ArticleBMJ open diabetes research & care2021
Association between hemoglobin A1c variability and hypoglycemia-related hospitalizations in veterans with diabetes mellitus.
Article in BMJ open diabetes research & care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Association between variation in hemoglobin A1c levels and diabetes therapy-related quality of life in patients with diabetes.Journal of diabetes investigation · 2024Article
- Glycated Hemoglobin A1c Time in Range and Dementia in Older Adults With Diabetes.JAMA network open · 2024Article
- Prevalence and predictors of hypoglycemia in older outpatients with type 2 diabetes mellitus.PloS one · 2024Article
- Association between visit-to-visit fasting glycemic variability and depression: a retrospective cohort study in a representative Korean population without diabetes.Scientific reports · 2022Article
- Article
- Lost in Translation: A Disconnect Between the Science and Medicare Coverage Criteria for Continuous Subcutaneous Insulin Infusion.Diabetes technology & therapeutics · 2021Article
- Increased Hemoglobin ADiabetes care · 2021Observational
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
introductionTo study the impact of hemoglobin A1c (A1c) variability on the risk of hypoglycemia-related hospitalization (HRH) in veterans with diabetes mellitus. RESEARCH DESIGN AND
methods342 059 veterans with diabetes aged 65 years or older were identified for a retrospective cohort study. All participants had a 3-year baseline period from January 1, 2005 to December 31, 2016, during which they had at least four A1c tests. A1c variability measures included coefficient of variation (A1c CV), A1c SD, and adjusted A1c SD. HRH was identified during a 2-year follow-up period from Medicare and the Veterans Health Administration through validated algorithms of International Classification of Diseases (ICD)-9 and ICD-10 codes. Logistic regression modeling was used to evaluate the relationship between A1c variability and HRH risk while controlling for relevant clinical covariates.
results2871 patients had one or more HRH in the 2-year follow-up period. HRH risk increased with greater A1c variability, and this was consistent across A1c CV, A1c SD, and adjusted A1c SD. Average A1c levels were also independently associated with HRH, with levels <7.0% (53 mmol/mol) having lower risk and >9% (75 mmol/mol) with greater risk. The relationships between A1c variability remained significant after controlling for average A1c levels and prior HRH during the baseline period.
conclusionIncreasing A1c variability and elevated A1c levels are associated with a greater risk of HRH in older adults with diabetes. Clinicians should consider A1c variability when assessing patients for risk of severe hypoglycemia.
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