Visit‐to‐visit HbA1c variability, risk of all‐cause mortality and diabetes‐related vascular complications among adult individuals with type 2 diabetes mellitus
Authors' conclusion
Higher HbA1c variability was associated with significantly increased risk of mortality and nephropathy, but not significantly associated with the risk of AMI, stroke, neuropathy, or LEA.
Study context
- Population
- Adults with T2D managed at specialist outpatient clinics, 2009–2017; mean age 63.8 ± 13.1 years, 55.1% male
- Participants
- 18,293 adults
- Exposure
- Highest vs lowest quartile of visit-to-visit HbA1c variability
- Outcome
- All-cause mortality
Methodological detailsspecialist outpatient clinics, Cox proportional hazards and weighted Cox models
- Specialist outpatient clinics
- Cox proportional hazards and weighted Cox models
Main finding
As reported in the abstract
Each group vs lowest quartileEstimate (95% CI)
Highest quartile
HR (COV) 2.03(1.43–2.88)
Highest quartile
HR (VIM) 2.70(1.61–4.53)
Highest quartile
HR (HVS) 2.32(1.49–3.62)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| NephropathyHighest quartilevs Lowest quartile | HR (COV) 1.34 (95% CI 1.14–1.56) | |
| NephropathyHighest quartilevs Lowest quartile | HR (VIM) 1.31 (95% CI 1.14–1.52) | |
| NephropathyHighest quartilevs Lowest quartile | HR (HVS) 1.20 (95% CI 1.04–1.39) | |
| AMI, stroke, neuropathy, LEAHighest quartilevs Lowest quartile | HR (AMI) 0.88 (95% CI 0.51–1.52) | |
| AMI, stroke, neuropathy, LEAHighest quartilevs Lowest quartile | HR (stroke) 1.19 (95% CI 0.92–1.56) | |
| AMI, stroke, neuropathy, LEAHighest quartilevs Lowest quartile | HR (neuropathy) 1.01 (95% CI 0.80–1.28) | |
| AMI, stroke, neuropathy, LEAHighest quartilevs Lowest quartile | HR (LEA) 1.00 (95% CI 0.65–1.55) | |
| 0.512Ratio (log scale) |
Nephropathy
- Statistically significant tests for linear trend
Acute myocardial infarction (AMI), stroke, neuropathy, lower extremity amputation (LEA)
- No significant associations with HbA1c variability
Original publication
Visit‐to‐visit HbA1c variability, risk of all‐cause mortality and diabetes‐related vascular complications among adult individuals with type 2 diabetes mellitus. Diabetes Obes Metab. Published 26 February 2026. doi:10.
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