Observational studyJournal of diabetes investigation2023
Glycated hemoglobin variability and the risk of cardiovascular events in patients with prediabetes and type 2 diabetes mellitus: A post-hoc analysis of a prospective and multicenter study.
Observational study in Journal of diabetes investigation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- HbA1c variability and risk of incident heart failure: A systematic review and meta-analysis.Biomolecules & biomedicine · 2025Pooled it
- Glycemic variability of glycated hemoglobin in patients with type 2 diabetes mellitus and the risk of cardiovascular diseases: a latest systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Pooled it
- Correlation of glycemic variability with the risk of atrial fibrillation and in-hospital mortality in patients diagnosed with obstructive sleep apnea: a retrospective study based on the Medical Information Mart for Intensive Care database.Journal of thoracic disease · 2026Article
- Non-Coding RNA in Type 2 Diabetes Cardio-Renal Complications and SGLT2 Inhibitor Response.International journal of molecular sciences · 2025Review
- Specificity and Areas of Usage of Cardiovascular Prediction Models Among Athletes-State-of-the-art Review.Reviews in cardiovascular medicine · 2025Review
- Risk of postoperative major adverse cerebrovascular events in patients with spontaneous intracranial hematoma stratified by type 2 diabetes mellitus.Frontiers in human neuroscience · 2025Article
- Glycated Hemoglobin and Cardiovascular Disease in Patients Without Diabetes.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
AIMS/
introductionHigh glycated hemoglobin (HbA1c) variability has been reported to be linked with cardiovascular events in type 2 diabetes patients. Only a few studies have been carried out on Asian patients. This study aimed to investigate the association of prediabetes and type 2 diabetes in Asian patients by performing a post-hoc analysis of a multicenter, prospective, observational study. MATERIALS AND
methodsData for prediabetes and type 2 diabetes patients were retrieved from a multicenter national registry entitled "CORE-Thailand study." The primary outcome was 4P-MACE (major adverse cardiovascular events, including non-fatal myocardial infarction, heart failure hospitalization, non-fatal stroke and all-cause death). Patients were stratified according to quartiles of HbA1c standard deviation. The Cox proportional hazards regression model was used to estimate the association of HbA1c variability with incident cardiovascular disease.
resultsA total of 3,811 patients with prediabetes and type 2 diabetes were included. The median follow-up duration was 54 months. In the fully adjusted model, the highest quartile of HbA1c variability showed a statistically significant association with 4P-MACE (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.77-4.35), fatal and non-fatal myocardial infarction (HR 6.91, 95% CI 1.90-25.12), hospitalization for heart failure (HR 3.34, 95% CI 1.20-9.26) and all-cause death (HR 3.10, 95% CI 1.72-5.57). All these outcomes were statistically significantly different among four quartiles of HbA1c (log-rank P-value <0.05). Fatal and non-fatal stroke showed no statistically significant association with high HbA1c variability.
conclusionHigh HbA1c variability in the highest quartile showed a statistically significant association with multiple adverse cardiovascular events in an Asian population. Minimizing HbA1c fluctuation during long-term follow up should be another important objective for type 2 diabetes patients.
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Registered trials
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