Observational studyDiabetes care2021
Increased Hemoglobin A
Observational study in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed.
- Association of serum potassium time in target range with cardiovascular outcomes in patients with HFpEF.Open heart · 2025Trial
- Haemoglobin A1c Time-In-Range and Mortality in Adults With Diabetes.Endocrinology, diabetes & metabolism · 2026Article
- Baseline Human Metabolic Profiling and Risk of Death from COVID-19: Conceptualization of Multivariate Prediction Model Development via Retrospective Database Analysis in the United States Department of Veterans Affairs.Journal of clinical medicine · 2026Article
- Association of liver elastography measurements with poor glycaemic control in elderly patients with type 2 diabetes.Archives of endocrinology and metabolism · 2025Observational
- Hemoglobin A1c time-in-range, mortality, and diabetes complications in older adults with diabetes.BMJ open diabetes research & care · 2025Observational
- The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study.Lipids in health and disease · 2025Article
- Effects of the leisure-time physical activity environment on odds of glycemic control among a nationwide cohort of United States veterans with a new type-2 diabetes diagnosis.Preventive medicine · 2025Article
- Body mass index trajectories and time in target range after delivery and long-term type 2 diabetes risk in women with a history of gestational diabetes mellitus.Diabetes, obesity & metabolism · 2025Article
- Glycated Hemoglobin A1c Time in Range and Dementia in Older Adults With Diabetes.JAMA network open · 2024Article
- Association of Body Weight Time in Target Range With the Risk of Kidney Outcomes in Patients With Overweight/Obesity and Type 2 Diabetes Mellitus.Diabetes care · 2024Article
- Relationship Between Glycosylated Hemoglobin Variability and the Severity of Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus.Journal of diabetes research · 2024Article
- Clinical and Financial Outcomes of a Pilot Pharmacist-Led Continuous Glucose Monitoring Clinic.Innovations in pharmacy · 2024Article
- Diabetes Mellitus in the Elderly Adults in Korea: Based on Data from the Korea National Health and Nutrition Examination Survey 2019 to 2020.Diabetes & metabolism journal · 2023Article
- Association of hemoglobin A1c stability with mortality and diabetes complications in older adults with diabetes.BMJ open diabetes research & care · 2023Observational
- Glucagon-Like Peptide 1 Receptor Agonists Have the Potential to Revolutionize the Attainment of Target A1C Levels in Type 2 Diabetes-So Why Is Their Uptake So Low?Clinical diabetes : a publication of the American Diabetes Association · 2023Article
- Association of hemoglobin A1c time in range with risk for diabetes complications.BMJ open diabetes research & care · 2022Observational
- Cardiovascular effects of intensive lifestyle intervention in adults with overweight/obesity and type 2 diabetes according to body weight time in range.EClinicalMedicine · 2022Article
- The Association Between Sustained HbA1c Control and Long-Term Complications Among Individuals with Type 2 Diabetes: A Retrospective Study.Advances in therapy · 2022Article
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
Abstract
objectiveShort- and long-term glycemic variability are risk factors for diabetes complications. However, there are no validated A1C target ranges or measures of A1C stability in older adults. We evaluated the association of a patient-specific A1C variability measure, A1C time in range (A1C TIR), on major adverse outcomes. RESEARCH DESIGN AND
methodsWe conducted a retrospective observational study using administrative data from the Department of Veterans Affairs and Medicare from 2004 to 2016. Patients were ≥65 years old, had diabetes, and had at least four A1C tests during a 3-year baseline period. A1C TIR was the percentage of days during the baseline in which A1C was in an individualized target range (6.0-7.0% up to 8.0-9.0%) on the basis of clinical characteristics and predicted life expectancy. Increasing A1C TIR was divided into categories of 20% increments and linked to mortality and cardiovascular disease (CVD) (i.e., myocardial infarction, stroke).
resultsThe study included 402,043 veterans (mean [SD] age 76.9 [5.7] years, 98.8% male). During an average of 5.5 years of follow-up, A1C TIR had a graded relationship with mortality and CVD. Cox proportional hazards models showed that lower A1C TIR was associated with increased mortality (A1C TIR 0 to <20%: hazard ratio [HR] 1.22 [95% CI 1.20-1.25]) and CVD (A1C TIR 0 to <20%: HR 1.14 [95% CI 1.11-1.19]) compared with A1C TIR 80-100%. Competing risk models and shorter follow-up (e.g., 24 months) showed similar results.
conclusionsIn older adults with diabetes, maintaining A1C levels within individualized target ranges is associated with lower risk of mortality and CVD.
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