Evidence map›Paper›PMID 35073913›Full record

ArticleCardiovascular diabetology2022

HbA1c variability predicts cardiovascular complications in type 2 diabetes regardless of being at glycemic target.

Antonio Ceriello, Giuseppe Lucisano, Francesco Prattichizzo, Rosalba La Grotta, Stefan Franzén, Ann-Marie Svensson, Björn Eliasson, Antonio Nicolucci

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 7 pooled it
9.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 7 syntheses or guidelines pooled it, 72 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Antonio CerielloIRCCS MultiMedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy. antonio.ceriello@hotmail.it.
Giuseppe LucisanoCORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
Francesco PrattichizzoIRCCS MultiMedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy. francesco.prattichizzo@multimedica.it.
Rosalba La GrottaIRCCS MultiMedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy.
Stefan FranzénHealth Metrics, Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Ann-Marie SvenssonCenter for Registries, Västra, Götaland, Sweden.
Björn EliassonInstitute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Antonio NicolucciCORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
MultiMedica · ITCenter for Outcomes Research and Clinical Epidemiology · ITUniversity of Gothenburg · SECentre of Registers Vastra Gotaland · SE

Funding

Ministero della Salute Ricerca Corrente to IRCCS MultiMedica
6 · The paper itself

Abstract

backgroundHbA1c variability has emerged as risk factor for cardiovascular diseases in diabetes. However, the impact of HbA1c variability on cardiovascular diseases in subjects within the recommended HbA1c target has been relatively unexplored.

methodsUsing data from a large database, we studied 101,533 people with type 2 diabetes without cardiovascular diseases. HbA1c variability was expressed as quartiles of the standard deviation of HbA1c during three years (exposure phase). The primary composite outcome included non-fatal myocardial infarction, non-fatal stroke, all-cause mortality and was assessed during five years following the first three years of exposure to HbA1c variability (longitudinal phase). An expanded composite outcome including non-fatal myocardial infarction, non-fatal stroke, coronary revascularization/reperfusion procedures, peripheral revascularization procedures, and all-cause mortality was also considered, as well as a series of specific cardiovascular complications. Cox models were adjusted for a large range of risk factors and results were expressed as adjusted hazard ratios.

resultsAn association between HbA1c variability and all the outcomes considered was found. The correlation between HbA1c variability and cardiovascular complications development was confirmed in both the subgroups of subjects with a mean HbA1c ≤ 53 mmol/mol (recommended HbA1c target) or > 53 mmol/mol during the exposure phase. The risk related to HbA1c variability was higher in people with mean HbA1c ≤ 53 mmol/mol for the primary outcome (p for interaction 0.004), for the expanded secondary outcome (p for interaction 0.001) and for the stroke (p for interaction 0.001), even though HbA1c remained at the target during the follow-up.

conclusionsThese findings suggest that HbA1c variability may provide additional information for an optimized management of diabetes, particularly in people within the target of HbA1c.

Indexed as

Glycemic ControlAgedBiomarkersBlood GlucoseCardiovascular DiseasesDatabases, FactualDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMiddle AgedPredictive Value of TestsPrevalenceRegistriesBiomarkersBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsCardiovascular diseasesDiabetes complicationsHbA1c variabilityType 2 diabetes

Identifiers

PMID35073913
PMCPMC8788128
OpenAlexW4206980299

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.