Glycated hemoglobin: A powerful tool not used enough in primary care

Salinas, María; López-Garrigós, Maite; Flores, Emilio; Leiva‐Salinas, Carlos

doi:10.1002/jcla.22310

Cited by 7 publications

(1 citation statement)

References 12 publications

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“…Diabetes is imposing an increasing burden on public health systems, and older individuals are more likely to be over-represented among those with diabetes [2,3]. Measurement of glycated haemoglobin A1c (HbA1c) is a diagnostic test that reflects the average blood sugar level over the previous 2-3 months, enabling effective monitoring of intervention strategies to lower blood sugar levels and associated risk of diabetic complications [4,5]. The pathogenesis of diabetes is complex leading to microvascular dysfunction [6,7], following prolonged periods of chronic hyperglycaemia that commonly leads to damage to the kidneys, retinas and peripheral nervous system and increased cardiovascular risk [8].…”

Section: Introductionmentioning

confidence: 99%

Retinal microvascular parameters are not associated with diabetes in the Northern Ireland Cohort for the Longitudinal Study of Ageing

O'Neill¹,

Maxwell²,

Kee³

et al. 2021

Ir J Med Sci

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Background The retinal microvasculature offers unique non-invasive evaluation of systemic microvascular abnormalities. Previous studies reported associations between retinal microvascular parameters (RMPs) and diabetes. The aim of this study was to assess associations between RMPs and diabetes in a cross-sectional analysis of older persons from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). Methods RMPs (central retinal arteriolar/venular equivalents, arteriolar to venular ratio, fractal dimension, and tortuosity) were measured from optic disc-centred fundus images using semi-automated software. Associations were assessed between RMPs and diabetes status with adjustment for potential confounders. Results Data were included for 1762 participants with 209 classified as having diabetes. Participants had a mean age of 62.1 ± 8.5 years, and 54% were female. As expected, participants with diabetes had significantly higher mean glycated haemoglobin A1c compared to participants without diabetes (57.4 ± 17.6 mmol/mol versus 37.0 ± 4.2 mmol/mol, respectively). In unadjusted and minimally adjusted regression, arteriolar to venular ratio, arteriolar tortuosity and venular tortuosity were significantly associated with diabetes (minimally adjusted odds ratio [OR] = 0.85; 95% confidence intervals [CIs] 0.73, 0.99; P = 0.04, OR = 1.18; 95% CI 1.02, 1.37; P = 0.03 and OR = 1.20; 95% CI 1.04, 1.38; P = 0.01, respectively), although all failed to remain significant following adjustment for potential confounders. No additional associations between other RMPs and diabetes were detected. Conclusion Despite previously reported associations between diabetes and RMPs, our study failed to corroborate these associations in an older community-based cohort.

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