ArticleDiabetes, obesity & metabolism2021
Association between visit-to-visit HbA1c variability and the risk of cardiovascular disease in patients with type 2 diabetes.
Article in Diabetes, obesity & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Glycemic variability of glycated hemoglobin in patients with type 2 diabetes mellitus and the risk of cardiovascular diseases: a latest systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Long-term HbA1c variability and macro-/micro-vascular complications in type 2 diabetes mellitus: a meta-analysis update.Acta diabetologica · 2023Pooled 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
- 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
- Joint effect of hepatic steatosis index and triglyceride glucose index on cardio-renal outcomes: a real-world study.Journal of diabetes and metabolic disorders · 2026Article
- Interplay of glycated hemoglobin and traditional risk factors for the risk of atherosclerotic cardiovascular disease and all-cause mortality in people without diabetes.Cardiovascular diabetology · 2025Observational
- Glycemic Control and Prostate Cancer Mortality Risk in Veterans with Type 2 Diabetes Mellitus.Cancer research communications · 2025Article
- Variability in HbA1c and the risk of major clinical outcomes in type 2 diabetes with chronic kidney disease: Post hoc analysis from the CREDENCE trial.Diabetes, obesity & metabolism · 2025Article
- Atrial APD prolongation caused by the upregulation of RAGE and subsequentActa biochimica et biophysica Sinica · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Modeling recurrent heart failure risk in type 2 diabetes: impact of flexible HbA1c trajectories using nonhomogeneous Poisson processes.Frontiers in endocrinology · 2025Article
- Article
- A retrospective analysis of the prognostic implications of glycemic variability on all-cause mortality in critically ill patients with mitral valve disease.Frontiers in endocrinology · 2025Article
- Prediction model for cardiovascular disease in patients with diabetes using machine learning derived and validated in two independent Korean cohorts.Scientific reports · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Development and validation of a blood biomarker score for predicting mortality risk in the general population.Journal of translational medicine · 2023Article
- Intensified glycemic control by HbA1c for patients with coronary heart disease and Type 2 diabetes: a review of findings and conclusions.Cardiovascular diabetology · 2023Review
- Association between initial in-hospital heart rate and glycemic control in patients with acute ischemic stroke and diabetes mellitus.BMC endocrine disorders · 2023Article
- Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association.Circulation · 2023Review
- Glycemic control is not related to cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes.Acta diabetologica · 2022Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
aimTo investigate the association between visit-to-visit HbA1c variability and the risk of cardiovascular disease in patients with type 2 diabetes. MATERIALS AND
methodsWe performed a retrospective cohort study of 29 260 patients with at least four HbA1c measurements obtained within 2 years of their first diagnosis of type 2 diabetes. Different HbA1c variability markers were calculated, including the standard deviation (SD), coefficient of variation (CV) and adjusted SD. Cox proportional hazards regression models were used to estimate the association of these HbA1c variability markers with incident cardiovascular disease.
resultsDuring a mean follow-up of 4.18 years, a total of 3746 incident cardiovascular disease cases were diagnosed. Multivariate-adjusted hazard ratios for cardiovascular disease across the first, second, third and fourth quartiles of HbA1c SD values were 1.00, 1.30 (95% confidence interval [CI] 1.18-1.42), 1.40 (95% CI 1.26-1.55) and 1.59 (95% CI 1.41-1.77) (P for trend <.001), respectively. When we utilized HbA1c CV and adjusted HbA1c SD values as exposures, similar positive associations were observed. HbA1c variability was also associated with the risk of first and recurrent severe hypoglycaemic events. A mediating effect of severe hypoglycaemia was observed between HbA1c variability and incident cardiovascular disease.
conclusionsLarge visit-to-visit HbA1c variability is associated with an increased risk of cardiovascular disease in patients with type 2 diabetes. Severe hypoglycaemia may mediate the association between HbA1c variability and incident cardiovascular disease.
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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.