ArticleTherapeutic advances in endocrinology and metabolism2025
The legacy effect of early HbA1c control on microvascular complications and hospital admissions in type 2 diabetes: findings from a large UK study.
Article in Therapeutic advances in endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Impact of a remote nutrition education on low-carbohydrate diet based in type 2 diabetes management: findings from a Brazilian primary care randomized controlled trial.Diabetology international · 2026Article
- Association between hemoglobin A1c to HDL cholesterol ratio and hypertension in middle-aged and older Chinese adults: a cross-sectional study.BMC cardiovascular disorders · 2026Article
- HbA1c as a Continuous Marker of Microvascular Vulnerability: Development of a Non-Linear Risk Framework in a Real-World Cohort.Metabolites · 2026Article
- Machine learning and engagement insights for personalized blood glucose management.Frontiers in digital health · 2026Article
- IL-6 as an integrative biomarker of residual inflammation and visceral adiposity in psoriasis: a VAI threshold-dependent model.Frontiers in immunology · 2025Article
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Authors and funding
5 authors.
Funding
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Abstract
Introduction: There is conflicting evidence regarding optimal glycaemic targets to reflect the legacy effect of hyperglycaemia in people with type 2 diabetes (T2D). We examined the risks of microvascular complications and hospital admission with glycated haemoglobin (HbA1c) levels from the diagnosis of T2D. Methods: We identified individuals with incident T2D from 1998 to 2007 from the Clinical Practice Research Datalink and Hospital Episode Statistics. A composite microvascular outcome was defined as a new diagnosis of neuropathy, nephropathy or retinopathy. A multivariate time-varying Cox regression analysis was performed to assess the risk of microvascular disease associated with HbA1c at five different levels (1.0% (11 mmol/mol) intervals). HbA1c 6.5%-7.5% (48.0-58.9 mmol/mol) was defined as the reference. Results: Conclusion: The risk of microvascular complications was lowest when HbA1c levels were within the non-diabetic range and increased with higher HbA1c levels. The risk of hospital admission was significantly elevated in individuals with HbA1c levels below 6.5%, suggesting a potential U-shaped association, although the increased risk at higher HbA1c levels did not reach statistical significance. This highlights the importance of maintaining individualised HbA1c targets in the management of T2D from diagnosis to prevent these complications.
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