ArticleDiabetes2009
A1C variability predicts incident cardiovascular events, microalbuminuria, and overt diabetic nephropathy in patients with type 1 diabetes.
Article in Diabetes, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 102 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Does Glycated Hemoglobin Variability in Type 2 Diabetes Differ Depending on the Diabetes Treatment Threshold Used in the Qatari Population: Implication on Diabetes Complication Risk?
Effect of Postprandial Hyperglycemia on Vasculature in Type 1 Diabetes and Healthy Adults
Who cites it
102 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Association between glycated hemoglobin variability and risk of diabetic kidney disease and diabetic retinopathy in diabetic patients: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Higher glucose fluctuation is associated with a higher risk of cardiovascular disease: Insights from pooled results among patients with diabetes.Journal of diabetes · 2023Pooled it
- HbA1C variability and the risk of renal status progression in Diabetes Mellitus: a meta-analysis.PloS one · 2014Pooled it
- Hemoglobin A1c Variability Metrics Predict Coronary Artery Calcium and Cardiovascular Events in Type 1 Diabetes: The CACTI Study.The Journal of clinical endocrinology and metabolism · 2023Trial
- Long-term glycemic variability and the risk of mortality in diabetic patients receiving peritoneal dialysis.PloS one · 2022Trial
- Disordered Eating Behaviors Are Not Increased by an Intervention to Improve Diet Quality but Are Associated With Poorer Glycemic Control Among Youth With Type 1 Diabetes.Diabetes care · 2018Trial
- Association of HbA1c and cardiovascular and renal disease in an adult Mediterranean population.BMC nephrology · 2013Trial
- Rapid improvement of glycemic control in type 2 diabetes using weekly intensive multifactorial interventions: structured glucose monitoring, patient education, and adjustment of therapy-a randomized controlled trial.Diabetes technology & therapeutics · 2011Trial
- Classification of glucose profile in Japanese patients with type 1 diabetes and its association with complications.The Journal of clinical endocrinology and metabolism · 2026Article
- HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program.Acta diabetologica · 2026Article
- Cardiovascular Disease and Dyslipidemia in Pediatric Type 1 Diabetes.Current atherosclerosis reports · 2026Review
- Cumulative exposures to glycaemia and lipids are associated with coronary artery disease in type 1 diabetes: a call for action.Cardiovascular diabetology · 2025Article
- Lessons learned from the FinnDiane Study: Epidemiology and metabolic risk factors for diabetic kidney disease in type 1 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2025Review
- Glucose control and variability assessed by continuous glucose monitoring in patients with type 1 diabetes and diabetic kidney disease.Biomedical reports · 2025Article
- The effect of HbA1C variability on the development and progression of diabetic nephropathy.Frontiers in clinical diabetes and healthcare · 2025Article
- The Association of HbADiabetes therapy : research, treatment and education of diabetes and related disorders · 2024Article
- Altered oxidant and antioxidant levels are associated with vascular stiffness and diabetic kidney disease in type 1 diabetes after exposure to acute and chronic hyperglycemia.Cardiovascular diabetology · 2024Article
- HbA1c Variability as an Independent Risk Factor for Microvascular Complications in Type 1 Diabetes.Journal of diabetes science and technology · 2024Article
- Serum Cytokines and Growth Factors in Subjects with Type 1 Diabetes: Associations with Time in Ranges and Glucose Variability.Biomedicines · 2023Article
- Long-term Visit-to-Visit Variability in Hemoglobin AAmerican journal of kidney diseases : the official journal of the National Kidney Foundation · 2023Observational
42 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveRecent data from the Diabetes Control and Complications Trial (DCCT) indicated that A1C variability is associated with the risk of diabetes microvascular complications. However, these results might have been influenced by the interventional study design. Therefore, we investigated the longitudinal associations between A1C variability and diabetes complications in patients with type 1 diabetes in the observational Finnish Diabetic Nephropathy (FinnDiane) Study. RESEARCH DESIGN AND
methodsA total of 2,107 patients in the FinnDiane Study had complete data on renal status and serial measurements of A1C from baseline to follow-up (median 5.7 years), and 1,845 patients had similar data on cardiovascular disease (CVD) events. Intrapersonal SD of serially measured A1C was considered a measure of variability.
resultsDuring follow-up, 10.2% progressed to a higher albuminuria level or to end-stage renal disease, whereas 8.6% had a CVD event. The SD of serial A1C was 1.01 versus 0.75 (P < 0.001) for renal status and 0.87 versus 0.79 (P = 0.023) for CVD in progressors versus nonprogressors, respectively. In a Cox regression model, SD of serial A1C was independently associated with progression of renal disease (hazard ratio 1.92 [95% CI 1.49-2.47]) and of a CVD event (1.98 [1.39-2.82]) even when adjusting for mean A1C and traditional risk factors. Interestingly for CVD, mean serial A1C itself was not predictive even though SD of A1C was.
conclusionsIn patients with type 1 diabetes, A1C variability was not only predictive of incident microalbuminuria and progression of renal disease but also of incident CVD events.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.