ArticleDiabetes, obesity & metabolism2026
Impact of early and tight HbA1c control on the risk of long-term complications and cardiovascular death in patients with type 2 diabetes from the Swedish National Diabetes Register.
Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo assess the relationship between haemoglobin A1c (HbA1c) levels and incidence of long-term complications in patients with type 2 diabetes (T2D). MATERIALS AND
methodsThis long-term, retrospective study acquired patient data from the Swedish National Diabetes Registry and linked national registers between 1 January 1998 and 31 December 2019. The incidence rates (IR) of microvascular/macrovascular outcomes and cardiovascular death were reported for the overall study population. The hazard ratios (HR) for these outcomes were compared across HbA1c ranges assessed over time and between the early HbA1c control groups: early tight control (HbA1c ≤6.5%), no early tight control (HbA1c >6.5%), and early adverse control (HbA1c >7%), from 18 months after diagnosis.
results57.2% of the overall population were male and a median age of 60 years. The IR per 100-patient-years of any microvascular complication remained relatively stable (2005: 8.75; 2014: 10.95; 2019: 8.71), while cardiovascular death increased from 2005 (IR: 0.12) to 2018 (IR: 0.46). Incidences of any macrovascular complication increased with HbA1c ranges (8.0% to <9.0%, HR:1.16 [95%CI: 1.12-1.20]; 7.0% to <8.0%, HR:1.08 [95%CI: 1.05-1.11]) compared to reference (6.0 to <7.0%). Between early HbA1c control groups, the rates of any microvascular/macrovascular complication, and cardiovascular death were reduced in the reference early tight control group compared to the no early tight control group (HR:0.84 [95%CI: 0.80-0.89]; HR:0.86 [95%CI: 0.79-0.93]; and HR:0.60 [95%CI: 0.46-0.79], respectively), with similar results achieved compared to the early adverse control group.
conclusionsElevated HbA1c levels were closely associated with long-term complications, while early tight control of HbA1c corresponded to significantly improved clinical outcomes in patients with T2D.
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