ArticleDiabetic medicine : a journal of the British Diabetic Association2013
Associations of HbA1c and educational level with risk of cardiovascular events in 32,871 drug-treated patients with Type 2 diabetes: a cohort study in primary care.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 37 citations in OpenAlex.
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- Intensified glycemic control by HbA1c for patients with coronary heart disease and Type 2 diabetes: a review of findings and conclusions.Cardiovascular diabetology · 2023Review
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- Factors associated with potential over- and undertreatment of hyperglycaemia and annual measurement of HbADiabetic medicine : a journal of the British Diabetic Association · 2021Article
- Haemoglobin A1c and hearing impairment: longitudinal analysis using a large occupational health check-up data of Japan.BMJ open · 2018Article
- Impact of differing glucose-lowering regimens on the pattern of association between glucose control and survival.Diabetes, obesity & metabolism · 2018Article
- Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes.Journal of diabetes research · 2018Article
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- Socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan.Environmental health and preventive medicine · 2016Article
- Body weight and risk of atrial fibrillation in 7,169 patients with newly diagnosed type 2 diabetes; an observational study.Cardiovascular diabetology · 2015Observational
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- Labor force participation and secondary education of gender inequality index (GII) associated with healthy life expectancy (HLE) at birth.International journal for equity in health · 2014Article
- Self-rated literacy level does not explain educational differences in health and disease.Archives of public health = Archives belges de sante publique · 2014Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo explore the association of HbA1c and educational level with risk of cardiovascular events and mortality in patients with Type 2 diabetes.
methodsA cohort of 32 871 patients with Type 2 diabetes aged 35 years and older identified by extracting data from electronic patient records for all patients who had a diagnosis of Type 2 diabetes and had glucose-lowering agents prescribed between 1999 and 2009 at 84 primary care centres in Sweden. Associations of mean HbA1c levels and educational level with risks of cardiovascular events and all-cause mortality were analysed.
resultsThe associations of HbA1c with risk of all-cause and cardiovascular mortality were J-shaped, with the lowest risk observed for cardiovascular mortality at an HbA1c level of 51 mmol/mol (6.8%) for subjects on oral agents and 56 mmol/mol (7.3%) in insulin-treated patients. The lowest risk observed for all-cause mortality was at an HbA1c level of 51 mmol/mol (6.8%) for subjects on oral agents and 56 mmol/mol (7.3%) in insulin-treated patients. There was an increased risk for cardiovascular death [hazard ratio 1.6 (1.2-2.1), P = 0.0008] at the lowest HbA1c decile for subjects in the low education category. For subjects with higher education there was no evident J curve for cardiovascular death [hazard ratio 1.2 (0.8-1.6), P = 0.3873].
conclusionsOur results lend support to the recent American Diabetes Association/ European Association for the Study of Diabetes position statement that emphasizes the importance of additional factors, including the propensity for hypoglycaemia, which should influence HbA1c targets and treatment choices for individual patients. (Clinical Trials Registry No; NCT 01121315).
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