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Diabetologia
Published in: Diabetologia 12/2012

01-12-2012 | Article

HbA1c variability is associated with microalbuminuria development in type 2 diabetes: a 7-year prospective cohort study

Authors: C. C. Hsu, H. Y. Chang, M. C. Huang, S. J. Hwang, Y. C. Yang, Y. S. Lee, S. J. Shin, T. Y. Tai

Published in: Diabetologia | Issue 12/2012

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Abstract

Aims/hypothesis

HbA1c variability has been shown to be an independent risk factor for nephropathy in patients with type 1 diabetes. In this study, we aimed to explore the association between HbA1c variability and microalbuminuria development in patients with type 2 diabetes. We also intended to test the applicability of serially measured HbA1c over 2 years for this risk assessment.

Methods

Between 2003 and 2005, we recruited 821 middle-aged normoalbuminuric individuals with type 2 diabetes and followed them through to the end of 2010. The average follow-up time was 6.2 years. We defined microalbuminuria as a urine albumin to creatinine ratio of 30 mg/g (3.4 mg/mmol) or higher. HbA1c variability was calculated by the SD of serially measured HbA1c. The Cox proportional hazards model was used to evaluate the association between HbA1c SD quartile and development of microalbuminuria.

Results

The incidence of microalbuminuria for the overall population was 58.4, 58.6, 60.8 and 91.9 per 1,000 person-years for Q1- to Q4-adjusted HbA1c SD, respectively (p for trend = 0.042). Compared with patients in Q1, those in Q4 were about 37% more likely to develop microalbuminuria. The HR derived from a series of 2 year HbA1c measurements was similar to that from data collection for longer than 4 years.

Conclusions/interpretation

In addition to mean HbA1c values, HbA1c variability, even measured as early as 2 years, is independently associated with the development of microalbuminuria in patients with type 2 diabetes.
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Metadata
Title
HbA1c variability is associated with microalbuminuria development in type 2 diabetes: a 7-year prospective cohort study
Authors
C. C. Hsu
H. Y. Chang
M. C. Huang
S. J. Hwang
Y. C. Yang
Y. S. Lee
S. J. Shin
T. Y. Tai
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 12/2012
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-012-2700-4

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