Observational studyBMC endocrine disorders2021
Glycemic and lipid variability for predicting complications and mortality in diabetes mellitus using machine learning.
Observational study in BMC endocrine disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 6 of them syntheses that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 6 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Diagnostic Performance of Machine Learning Algorithms for Predicting Heart Failure in Diabetic Patients: A Systematic Review and Meta-Analysis.Endocrinology, diabetes & metabolism · 2025Pooled it
- Lipid variability and risk of microvascular complications in patients with diabetes: a systematic review and meta-analysis.BMC endocrine disorders · 2024Pooled it
- Glycemic variability and the risk of atrial fibrillation: a meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Artificial intelligence based prediction models for individuals at risk of multiple diabetic complications: A systematic review of the literature.Journal of nursing management · 2022Pooled it
- HbA1c Variability and the Risk of Dementia in Patients with Diabetes: A Meta-Analysis.International journal of clinical practice · 2022Pooled it
- The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Oxidative medicine and cellular longevity · 2021Pooled it
- Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis.Journal of diabetes · 2022Trial
- Homebound status and glycemic control among older adults: results from a national survey.GeroScience · 2026Article
- C-reactive protein-to-albumin ratio as a novel prognostic biomarker for long-term mortality in pericarditis: a real-world study.BMC cardiovascular disorders · 2025Article
- Visit-to-visit lipid variability, coronary artery calcification, inflammation, and mortality in the Multi-Ethnic Study of Atherosclerosis.European journal of preventive cardiology · 2025Observational
- Artificial Intelligence in Personalized Medicine for Diabetes Mellitus: A Narrative Review.Cureus · 2025Review
- Systemic Immune-Inflammation Index and Related Hematologic Markers as Prognostic Tools in Type 2 Diabetes.Medicina (Kaunas, Lithuania) · 2025Article
- Association between stress hyperglycemia ratio and neovascular glaucoma in patients with proliferative diabetic retinopathy.BMC ophthalmology · 2025Article
- Seasonal fluctuations of CGM metrics in individuals with type 1 diabetes using an intermittently scanned CGM device or sensor augmented pump.Endocrine · 2025Article
- Explainable artificial intelligence model predicting the risk of all-cause mortality in patients with type 2 diabetes mellitus.Frontiers in endocrinology · 2025Article
- Establishment and external validation of an early warning model of diabetic peripheral neuropathy based on random forest and logistic regression.BMC endocrine disorders · 2024Article
- HbAAlzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- PowerAI-Diabetes: Review of glycemic and lipid variability to predict cardiovascular events in Chinese diabetic population.npj metabolic health and disease · 2024Review
- Lipid Swings Provoke Vascular Inflammation.Endocrinology and metabolism (Seoul, Korea) · 2024Article
- Role of angiotensin receptor-neprilysin inhibitor in diabetic complications.World journal of diabetes · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRecent studies have reported that HbA1c and lipid variability is useful for risk stratification in diabetes mellitus. The present study evaluated the predictive value of the baseline, subsequent mean of at least three measurements and variability of HbA1c and lipids for adverse outcomes.
methodsThis retrospective cohort study consists of type 1 and type 2 diabetic patients who were prescribed insulin at outpatient clinics of Hong Kong public hospitals, from 1st January to 31st December 2009. Standard deviation (SD) and coefficient of variation were used to measure the variability of HbA1c, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride. The primary outcome is all-cause mortality. Secondary outcomes were diabetes-related complications.
resultThe study consists of 25,186 patients (mean age = 63.0, interquartile range [IQR] of age = 15.1 years, male = 50%). HbA1c and lipid value and variability were significant predictors of all-cause mortality. Higher HbA1c and lipid variability measures were associated with increased risks of neurological, ophthalmological and renal complications, as well as incident dementia, osteoporosis, peripheral vascular disease, ischemic heart disease, atrial fibrillation and heart failure (p < 0.05). Significant association was found between hypoglycemic frequency (p < 0.0001), HbA1c (p < 0.0001) and lipid variability against baseline neutrophil-lymphocyte ratio (NLR).
conclusionRaised variability in HbA1c and lipid parameters are associated with an elevated risk in both diabetic complications and all-cause mortality. The association between hypoglycemic frequency, baseline NLR, and both HbA1c and lipid variability implicate a role for inflammation in mediating adverse outcomes in diabetes, but this should be explored further in future studies.
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Registered trials
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.