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Changes in HbA(1c) and frequency of measuring HbA(1c) and adjusting glucose-lowering medications in the 10 years following diagnosis of type 2 diabetes: a population-based study in the UK

Marcus Lind ; A. Pivodic ; L. Cea-Soriano ; Olle Nerman (Institutionen för matematiska vetenskaper, matematisk statistik) ; N. G. Pehrsson ; L. A. Garcia-Rodriguez
Diabetologia (0012-186X). Vol. 57 (2014), 8, p. 1586-1594.
[Artikel, refereegranskad vetenskaplig]

Aim/hypothesis The aim of this work was to study levels of HbA(1c) and patterns of adjusting glucose-lowering drugs in patients with impaired glycaemic control over 10 years after diagnosis of type 2 diabetes. Methods We studied 4,529 individuals in The Health Improvement Network Database newly diagnosed with type 2 diabetes in the year 2000. Results From 6 months to 10 years after diagnosis, the HbA(1c) increased from 7.04% (53.4 mmol/mol) to 7.49% (58.3 mmol/mol) (average annual change: 0.047% [0.51 mmol/mol]). The greatest annual change occurred between 6 months and 2 years (0.21% [2.30 mmol/mol] increase per year, p < 0.001), followed by the 2-5 year time period (0.033% [0.36 mmol/mol] increase per year, p < 0.001). No significant increase in HbA(1c) occurred between 5 and 10 years (p = 0.20). In multivariable analyses, patients who were younger (p < 0.001), with higher BMI (p = 0.033) and who were current insulin users (p = 0.024) at diagnosis had greater increases in HbA(1c) between 6 months and 2 years. For individuals with HbA(1c) above 7.0% (53 mmol/mol) the mean time to next measurement of HbA(1c) was 0.53 years and increase in doses or changes to other glucose-lowering medications were performed in 26% of cases. Conclusions/interpretation HbA(1c) increases by approximately 0.5% (5 mmol/mol) over 10 years after diagnosis of type 2 diabetes, with the main increase appearing in the first years after diagnosis. More frequent monitoring of HbA(1c) and adjustments of glucose-lowering drugs may be essential to prevent the decline.

Nyckelord: HbA(1c), Medication, Type 2 diabetes, PRIMARY-CARE, RISK, PREVALENCE, TRENDS, COMPLICATIONS, MORTALITY, METFORMIN, MELLITUS, OUTCOMES, HEALTH, Endocrinology & Metabolism



Denna post skapades 2014-08-18. Senast ändrad 2014-08-26.
CPL Pubid: 201540

 

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Institutioner (Chalmers)

Institutionen för medicin (GU)
Institutionen för matematiska vetenskaper, matematisk statistik (2005-2016)

Ämnesområden

Endokrinologi

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