(HealthDay)—Hemoglobin A1c (HbA1c) variability may be a more powerful predictor of all-cause mortality with type 2 diabetes than average HbA1c, according to a study published in the August issue of Diabetes, Obesity and Metabolism.
Emanuela Orsi, M.D., from the University of Milan, and colleagues assessed three to five HbA1c measures for 8,290 patients during the two-year period (seen at nine centers) before enrollment in the Renal Insufficiency And Cardiovascular Events Italian multicenter study.
The researchers found that the measures of HbA1c variability increased according to quartiles of average HbA1c, and vice versa. There was an association between average HbA1c and measures of HbA1c variability with all-cause mortality. Mortality increased with quartiles of average HbA1c, intra-individual standard deviation (HbA1c-SD), SD adjusted for the number of HbA1c assessments, and coefficient of variation. However, after adjustment for confounders and/or each other measure, only the association with HbA1c variability measures remained. Mortality risk was lower for HbA1c-SD below the median and higher for HbA1c-SD above the median, regardless of whether average HbA1c was below or above the median, in fully adjusted models.
“HbA1c variability is a strong, independent predictor of all-cause mortality in type 2 diabetes and appears to be even more powerful than average HbA1c in predicting mortality,” the authors write.
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