Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
Main finding · MALEsResult — go to the resultHazard ratio 1.25 95% CI 1.10–1.41Authors' conclusion
HbA1c variation was independently associated with a long-term risk of MALEs and lower limb amputations in patients with type 2 diabetes.
Study context
- Population
- Patients with first diagnosis of T2D, no lower extremity arterial disease, ≥1 hemoglobin A1c (HbA1c) measurement in each of the 4 following years, referral center, multicenter database
- Participants
- 56,872 patients
- Exposure
- Highest vs lower quartiles of visit-to-visit HbA1c variation
- Outcome
- Incidence of MALE: composite of revascularization, foot ulcers and lower limb amputations
- Follow-up
- From fifth year after diagnosis; mean 6.1 years
Methodological detailsretrospective database study, multicenter database, adjusted for mean HbA1c and baseline characteristics, Mean 12.6 HbA1c measurements; mean follow-up 6.1 years
- Retrospective database study
- Multicenter database
- Adjusted for mean HbA1c and baseline characteristics
- Mean 12.6 HbA1c measurements; mean follow-up 6.1 years
Main finding
MALEs
Hazard ratio
1.25
95% CI 1.10–1.41
Highestvs lower quartiles of visit-to-visit HbA1c variation
HR 1.25 (95% CI 1.10–1.41)
As reported in the abstract
- Cumulative incidence of major adverse limb events (MALEs)
- 9.25 per 1000 person-years
Observational data: associations, not effects.
Further findings
Lower limb amputation
| HR (95% CI) | ||
|---|---|---|
| Highest quartileReference quartile not stated · multivariate adjustment | 3.05 (1.97–4.74) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes. J Clin Endocrinol Metab. Published 6 April 2023. doi:10.
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