Higher HbA1c after type 2 diagnosis linked to poor long-term outcomes
People with a HbA1c of 6.5% and above in the first year of developing type 2 diabetes were associated with poor outcomes in the longer term, a study has found.
The research, published by Diabetes Care, suggests immediate and intensive treatment for people newly diagnosed with the condition may be necessary to avoid long-term risk for complications and mortality.
The cohort study by the University of Chicago examined the legacy of early glycaemic control on complications and life expectancy.
Associations between HbA1c and future microvascular and macrovascular episodes were examined in more than 34,000 people who had lived with type 2 diabetes for ten years after being diagnosed with the condition.
Summarising the results, the researchers said: “Compared with HbA1c <6.5% (<48 mmol/mol) for the 0–1-year early exposure period, HbA1c levels ≥6.5% (≥48 mmol/mol) were associated with increased microvascular and macrovascular events (e.g., HbA1c 6.5% to <7.0% [48 to <53 mmol/mol] microvascular: hazard ratio 1.204 [95% CI 1.063–1.365]), and HbA1c levels ≥7.0% (≥53 mmol/mol) were associated with increased mortality (e.g., HbA1c 7.0% to <8.0% [53 to <64 mmol/mol]: 1.290 [1.104–1.507]). Longer periods of exposure to HbA1c levels ≥8.0% (≥64 mmol/mol) were associated with increasing microvascular event and mortality risk.”
They concluded: “Among patients with newly diagnosed diabetes and 10 years of survival, HbA1c levels ≥6.5% (≥48 mmol/mol) for the first year after diagnosis were associated with worse outcomes. Immediate, intensive treatment for newly diagnosed patients may be necessary to avoid irremediable long-term risk for diabetic complications and mortality.”
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