Impact of early and tight haemoglobin A1c (HbA1c) control on the risk of long‐term complications and cardiovascular death in patients with type 2 diabetes from the Swedish National Diabetes Register
Authors' conclusion
Elevated 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.
Study context
- Population
- Patients with T2D in the Swedish National Diabetes Registry, 1998–2019; 57.2% male, median age 60 years
- Exposure
- Early tight HbA1c control vs no early tight control and early adverse control
- Outcome
- Microvascular/macrovascular complications and cardiovascular death
Methodological detailsregistry-based, Swedish National Diabetes Register linked to national registers
- Registry-based
- Swedish National Diabetes Register linked to national registers
Main finding
As reported in the abstract
Any microvascular complication, any macrovascular complication, cardiovascular death
Early tight control vs No early tight controlHazard ratio (95% CI)
Any microvascular complication
0.84(0.80–0.89)
Any macrovascular complication
0.86(0.79–0.93)
Cardiovascular death
0.60(0.46–0.79)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Any macrovascular complication by HbA1c range (reference 6.0 to <7.0%)HbA1c 8.0% to <9.0%vs HbA1c 6.0 to <7.0% | 1.16 (1.12–1.20) | |
| Any macrovascular complication by HbA1c range (reference 6.0 to <7.0%)HbA1c 7.0% to <8.0%vs HbA1c 6.0 to <7.0% | 1.08 (1.05–1.11) | |
| 0.512Hazard ratio (log scale) |
Incidence rates (IR) per 100-patient-years of any microvascular complication, overall population
- 2005
- 8.75
- 2014
- 10.95
- 2019
- 8.71
- Relatively stable
IR of cardiovascular death, overall population
- 2005
- 0.12
- 2018
- 0.46
Original publication
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. Diabetes Obes Metab. Published 27 February 2026. doi:10.
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