Association between HbA1c variability and mortality in patients with type 2 diabetes

Takao, Toshiko; Matsuyama, Yutaka; Yanagisawa, Hiroyuki; Kikuchi, Masatoshi; Kawazu, Shoji

doi:10.1016/j.jdiacomp.2014.02.006

Cited by 65 publications

(82 citation statements)

References 26 publications

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“…Twenty studies in 87,641 participants met the inclusion criteria. Ten studies included participants from Europe (10,11,14,(16)(17)(18)(19)26,29,35,36), eight from Asia (12,13,15,18,20,24,27,28), four from North America (6,18,23, 25), and one from Australasia (18). The number of participants in each study ranged from 234 to 35,891.…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

“…Thirteen studies included 43,620 participants with type 2 diabetes (12,13,(15)(16)(17)(18)(19)(20)23,24,(26)(27)(28)36). These comprised six retrospective cohort studies (13,15,20,23,28,36), five prospective cohort studies (12,16,17,19,26,27), and two post hoc analyses of randomized controlled trials (18,24).…”

Section: Type 2 Diabetesmentioning

confidence: 99%

“…These comprised six retrospective cohort studies (13,15,20,23,28,36), five prospective cohort studies (12,16,17,19,26,27), and two post hoc analyses of randomized controlled trials (18,24). All studies used secondary care data apart from one of primary and secondary care data (19) and one of solely U.S. primary care data (23).…”

Section: Type 2 Diabetesmentioning

confidence: 99%

“…A recent meta-analysis concluded that HbA 1c variability, assessed by the SD, is associated with renal disease in type 1 and type 2 diabetes (9). However, no systematic reviews or meta-analyses have evaluated the relationship between long-term glycemic variability and other complications in diabetes, despite contradictory literature providing evidence in support (6,(10)(11)(12)(13)(14)(15) and against (16)(17)(18)(19)(20) such a relationship.…”

mentioning

confidence: 99%

“…First, unlike short-term glycemic variability, longterm glycemic variability may predict complications in both type 1 and type 2 diabetes (6,(10)(11)(12)(13)(14)(15)(21)(22)(23)(24)(25)(26)(27)(28)(29). Second, HbA 1c is routinely recorded in primary care for both types of diabetes, whereas measures of short-term variability are not (30,31).…”

mentioning

confidence: 99%

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Long-term Glycemic Variability and Risk of Adverse Outcomes: A Systematic Review and Meta-analysis

et al. 2015

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OBJECTIVEGlycemic variability is emerging as a measure of glycemic control, which may be a reliable predictor of complications. This systematic review and meta-analysis evaluates the association between HbA 1c variability and micro-and macrovascular complications and mortality in type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODSMedline and Embase were searched (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) for studies describing associations between HbA 1c variability and adverse outcomes in patients with type 1 and type 2 diabetes. Data extraction was performed independently by two reviewers. Random-effects meta-analysis was performed with stratification according to the measure of HbA 1c variability, method of analysis, and diabetes type. RESULTS

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Section: Data Synthesis and Analysismentioning

confidence: 99%

Section: Type 2 Diabetesmentioning

confidence: 99%

Section: Type 2 Diabetesmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Long-term Glycemic Variability and Risk of Adverse Outcomes: A Systematic Review and Meta-analysis

et al. 2015

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Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Tsur

Cahn

Israel

et al. 2020

Diabetes Metabolism Res

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BackgroundWe evaluated the impact of flash continuous glucose monitoring (FCGM) on glycemic control and healthcare burden in a large real‐world cohort of patients with type 1 diabetes (T1D) initiating FCGM technology.MethodsIn this retrospective cohort study, we included adults (age ≥18 years) with T1D from a large Health Maintenance Organization in Israel, who initiated FCGM during 2018. Primary outcomes included change in HbA1c ≥3 months following FCGM commencement and change in rate of internal‐medicine hospitalization. Additional outcomes included changes in glucose test strip purchases, diabetes related outpatient health care visits and hospitalization for diabetic ketoacidosis (DKA) and/or severe hypoglycemia.ResultsThe study included 3490 patients, followed for a median of 14 (inter‐quartile range 11‐15) months after FCGM commencement. Among 2682 patients with an HbA1c measured both at baseline and ≥3 months after FCGM initiation, average HbA1c declined from 8.1% ± 1.46% to 7.9% ± 1.31% (P < .001) at first measurement and was maintained during follow up. Specifically, in those with HbA1c ≥8%, a mean decline of 0.5% (P < .001) was observed. A clinically significant HbA1c reduction of ≥0.5% was experienced by 25.5% of the patients. The rate of internal medicine hospitalization, visits to primary care, or visits to endocrine/diabetes specialists in the period following FCGM commencement vs the 6 months prior was significantly reduced (P < .001). Hospitalization for DKA and/or hypoglycemia declined as well (P = .004).ConclusionsFCGM was associated with significant and durable improvement in glycemic control as well as reduced consumption of healthcare services.

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Glucagon in type 2 diabetes: Friend or foe?

Marrano

Biondi

Genchi

et al. 2023

Diabetes Metabolism Res

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Hyperglucagonemia is one of the ‘ominous’ eight factors underlying the pathogenesis of type 2 diabetes (T2D). Glucagon is a peptide hormone involved in maintaining glucose homoeostasis by increasing hepatic glucose output to counterbalance insulin action. Long neglected, the introduction of dual and triple agonists exploiting glucagon signalling pathways has rekindled the interest in this hormone beyond its classic effect on glycaemia. Glucagon can promote weight loss by regulating food intake, energy expenditure, and brown and white adipose tissue functions through mechanisms still to be fully elucidated, thus its role in T2D pathogenesis should be further investigated. Moreover, the role of glucagon in the development of T2D micro‐ and macro‐vascular complications is elusive. Mounting evidence suggests its beneficial effect in non‐alcoholic fatty liver disease, while few studies postulated its favourable role in peripheral neuropathy and retinopathy. Contrarily, glucagon receptor agonism might induce renal changes resembling diabetic nephropathy, and data concerning glucagon actions on the cardiovascular system are conflicting. This review aims to summarise the available findings on the role of glucagon in the pathogenesis of T2D and its complications. Further experimental and clinical data are warranted to better understand the implications of glucagon signalling modulation with new antidiabetic drugs.

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Association between HbA1c variability and mortality in patients with type 2 diabetes

Cited by 65 publications

References 26 publications

Long-term Glycemic Variability and Risk of Adverse Outcomes: A Systematic Review and Meta-analysis

Long-term Glycemic Variability and Risk of Adverse Outcomes: A Systematic Review and Meta-analysis

Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: A nationwide cohort study

Glucagon in type 2 diabetes: Friend or foe?

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