Longitudinal HbA1c patterns before the first treatment of diabetes in routine clinical practice: A latent class trajectory analysis
Authors' conclusion
We identified four distinct longitudinal HbA1c patterns before initiation of diabetes treatment in clinical practice. All had mean HbA1c levels exceeding the diagnostic threshold many months before treatment initiation, indicating therapeutic inertia.
Study context
- Population
- Individuals initiating diabetes treatment (first glucose-lowering drug prescription) during 2017–2018, irrespective of type of diabetes20,733 (96 %) had HbA1c measured
- Participants
- 21,556 individuals
- Outcome
- Longitudinal HbA1c patterns before first glucose-lowering drug prescription
- Follow-up
- 5 years preceding treatment initiation
Methodological detailsroutine laboratory and healthcare databases
- Routine laboratory and healthcare databases
Main finding
As reported in the abstract
HbA1c trajectories before treatment initiation
- Distinct HbA1c trajectory classes identified, with varying steepness of increase in HbA1c
- 4
- Largest class, share of individuals
- 74 %
- Largest class: mean HbA1c above 48 mmol/mol threshold before treatment initiation
- 9 months
- Largest class: mean HbA1c at treatment initiation
- 52 mmol/mol (95 % CI 52-52)
- Remaining three classes: mean HbA1c exceeded 48 mmol/mol before treatment initiation
- almost 1.5 years
- Remaining three classes: mean HbA1c reached before treatment initiation
- 79 mmol/mol (95 % CI 78-80), 105 mmol/mol (95 % CI 104-106), and 137 mmol/mol (95 % CI 135-140)
Observational data: associations, not effects.
Further findings
HbA1c measurements per individual · 5 years preceding treatment initiation
- Number of HbA1c measurements
- median 4 [IQR 2-7]
Original publication
Longitudinal HbA1c patterns before the first treatment of diabetes in routine clinical practice: A latent class trajectory analysis. Diabetes Res Clin Pract. Published 28 May 2024. doi:10.
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