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Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes

CONTEXT: Glycemic variation had been demonstrated to be associated with several complications of diabetes. OBJECTIVE: Investigation of the association between visit to visit hemoglobin A1c (HbA1c) variation and the long-term risk of major adverse limb events (MALEs). METHODS: Retrospective database...

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Autores principales: Hsiao, Fu-Chih, Chan, Yi-Hsin, Tung, Ying-Chang, Lin, Chia-Pin, Lee, Ting-Hein, Wang, Yu-Chiang, Chu, Pao-Hsien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505528/
https://www.ncbi.nlm.nih.gov/pubmed/37022983
http://dx.doi.org/10.1210/clinem/dgad203
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author Hsiao, Fu-Chih
Chan, Yi-Hsin
Tung, Ying-Chang
Lin, Chia-Pin
Lee, Ting-Hein
Wang, Yu-Chiang
Chu, Pao-Hsien
author_facet Hsiao, Fu-Chih
Chan, Yi-Hsin
Tung, Ying-Chang
Lin, Chia-Pin
Lee, Ting-Hein
Wang, Yu-Chiang
Chu, Pao-Hsien
author_sort Hsiao, Fu-Chih
collection PubMed
description CONTEXT: Glycemic variation had been demonstrated to be associated with several complications of diabetes. OBJECTIVE: Investigation of the association between visit to visit hemoglobin A1c (HbA1c) variation and the long-term risk of major adverse limb events (MALEs). METHODS: Retrospective database study. Average real variability was used to represent glycemic variations with all the HbA1c measurements during the 4 following years after the initial diagnosis of type 2 diabetes. Participants were followed from the beginning of the fifth year until death or the end of the follow-up. The association between HbA1c variations and MALEs was evaluated after adjusting for mean HbA1c and baseline characteristics. Included were 56 872 patients at the referral center with a first diagnosis of type 2 diabetes, no lower extremity arterial disease, and at least 1 HbA1c measurement in each of the 4 following years were identified from a multicenter database. The main outcome measure was incidence of a MALE, which was defined as the composite of revascularization, foot ulcers, and lower limb amputations. RESULTS: The average number of HbA1c measurements was 12.6. The mean follow-up time was 6.1 years. The cumulative incidence of MALEs was 9.25 per 1000 person-years. Visit to visit HbA1c variations were significantly associated with MALEs and lower limb amputation after multivariate adjustment. People in the highest quartile of variations had increased risks for MALEs (HR 1.25, 95% CI 1.10-1.41) and lower limb amputation (HR 3.05, 95% CI 1.97-4.74). CONCLUSION: HbA1c variation was independently associated with a long-term risk of MALEs and lower limb amputations in patients with type 2 diabetes.
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spelling pubmed-105055282023-09-19 Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes Hsiao, Fu-Chih Chan, Yi-Hsin Tung, Ying-Chang Lin, Chia-Pin Lee, Ting-Hein Wang, Yu-Chiang Chu, Pao-Hsien J Clin Endocrinol Metab Clinical Research Article CONTEXT: Glycemic variation had been demonstrated to be associated with several complications of diabetes. OBJECTIVE: Investigation of the association between visit to visit hemoglobin A1c (HbA1c) variation and the long-term risk of major adverse limb events (MALEs). METHODS: Retrospective database study. Average real variability was used to represent glycemic variations with all the HbA1c measurements during the 4 following years after the initial diagnosis of type 2 diabetes. Participants were followed from the beginning of the fifth year until death or the end of the follow-up. The association between HbA1c variations and MALEs was evaluated after adjusting for mean HbA1c and baseline characteristics. Included were 56 872 patients at the referral center with a first diagnosis of type 2 diabetes, no lower extremity arterial disease, and at least 1 HbA1c measurement in each of the 4 following years were identified from a multicenter database. The main outcome measure was incidence of a MALE, which was defined as the composite of revascularization, foot ulcers, and lower limb amputations. RESULTS: The average number of HbA1c measurements was 12.6. The mean follow-up time was 6.1 years. The cumulative incidence of MALEs was 9.25 per 1000 person-years. Visit to visit HbA1c variations were significantly associated with MALEs and lower limb amputation after multivariate adjustment. People in the highest quartile of variations had increased risks for MALEs (HR 1.25, 95% CI 1.10-1.41) and lower limb amputation (HR 3.05, 95% CI 1.97-4.74). CONCLUSION: HbA1c variation was independently associated with a long-term risk of MALEs and lower limb amputations in patients with type 2 diabetes. Oxford University Press 2023-04-06 /pmc/articles/PMC10505528/ /pubmed/37022983 http://dx.doi.org/10.1210/clinem/dgad203 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research Article
Hsiao, Fu-Chih
Chan, Yi-Hsin
Tung, Ying-Chang
Lin, Chia-Pin
Lee, Ting-Hein
Wang, Yu-Chiang
Chu, Pao-Hsien
Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
title Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
title_full Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
title_fullStr Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
title_full_unstemmed Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
title_short Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
title_sort visit to visit hemoglobin a1c variation and long-term risk of major adverse limb events in patients with type 2 diabetes
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505528/
https://www.ncbi.nlm.nih.gov/pubmed/37022983
http://dx.doi.org/10.1210/clinem/dgad203
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