Observational studyBMJ open diabetes research & care2022
Association of hemoglobin A1c time in range with risk for diabetes complications.
Observational study in BMJ open diabetes research & care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Haemoglobin A1c Time-In-Range and Mortality in Adults With Diabetes.Endocrinology, diabetes & metabolism · 2026Article
- The combined impact of time in range and HOMA-IR on neonatal outcomes in gestational diabetes mellitus: A retrospective cohort study.Medicine · 2026Article
- Integrating Acceptance and Commitment Therapy with intervention mapping to enhance self-care in type 2 diabetes: a conceptual framework.Frontiers in psychology · 2026Review
- Hemoglobin A1c time-in-range, mortality, and diabetes complications in older adults with diabetes.BMJ open diabetes research & care · 2025Observational
- Examining the association between medication adherence trajectories and disease-specific clinical outcomes: An analysis focusing on the drug classes included in Part D quality bonus payments.Journal of managed care & specialty pharmacy · 2025Article
- Glycemic Control and Quality of Life Among People with Type 1 Diabetes: Relationships with Insulin Therapy and Carbohydrate Counting.Nutrients · 2025Article
- Prevalence of macro-vascular complications among type 2 diabetic adults aged 50 and over: results from Ardakan cohort study on aging (ACSA).Journal of diabetes and metabolic disorders · 2025Article
- The dialysis foot- the impact of presenting estimated glomerular filtration rate on clinical outcomes in patients hospitalized with diabetic foot infections.International wound journal · 2025Article
- Glycated Hemoglobin A1c Time in Range and Dementia in Older Adults With Diabetes.JAMA network open · 2024Article
- Proactive Identification of Patients with Diabetes at Risk of Uncontrolled Outcomes during a Diabetes Management Program: Conceptualization and Development Study Using Machine Learning.JMIR formative research · 2024Article
- Association of hemoglobin A1c stability with mortality and diabetes complications in older adults with diabetes.BMJ open diabetes research & care · 2023Observational
- Adapted Diabetes Complications Severity Index and Charlson Comorbidity Index in predicting all-cause and cause-specific mortality among patients with type 2 diabetes.BMJ open diabetes research & care · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
introductionWe assessed the association between hemoglobin A1c time in range (A1c TIR), based on unique patient-level A1c target ranges, with risks of developing microvascular and macrovascular complications in older adults with diabetes. RESEARCH DESIGN AND
methodsWe used a retrospective observational study design and identified patients with diabetes from the Department of Veterans Affairs (n=397 634). Patients were 65 years and older and enrolled in Medicare during the period 2004-2016. Patients were assigned to individualized A1c target ranges based on estimated life expectancy and the presence or absence of diabetes complications. We computed A1c TIR for patients with at least four A1c tests during a 3-year baseline period. The association between A1c TIR and time to incident microvascular and macrovascular complications was studied in models that included A1c mean and A1c SD.
resultsWe identified 74 016 patients to assess for incident microvascular complications and 89 625 patients to assess for macrovascular complications during an average follow-up of 5.5 years. Cox proportional hazards models showed lower A1c TIR was associated with higher risk of microvascular (A1c TIR 0% to <20%; HR=1.04; 95%) and macrovascular complications (A1c TIR 0% to <20%; HR=1.07; 95%). A1c mean was associated with increased risk of microvascular and macrovascular complications but A1c SD was not. The association of A1c TIR with incidence and progression of individual diabetes complications within the microvascular and macrovascular composites showed similar trends.
conclusionsMaintaining stability of A1c levels in unique target ranges was associated with lower likelihood of developing microvascular and macrovascular complications in older adults with diabetes.
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