Abstract | AIMS/INTRODUCTION: Long-term glycemic variability is important for predicting diabetic complications, but evaluation in a Japanese population is lacking. The aim of this study was to explore the relationship between visit-to-visit glycemic variability (VVV) and cardiovascular diseases (CV) in Japanese patients with type 2 diabetes, using the prospective cohort of the EMPATHY trial. MATERIALS AND METHODS: Among 4532 participants with at least three HbA1c measurements, VVV was defined using the coefficient of variation (CV-HbA1c). The outcomes were the composite cardiovascular endpoints, including cardiac, cerebral, renal, and vascular events. The odds ratios ( ORs) for the development of outcomes were estimated by using logistic regression models. RESULTS: During a median follow-up of 38 months, 190 subjects developed CV events. The risk of developing CV events increased significantly with increasing quintile of CV-HbA1c, after multivariable adjustment including the mean-HbA1c (OR for the fifth vs first quintile, 1.73; 95%CI, 1.03-2.91; P for trend test = 0.003). There was a stronger association between CV-HbA1c and CV events in patients with a mean-HbA1c of <7% compared with those with a mean-HbA1c of ≥7% (OR per 1 standard deviation, 1.51; 95%CI, 1.23-1.85 and 1.13; 95%CI, 0.98-1.29, respectively; P for interaction = 0.02). CONCLUSIONS: Increases of VVV were associated with the risk of CV events in Japanese patients with type 2 diabetes independent of the mean-HbA1c. The long-term variability of HbA1c as well as the mean HbA1c might be an important glycemic indicator in the management of patients with type 2 diabetes, especially in those with a mean-HbA1c of <7%.
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Authors | Midori Sato, Jun Inaishi, Yoshifumi Saisho, Yasunori Sato, Issei Komuro, Hiroshi Itoh |
Journal | Journal of diabetes investigation
(J Diabetes Investig)
Vol. 12
Issue 12
Pg. 2190-2196
(Dec 2021)
ISSN: 2040-1124 [Electronic] Japan |
PMID | 34013644
(Publication Type: Journal Article)
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Copyright | © 2021 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd. |
Chemical References |
- Blood Glucose
- Glycated Hemoglobin A
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Topics |
- Aged
- Ambulatory Care
(statistics & numerical data)
- Analysis of Variance
- Blood Glucose
(analysis)
- Cardiovascular Diseases
(epidemiology, etiology)
- Diabetes Mellitus, Type 2
(blood, complications)
- Diabetic Cardiomyopathies
(epidemiology, etiology)
- Female
- Glycated Hemoglobin
(analysis)
- Glycemic Control
(statistics & numerical data)
- Humans
- Japan
(epidemiology)
- Logistic Models
- Male
- Middle Aged
- Odds Ratio
- Prospective Studies
- Randomized Controlled Trials as Topic
- Risk Assessment
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