Mean blood glucose compared with HbA1c in the prediction of cardiovascular disease in patients with type 1 diabetes

Kilpatrick, E. S.; Rigby, A. S.; Atkin, S. L.

Abstract

Aims/hypothesisIt is not known whether mean blood glucose (MBG) predicts the risk of macrovascular complications in diabetes any differently from HbA1c. In this study we therefore analysed data from the Diabetes Control and Complications Trial (DCCT) to assess the relationship between MBG, HbA1c and glucose variability with regard to the risk of cardiovascular disease in patients with type 1 diabetes. MethodsPre- and postprandial seven-point glucose profiles were collected quarterly during the DCCT in 1441 individuals. The relationship between time to first cardiovascular event and MBG, HbA1c and daily SD of blood glucose was assessed by Cox regression after adjusting for the known risk factors of macrovascular disease and the treatment groups of the patients. ResultsCox regression showed MBG to be predictive of a cardiovascular event (p = 0.019), but not HbA1c (p = 0.858). A rise of 1mmol/l in MBG was associated with an 11% rise in cardiovascular risk. MBG remained highly predictive (p = 0.015) even after adjustment for HbA1c values and glucose variability. Conclusions/interpretationThis study has shown that during the DCCT MBG was a better predictor of the macrovascular complications of type 1 diabetes than HbA1c. It indicates that the cardiovascular risk associated with hyperglycaemia appeared within the time period of the study and that blood glucose rather than HbA1c may be the preferred means of assessing this risk.

Citation

Kilpatrick, E. S., Rigby, A. S., & Atkin, S. L. (2008). Mean blood glucose compared with HbA1c in the prediction of cardiovascular disease in patients with type 1 diabetes. Diabetologia, 51(2), 365-371. https://doi.org/10.1007/s00125-007-0883-x

• Journal Article Type: Article
• Acceptance Date: Oct 22, 2007
• Online Publication Date: Nov 27, 2007
• Publication Date: Feb 1, 2008
• Deposit Date: Nov 13, 2014
• Journal: Diabetologia
• Print ISSN: 0012-186X
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 2
• Pages: 365-371
• DOI: https://doi.org/10.1007/s00125-007-0883-x
• Keywords: Internal Medicine; Endocrinology, Diabetes and Metabolism
• Public URL: https://hull-repository.worktribe.com/output/463297
• Publisher URL: https://link.springer.com/article/10.1007%2Fs00125-007-0883-x
• Contract Date: Nov 13, 2014