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Glycaemic streaming in type 1 diabetes: implications for intervention?
Author(s) -
Gill GV,
Wallymahmed ME,
Wallymahmed A,
MacFarlane IA,
Woodward A
Publication year - 2013
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.1781
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , glycated haemoglobin , population , type 1 diabetes , gastroenterology , endocrinology , environmental health
Evidence exists that mean glycaemia in individuals with type 1 diabetes may remain remarkably constant (glycaemic ‘streaming’ or ‘tracking’). We have re‐examined this in a group of type 1 patients, to explore whether any subgroups may be more or less amenable to glycaemic improvement. We made a retrospective analysis between 2003 and 2007 of 181 people with type 1 diabetes. Basic demographic information, and sequential glycated haemoglobin (HbA1c) levels during the five‐year follow‐up period (2003–2007), were recorded. First (2003) and last HbA1c levels were recorded, and mean HbA1c for the whole period. These were analysed as a total group, by gender, and by glycaemic control (initial HbA1c over or below 64mmol/mol [8.0%]). Mean age was 41±8 years, diabetes duration 19±9 years, 58% were male, and mean HbA1c was 75±17mmol/mol (9.0±1.6%). Over the study period there was a small improvement in total population mean HbA1c (75±17 to 72±16mmol/mol [9.0±1.6 to 8.7±1.5%], p=0.003). This was accounted for by improvements in male (74±17 to 70±15mmol/mol [8.9±1.6 to 8.6±1.4%], p=0.005) and poorly‐controlled (HbA1c ≥65mmol/mol [8.1%]) patients (79±15 to 75±15mmol/mol [9.4±1.4 to 9.0±1.4%], p=0.002). Female and well‐controlled (HbA1c ≤64mmol/mol [8.0%]) patients showed no change in mean glycaemia. Most patients maintained closely similar HbA1c levels over time. Interventions in type 1 diabetes may be more usefully aimed at risk factors rather than glycaemia. Copyright © 2013 John Wiley & Sons.