HbA1c, systolic blood pressure variability and diabetic retinopathy in Asian type 2 diabetics

Abstract

In a cohort of Asian patients with T2D, both higher mean HbA1c levels and SBP, but not their variability, were associated with moderate DR. Among those with good glycemic control, wider variability of SBP is associated with moderate DR.

Haemoglobin A1c variability is a strong, independent predictor of all‐cause mortality in patients with type 2 diabetes

“…These findings might imply that the impact of average HbA1c on the risk of all‐cause mortality is lower than that of HbA1c variability and is mediated predominantly through its effect that favours the development of long‐term complications. Conversely, HbA1c variability seems to affect mortality risk to a greater extent than does HbA1c‐MEAN and beyond the previously reported effect on complications, which was found to be even stronger than that of HbA1c‐MEAN for (albuminuric) DKD . However, the higher prevalence of advanced DR and CVD in subjects with high HbA1c‐MEAN than in those with high HbA1c‐SD suggests that this heavier burden of non‐renal complications, particularly CVD, may have masked the influence of average HbA1c on the risk of mortality in regression models.…”

“…Although this and other studies have provided strong evidence in favour of an independent association of the HbA 1c change from one visit to the next with unfavourable outcomes (including mortality), it remains unclear whether this association reflects a causal relationship or, rather, depends on confounding factors that characterize subjects with high HbA1c variability. A possible mechanism underlying a promoting effect of HbA1c variability on mortality is that periods of sustained hyperglycaemia and higher HbA1c levels may be “remembered” during subsequent periods of normoglycaemia and lower HbA1c values, because of the induction of long‐lasting epigenetic changes .…”

“…12,13 In detail, studies in patients with type 1 diabetes [14][15][16][17] consistently showed that HbA1c variability is an independent risk factor for microvascular complications, and one such study also found a relation with cardiovascular disease (CVD), 16 even after adjusting for average HbA1c. Studies in subjects with type 2 diabetes were concordant in reporting an independent association of HbA1c variability with diabetic kidney disease (DKD), especially albuminuric DKD, [18][19][20][21] whereas conflicting results were obtained for diabetic retinopathy (DR) 20,22 and CVD. 23,24 Finally, a few studies reported an association of HbA1c variability with mortality, independent of average HbA1c.…”

Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta‐analysis

“…Full‐text versions of the remaining 73 articles were retrieved and singularly examined. Ultimately, 47 studies were excluded and, of the remaining 26 papers that were included, 22 were selected for quantitative analysis . Secondary endpoints (i.e.…”

A Rapid Test Strip for Diagnosing Glycosylated Hemoglobin (HbA1c) Based on Fluorescent Affinity Immunochromatography

“…People with type II dibetes have many complications such as high blood pressure, cerebral infarction and nephrotic syndrome [1][2][3][4] . In China, the prevalence rate of adult with diabetes is 10.9% , and the morbidity is as high as 5.9% under the age of 40.…”