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Effect of mean HbA1c on the association of HbA1c variability and all‐cause mortality in patients with type 2 diabetes
Author(s) -
Tseng JueiYu,
Chen HsinHung,
Huang KuoChin,
Hsu ShengPang,
Chen ChingChu
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13951
Subject(s) - quartile , medicine , coefficient of variation , standard deviation , diabetes mellitus , correlation , type 2 diabetes , statistics , confidence interval , endocrinology , mathematics , geometry
Abstract Aim To evaluate the effect of mean HbA1c on the correlation between HbA1c variability and all‐cause mortality, and the risks associated with different levels of HbA1c and glycaemic control status in patients with type 2 diabetes. Materials and Methods Patients with type 2 diabetes and at least three HbA1c measurements within 12–24 months were included. HbA1c variability score, coefficient of variation (CV) and standard deviation (SD) were used to evaluate variability. A variability score of 50 was set as a cutoff to define low and high variability. Results A total of 4216 patients were included, of whom 1196 died during the observation period (11.1 ± 3.2 years). All‐cause mortality increased with HbA1c variability score and the quartiles of HbA1c CV and SD. The strength of this association was attenuated after adjustment for mean HbA1c, and the risks associated with HbA1c variability and glycaemic control status were similar. The highest associated risk was observed with an HbA1c variability score of >50 and mean HbA1c of ≥7.5%. Mortality risk was significantly higher with a mean HbA1c of ≤6.0% and >8.5% and of ≤6.0% and >8.0% for low and high HbA1c variability, respectively. Conclusions Mean HbA1c contributed to the correlation between HbA1c variability and all‐cause mortality. The risks associated with HbA1c variability and glycaemic control status were similar. The relationship between mean HbA1c and mortality presented a J‐shaped distribution for both low and high HbA1c variability.