Evidence mapPaperPMID 25664182Full record

ArticleBMJ open diabetes research & care2015

Relationship of HbA1c variability, absolute changes in HbA1c, and all-cause mortality in type 2 diabetes: a Danish population-based prospective observational study.

Mette V Skriver, Annelli Sandbæk, Jette K Kristensen, Henrik Støvring

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Article in BMJ open diabetes research & care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.

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33citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

33 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Mette V SkriverDepartment of Public Health , Health, Aarhus University , Aarhus C , Denmark.
Annelli SandbækDepartment of Public Health , Health, Aarhus University , Aarhus C , Denmark.
Jette K KristensenDepartment of Public Health , Health, Aarhus University , Aarhus C , Denmark.
Henrik StøvringDepartment of Public Health , Health, Aarhus University , Aarhus C , Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe assessed the relationship of mortality with glycated hemoglobin (HbA1c) variability and with absolute change in HbA1c.

designA population-based prospective observational study with a median follow-up time of 6 years.

methodsBased on a validated algorithm, 11 205 Danish individuals with type 2 diabetes during 2001-2006 were identified from public data files, with at least three HbA1c measurements: one index measure, one closing measure 22-26 months later, and one measurement in-between. Medium index HbA1c was 7.3%, median age was 63.9 years, and 48% were women. HbA1c variability was defined as the mean absolute residual around the line connecting index value with closing value. Cox proportional hazard models with restricted cubic splines were used, with all-cause mortality as the outcome.

resultsVariability between 0 and 0.5 HbA1c percentage point was not associated with mortality, but for index HbA1c ≤8% (64 mmol/mol), a variability above 0.5 was associated with increased mortality (HR of 1 HbA1c percentage point variability was 1.3 (95% CI 1.1 to 1.5) for index HbA1c 6.6-7.4%). For index HbA1c≤8%, mortality increased when HbA1c declined, but was stable when HbA1c rose. For index HbA1c>8%, change in HbA1c was associated with mortality, with the lowest mortality for greatest decline (HR=0.9 (95% CI 0.80 to 0.98) for a 2-percentage point decrease).

conclusionsFor individuals with an index HbA1c below 8%, both high HbA1c variability and a decline in HbA1c were associated with increased mortality. For individuals with index HbA1c above 8%, change in HbA1c was associated with mortality, whereas variability was not.

Indexed as

ChangeHbA1cMortalityType 2 Diabetes

Identifiers

PMID25664182
PMCPMC4317527

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.