Glycemic Measures in Childhood as Predictors of Future Diabetes-Related Microvascular Complications in an Indigenous American Population
Authors' conclusion
In this study, higher glycemia levels ascertained by HbA1c and 2-h PG during childhood were associated with future microvascular complications; this demonstrates the potential utility of screening tests performed in high-risk children in predicting long-term health outcomes.
Study context
- Population
- High-risk indigenous American children (age 5 to <20 years) with glycemic measures in childhood, 1965–2007
- Exposure
- Childhood HbA1c and 2-h plasma glucose (PG) as predictors of future microvascular complications
- Outcome
- Future albuminuria (ACR ≥30 mg/g), severe albuminuria (ACR ≥300 mg/g) and retinopathy
Main finding
As reported in the abstract
Severe albuminuria by baseline glycemic measures
HbA1c, HR per %
1.45
95% CI 1.02–2.05
2-h PG, HR per mmol/L
1.21
95% CI 1.16–1.27
Observational data: associations, not effects.
Further findings
| Outcome | Normal HbA1c | Prediabetes |
|---|---|---|
| Incidence of albuminuria by baseline HbA1c category | 23.8 cases per 1,000 PY | 29.7 cases per 1,000 PY |
| Incidence of severe albuminuria by baseline HbA1c category | 2.4 cases per 1,000 PY | 3.8 cases per 1,000 PY |
| Incidence of retinopathy by baseline HbA1c category | 1.7 cases per 1,000 PY | 7.1 cases per 1,000 PY |
Incidence of albuminuria by baseline HbA1c category
- Children with diabetes at baseline had the highest incidence
Incidence of severe albuminuria by baseline HbA1c category
- Children with diabetes at baseline had the highest incidence
Incidence of retinopathy by baseline HbA1c category
- Children with diabetes at baseline had the highest incidence
AUCs of HbA1c, 2-h PG and fasting PG models
- No significant differences between AUCs when predicting albuminuria, severe albuminuria or retinopathy
Original publication
Glycemic Measures in Childhood as Predictors of Future Diabetes-Related Microvascular Complications in an Indigenous American Population. Diabetes Care. Published 11 July 2023. doi:10.
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