Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis
Abstract. Background:. Current practice uses the latest measure of glycated hemoglobin (HbAlc) to facilitate clinical decision-making. Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes. However, the role of HbAlc variability is unclear in clinical...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-10-01
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| Series: | Chinese Medical Journal |
| Online Access: | http://journals.lww.com/10.1097/CM9.0000000000002073 |
| _version_ | 1797978578308038656 |
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| author | Furong Qu Qingyang Shi Yang Wang Yanjiao Shen Kaixin Zhou Ewan R. Pearson Sheyu Li Lishao Guo |
| author_facet | Furong Qu Qingyang Shi Yang Wang Yanjiao Shen Kaixin Zhou Ewan R. Pearson Sheyu Li Lishao Guo |
| author_sort | Furong Qu |
| collection | DOAJ |
| description | Abstract. Background:. Current practice uses the latest measure of glycated hemoglobin (HbAlc) to facilitate clinical decision-making. Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes. However, the role of HbAlc variability is unclear in clinical practice. This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro- and macro-vascular complications and death in people with type 2 diabetes.
Methods:. We searched PubMed, EMBASE (via OVID), and Cochrane Central Register (CENTRAL, via OVID) for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation (SD), coefficient of variation (CV), and HbAlc variability score (HVS).
Results:. In people with type 2 diabetes, the highest quantile of all three HbAlc variability metrics (HbAlc-standard deviation [HbAlc-SD], HbAlc-coefficient of variance [HbAlc-CV], and HVS) is associated with increased risks of all-cause mortality, cardiovascular events, progression to chronic kidney disease, amputation, and peripheral neuropathy. For example, the hazard ratio of HbAlc-SD on all-cause mortality was l.89 with 95% confidence interval (95% CI) l.46–2.45 (HbAlc-CV l.47, 95% CI l.26–l.72; HVS l.67, 95% CI l.34–2.09).
Conclusions:. High HbAlc variability leads to micro- and macro-vascular complications of type 2 diabetes and related death. People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes. |
| first_indexed | 2024-04-11T05:25:11Z |
| format | Article |
| id | doaj.art-b07c8fa2f7dc46f38d9a72c18371d5a6 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 2542-5641 |
| language | English |
| last_indexed | 2024-04-11T05:25:11Z |
| publishDate | 2022-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-b07c8fa2f7dc46f38d9a72c18371d5a62022-12-23T07:55:22ZengWolters KluwerChinese Medical Journal0366-69992542-56412022-10-01135192294230010.1097/CM9.0000000000002073202210050-00004Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysisFurong QuQingyang ShiYang WangYanjiao ShenKaixin ZhouEwan R. PearsonSheyu LiLishao GuoAbstract. Background:. Current practice uses the latest measure of glycated hemoglobin (HbAlc) to facilitate clinical decision-making. Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes. However, the role of HbAlc variability is unclear in clinical practice. This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro- and macro-vascular complications and death in people with type 2 diabetes. Methods:. We searched PubMed, EMBASE (via OVID), and Cochrane Central Register (CENTRAL, via OVID) for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation (SD), coefficient of variation (CV), and HbAlc variability score (HVS). Results:. In people with type 2 diabetes, the highest quantile of all three HbAlc variability metrics (HbAlc-standard deviation [HbAlc-SD], HbAlc-coefficient of variance [HbAlc-CV], and HVS) is associated with increased risks of all-cause mortality, cardiovascular events, progression to chronic kidney disease, amputation, and peripheral neuropathy. For example, the hazard ratio of HbAlc-SD on all-cause mortality was l.89 with 95% confidence interval (95% CI) l.46–2.45 (HbAlc-CV l.47, 95% CI l.26–l.72; HVS l.67, 95% CI l.34–2.09). Conclusions:. High HbAlc variability leads to micro- and macro-vascular complications of type 2 diabetes and related death. People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes.http://journals.lww.com/10.1097/CM9.0000000000002073 |
| spellingShingle | Furong Qu Qingyang Shi Yang Wang Yanjiao Shen Kaixin Zhou Ewan R. Pearson Sheyu Li Lishao Guo Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis Chinese Medical Journal |
| title | Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_full | Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_fullStr | Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_full_unstemmed | Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_short | Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_sort | visit to visit glycated hemoglobin a1c variability in adults with type 2 diabetes a systematic review and meta analysis |
| url | http://journals.lww.com/10.1097/CM9.0000000000002073 |
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