HbA<sub>1c</sub> 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes

Kerr, David; Partridge, Helen; Knott, J. Eugene; Thomas, Peter

doi:10.1111/j.1464-5491.2011.03443.x

Cited by 21 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Observational studies have demonstrated that hyperglycaemia is an important predictor of mortality and CVD risk [2][3][4][5][6][7][8][9][10][11][12][13][14][15], with the majority of studies showing positive linear relationships between HbA 1c and mortality or CVD risk [4,6,7,11,14,15]. However, several other important studies have suggested non-linear (U-or J-shaped) relationships [3, 5, 8-10, 12, 13, 16].…”

Section: Observational Studies Hba 1c and Mortalitymentioning

confidence: 99%

Low HbA1c and mortality: causation and confounding

Rutter

2012

Diabetologia

View full text Add to dashboard Cite

show abstract

Section: Observational Studies Hba 1c and Mortalitymentioning

confidence: 99%

Low HbA1c and mortality: causation and confounding

Rutter

2012

Diabetologia

View full text Add to dashboard Cite

show abstract

“…All studies show an increase in allcause mortality with HbA1c values, where only the degree and pattern of association differ. Whilst most studies highlight a linear relationship [20][21][22][23][24][25][26][27][28][29], several studies report a J-or U-shaped relationship [30][31][32][33][34], indicating an increased all-cause mortality at lower HbA1c levels similar to that seen in the ACCORD trial.…”

Section: Introductionmentioning

confidence: 98%

“…Provision of appropriate tables and graphics [18][19][20][21][22][23] See also other supplementary tables…”

mentioning

confidence: 99%

The HbA1c and All-Cause Mortality Relationship in Patients with Type 2 Diabetes is J-Shaped: A Meta-Analysis of Observational Studies

Arnold

Wang

2014

Rev Diabet Stud

View full text Add to dashboard Cite

■ AbstractBACKGROUND: Low blood glucose and HbA1c levels are recommended in the literature on management of diabetes. However, data have shown that low blood glucose is associated with serious adverse effects for the patients and the recommendation has been criticized. Therefore, this article revisits the relationship between HbA1c and all-cause mortality by a meta-analysis of observational studies. AIM: The aim of this study is to determine whether there is a J-or Ushaped non-linear relationship between HbA1c and all-cause mortality in type 2 diabetes patients, implying an increased risk to premature all-cause mortality at high and low levels of HbA1c. METHODS: A comprehensive literature search was conducted using PubMed, Medline, and Cochrane Library databases with strict inclusion/exclusion criteria. The published adjusted hazard ratios (HR) with 95% confidence intervals of all-cause mortality for each HbA1c category and per study were analyzed. Fractional polynomial regression was used with random effect modeling to assess the nonlinear relationship of the HR trends between studies. Seven eligible observational studies with a total of 147,424 participants were included in the study. RESULTS: A significant Jshaped relationship was observed between HbA1c and allcause mortality. Crude relative risk for all-cause mortality identified a decreased risk per 1% increase in HbA1c below 7.5% (58 mmol/mol) (0.90, CI 0.86-0.94) and an increased risk per 1% increase in HbA1c above 7.5% (58 mmol/mol) (1.04, CI 1.01-1.06). Observational studies revealed a Jshaped relationship between HbA1c and all-cause mortality, equivalent to an increased risk of mortality at high and low HbA1c levels. CONCLUSIONS: This increased mortality at high and low HbA1c levels has significant implications on investigating optimum clinical HbA1c targets as it suggests that there are upper and lower limits for creating a 'security zone' for diabetes management.

show abstract

“…Elevated HbA1c level has also been linked to a higher risk of diabetic retinopathy [48], nephropathy [49], cardiovascular diseases [50,51] and premature death [52,53]. Other studies must be done to establish the best cut point of A1C that correlates with specific diabetic microvascular complications, especially when the diagnostic tests are discordant.…”

Section: Resultsmentioning

confidence: 99%

Can A1C Replace Oral Glucose Tolerance Test in the Evaluation of Patients with Impaired Fasting Glucose?

Mv¹,

Mw²,

Ap³

et al. 2017

EMIJ

View full text Add to dashboard Cite

Aim: The aim of this study is to correlate the A1C values with the OGTT in individuals without type 2 Diabetes (DM) but with impaired fasting glucose (IFG) (FPG: 5.6-6.9mmol/l). Methods:We investigated 119 subjects with IFG divided according to A1C levels (<5.7%; 5.7-6.4%, ≥6.5%) and analyzed the correlation among A1C, FPG and 2-hPG by Pearson's coefficient. Kappa coefficient was used to test agreement between A1C and 2-hPG for the diagnosis of DM. Results:The average age of the subjects was 54.2 ± 14.6 years, the average BMI was 30.2 ±5.5 and 70.5% were women. While levels of A1C ≥6.5% were associated to alterations in the 2-hPG in 86.7%, only 28.6% of these patients had 2-hPG >11.1mmol/l. Furthermore, 31.6% of the patients with DM diagnosed by the OGTT had A1C levels ≥6.5% and 64.3% of the patients with A1C < 5.7% had a normal OGTT. The Kappa coefficient of reliability between A1C and 2-hPG to diagnose DM was 0.71. Conclusion:A1C is a useful tool in evaluating IFG patients and correlates better to 2-hPG than to FPG. Yet, the agreement between A1C and OGTT to diagnose DM in this group was moderate (71%). It may be too soon to consider A1C as a substitute exam for OGTT.

show abstract

HbA_1c 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes

Cited by 21 publications

References 17 publications

Low HbA1c and mortality: causation and confounding

Low HbA1c and mortality: causation and confounding

The HbA1c and All-Cause Mortality Relationship in Patients with Type 2 Diabetes is J-Shaped: A Meta-Analysis of Observational Studies

Can A1C Replace Oral Glucose Tolerance Test in the Evaluation of Patients with Impaired Fasting Glucose?

Contact Info

Product

Resources

About

HbA1c 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes

Cited by 21 publications

References 17 publications

Low HbA1c and mortality: causation and confounding

Low HbA1c and mortality: causation and confounding

The HbA1c and All-Cause Mortality Relationship in Patients with Type 2 Diabetes is J-Shaped: A Meta-Analysis of Observational Studies

Can A1C Replace Oral Glucose Tolerance Test in the Evaluation of Patients with Impaired Fasting Glucose?

Contact Info

Product

Resources

About

HbA_1c 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes