Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB Prospective Complications Study

Schoenaker, Danielle A. J. M., Simon, Dominique, Chaturvedi, Nish, Fuller, John H., Soedamah-Muthu, Sabita S. and EURODIAB Prospective Complications Study Group (2014) Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB Prospective Complications Study. Journal of Clinical Endocrinology and Metabolism, 1-9. doi:10.1210/jc.2013-2824

Attached Files (Some files may be inaccessible until you login with your UQ eSpace credentials)
Name Description MIMEType Size Downloads

Author Schoenaker, Danielle A. J. M.
Simon, Dominique
Chaturvedi, Nish
Fuller, John H.
Soedamah-Muthu, Sabita S.
EURODIAB Prospective Complications Study Group
Total Author Count Override 6
Title Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB Prospective Complications Study
Journal name Journal of Clinical Endocrinology and Metabolism   Check publisher's open access policy
ISSN 0021-972X
1945-7197
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1210/jc.2013-2824
Open Access Status
Start page 1
End page 9
Total pages 9
Place of publication Chevy Chase, MD, United States
Publisher The Endocrine Society
Collection year 2015
Language eng
Formatted abstract
Context: Glycemic targets and the benefit of intensive glucose control are currently under debate as intensive glycemic control has been suggested to have negative effects on mortality risk in type 2 diabetes patients.

Objective: We examined the association between glycated hemoglobin (HbA1c) and all-cause mortality in patients with type 1 diabetes mellitus.

Design, Setting, and Patients: A clinic-based prospective cohort study was performed in 2,764 European patients with type 1 diabetes aged 15–60 years enrolled in the EURODIAB Prospective Complications Study.

Outcome measure: Possible non-linearity of the association between HbA1c and all-cause mortality was examined using multivariable restricted cubic spline regression using three (at HbA1c 5.6, 7.1, 8.1, 9.5 and 11.8%) and five knots (additionally at HbA1c 7.1 and 9.5%). Mortality data were collected ~7 years after baseline examination.

Results: HbA1c was related to all-cause mortality in a non-linear manner after adjustment for age and sex. All-cause mortality risk was increased at both low (5.6%) and high (11.8%) HbA1c compared to the reference (median HbA1c: 8.1%) following a U-shaped association (P overall effect=0.008 and 0.04, P non-linearity=0.03 and 0.11 (three and five knots, respectively)).

Conclusions: Results from our study in type 1 diabetes patients suggest that target HbA1c below a certain threshold may not be appropriate in this population. We recognize that these low HbA1c levels may be related to anemia, renal insufficiency, infection, or other factors not available in our database. If our data are confirmed, the potential mechanisms underlying this increased mortality risk among those with low HbA1c will need further study
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published Online: January 01, 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 12 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 21 Jan 2014, 13:16:45 EST by Danielle Schoenaker on behalf of School of Public Health