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The rise and fall of HbA(1c) as a risk marker for diabetes complications

E S Kilpatrick1

  • 1Department of Clinical Biochemistry, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK. Eric.Kilpatrick@hey.nhs.uk.

Diabetologia
|June 20, 2012
PubMed

Insights

Glycemic variability, specifically HbA1c fluctuations, predicts microvascular complications in type 2 diabetes. Reducing these glucose swings may prevent vascular disease without increasing hypoglycemia risk.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Research

Background:

  • Short-term glycemic variability's role in diabetes complications remains unclear.
  • Longer-term fluctuations in glucose, indicated by HbA1c variability, are increasingly linked to microvascular disease risk.
  • Previous studies primarily focused on type 1 diabetes.

Purpose of the Study:

  • To investigate if HbA1c variability predicts nephropathy risk in type 2 diabetic patients.
  • To explore the potential of managing HbA1c fluctuations for vascular disease prevention.

Main Methods:

  • Analysis of data from the Tsukuba Kawai Diabetes Registry in Japan.
  • Examining the association between HbA1c variability and the risk of nephropathy.

Main Results:

  • HbA1c variability was found to predict the risk of nephropathy in type 2 diabetic patients.
  • This finding extends previous observations from type 1 diabetes.

Conclusions:

  • HbA1c variability is a significant predictor of microvascular complications, specifically nephropathy, in type 2 diabetes.
  • Strategies aimed at reducing HbA1c fluctuations may offer a way to mitigate hyperglycaemia-related vascular disease.
  • This approach may reduce the risk of hypoglycemia compared to solely focusing on lowering mean HbA1c.

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