, stroke, or peripheral vascular diseases.

Limitations

  • The study was observational, and researchers did not have access to treatment information or HbA1c measurements during follow-up.