All-cause mortality in relation to glycated haemoglobin in individuals with newly diagnosed type 2 diabetes: a retrospective cohort study

Khunti, Kamlesh, Weston, Claire, Gholap, Nitin, Molokhia, Mariam, Paul, Sanjoy, Millett, Christopher, Curcin, Vasa, Majeed, Azeem and Davies, Melanie J. (2012) All-cause mortality in relation to glycated haemoglobin in individuals with newly diagnosed type 2 diabetes: a retrospective cohort study. British Journal of Diabetes and Vascular Disease, Article in press 1-9. doi:10.1177/1474651412468297


Author Khunti, Kamlesh
Weston, Claire
Gholap, Nitin
Molokhia, Mariam
Paul, Sanjoy
Millett, Christopher
Curcin, Vasa
Majeed, Azeem
Davies, Melanie J.
Title All-cause mortality in relation to glycated haemoglobin in individuals with newly diagnosed type 2 diabetes: a retrospective cohort study
Journal name British Journal of Diabetes and Vascular Disease   Check publisher's open access policy
ISSN 1474-6514
1753-4305
Publication date 2012-12-04
Year available 2012
Sub-type Article (original research)
DOI 10.1177/1474651412468297
Volume Article in press
Start page 1
End page 9
Total pages 9
Place of publication London, United Kingdom
Publisher Sage Publications
Collection year 2013
Language eng
Formatted abstract
Aims: To explore the effect of glycated haemoglobin A1C (HbA1C) on all cause mortality in individuals newly diagnosed with type 2 diabetes, with and without previous cardiovascular disease.

Methods: We identified a total of 110,372 of individuals aged 18 to 80 years newly diagnosed with type 2 diabetes (including 9721 (8.8%) with established cardiovascular disease before diagnosis of diabetes) from the UK General Practice Research Database from 1990 to 2005. Primary outcome was all cause mortality. Cox proportional hazards models were used to assess the impact of HbA1C on survival.

Results: Over a median follow up of 5.2 years (interquartile range 2.9 to 8.1 years) there were 20,481 deaths. The hazard ratios for all cause mortality in individuals without cardiovascular disease, using the category of 6–6.49% as reference, were 1.28 (1.08 to 1.52), 1.16 (1.00 to 1.39), 1.43 (1.20 to 1.72), 1.62 (1.35 to 1.95), 1.80 (1.52 to 2.23), and 2.43 (2.01 to 2.97) for HbA1C categories of < 6.0%, 6.50–6.99%, 7.0–7.49%, 7.5–7.99%, 8.0–8.99%, and > 9.0% respectively. In individuals with established cardiovascular disease a significant increased risk of mortality was observed for HbA1C categories above 8.00%; hazard ratios 1.91 (1.30–2.83) for HbA1C 8.00–8.99% and 1.95 (1.30–2.90) for HbA1C > 9.0%.

Conclusions: A target of HbA1C between 6.0 and 6.5% is appropriate for individuals newly diagnosed with type 2 diabetes without cardiovascular disease. However, a target of < 8.0% may be less beneficial in individuals with established cardiovascular disease.
Keyword Cardiovascular disease
HbA1C
Mortality
New type 2 diabetes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online before print December 4, 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
Versions
Version Filter Type
Citation counts: Scopus Citation Count Cited 1 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 16 Jan 2013, 15:07:00 EST by Geraldine Fitzgerald on behalf of School of Public Health