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Intrapersonal HbA(1c) variability and the risk of progression of nephropathy in patients with Type 2 diabetes.
Diabet Med. 2012 Dec; 29(12):1562-6.DM

Abstract

AIM

To investigate the association between nephropathy and HbA(1c) variability (assessed as the standard deviation of each patient's HbA(1c) measurements) among patients with Type 2 diabetes.

METHODS

Albumin excretion rate and HbA(1c) were measured in 2103 patients followed up for a mean 6.6 years. Multivariate Cox regression analysis was used to determine the influence of HbA(1c) variability on the risk of progression of nephropathy after adjustment for age, sex, duration of diabetes, baseline condition (two cohorts defined by duration of diabetes, retinopathy and albumin excretion rate), baseline HbA(1c) , insulin use, BMI, use of anti-hypertensive agents, smoking, lipid status, retinopathy, updated mean HbA(1c) and number of HbA(1c) measurements.

RESULTS

Nephropathy progressed in 18.3% of subjects. HbA(1c) variability was significantly greater among progressors than among non-progressors (12 vs. 10 mmol/mol; 1.12 vs. 0.90%; P < 0.0001) and was a significant predictor of progression of nephropathy even after adjustment for updated mean HbA(1c) and other risk factors (hazard ratio 1.37, 95% CI 1.12-1.69).

CONCLUSION

In patients with Type 2 diabetes, the risk of progression of nephropathy increases significantly with HbA(1c) variability, independently of the influence of updated mean HbA(1c) .

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Authors+Show Affiliations

Rodríguez-Segade S
Department of Biochemistry and Molecular Biology, The University Hospital, Santiago de Compostela, Spain. ssegade@telefonica.net
Rodríguez J
No affiliation info available
García López JM
No affiliation info available
Casanueva FF
No affiliation info available
Camiña F
No affiliation info available

MeSH

AlbuminuriaBlood GlucoseDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionFemaleFollow-Up StudiesGlycated Hemoglobin AHumansMaleMiddle AgedPredictive Value of TestsProportional Hazards ModelsRisk FactorsSpain

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22913483

Citation

Rodríguez-Segade, S, et al. "Intrapersonal HbA(1c) Variability and the Risk of Progression of Nephropathy in Patients With Type 2 Diabetes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 29, no. 12, 2012, pp. 1562-6.
Rodríguez-Segade S, Rodríguez J, García López JM, et al. Intrapersonal HbA(1c) variability and the risk of progression of nephropathy in patients with Type 2 diabetes. Diabet Med. 2012;29(12):1562-6.
Rodríguez-Segade, S., Rodríguez, J., García López, J. M., Casanueva, F. F., & Camiña, F. (2012). Intrapersonal HbA(1c) variability and the risk of progression of nephropathy in patients with Type 2 diabetes. Diabetic Medicine : a Journal of the British Diabetic Association, 29(12), 1562-6. https://doi.org/10.1111/j.1464-5491.2012.03767.x
Rodríguez-Segade S, et al. Intrapersonal HbA(1c) Variability and the Risk of Progression of Nephropathy in Patients With Type 2 Diabetes. Diabet Med. 2012;29(12):1562-6. PubMed PMID: 22913483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrapersonal HbA(1c) variability and the risk of progression of nephropathy in patients with Type 2 diabetes. AU - Rodríguez-Segade,S, AU - Rodríguez,J, AU - García López,J M, AU - Casanueva,F F, AU - Camiña,F, PY - 2012/8/24/entrez PY - 2012/8/24/pubmed PY - 2013/5/18/medline SP - 1562 EP - 6 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 29 IS - 12 N2 - AIM: To investigate the association between nephropathy and HbA(1c) variability (assessed as the standard deviation of each patient's HbA(1c) measurements) among patients with Type 2 diabetes. METHODS: Albumin excretion rate and HbA(1c) were measured in 2103 patients followed up for a mean 6.6 years. Multivariate Cox regression analysis was used to determine the influence of HbA(1c) variability on the risk of progression of nephropathy after adjustment for age, sex, duration of diabetes, baseline condition (two cohorts defined by duration of diabetes, retinopathy and albumin excretion rate), baseline HbA(1c) , insulin use, BMI, use of anti-hypertensive agents, smoking, lipid status, retinopathy, updated mean HbA(1c) and number of HbA(1c) measurements. RESULTS: Nephropathy progressed in 18.3% of subjects. HbA(1c) variability was significantly greater among progressors than among non-progressors (12 vs. 10 mmol/mol; 1.12 vs. 0.90%; P < 0.0001) and was a significant predictor of progression of nephropathy even after adjustment for updated mean HbA(1c) and other risk factors (hazard ratio 1.37, 95% CI 1.12-1.69). CONCLUSION: In patients with Type 2 diabetes, the risk of progression of nephropathy increases significantly with HbA(1c) variability, independently of the influence of updated mean HbA(1c) . SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/22913483/Intrapersonal_HbA_1c__variability_and_the_risk_of_progression_of_nephropathy_in_patients_with_Type_2_diabetes_ L2 - https://doi.org/10.1111/j.1464-5491.2012.03767.x DB - PRIME DP - Unbound Medicine ER -