Related Experiment Video
Updated: May 19, 2026
07:22
Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
Published on: March 7, 2025
HbA1c variability is associated with microalbuminuria development in type 2 diabetes: a 7-year prospective cohort
C C Hsu1, H Y Chang, M C Huang
1Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Diabetologia
|August 28, 2012
Summary
Glycemic variability, measured by HbA1c standard deviation, is a significant risk factor for developing microalbuminuria in type 2 diabetes patients. This risk can be assessed using HbA1c measurements taken over two years.
Area of Science:
- Endocrinology
- Nephrology
- Diabetology
Background:
- Glycemic variability, specifically HbA1c variability, is an established risk factor for nephropathy in type 1 diabetes.
- Microalbuminuria is an early indicator of diabetic kidney disease.
Purpose of the Study:
- To investigate the association between HbA1c variability and the development of microalbuminuria in type 2 diabetes patients.
- To assess the utility of 2-year HbA1c measurements for predicting microalbuminuria risk.
Main Methods:
- A cohort of 821 middle-aged, normoalbuminuric type 2 diabetes patients were followed from 2003-2010 (average 6.2 years).
- Microalbuminuria defined as urine albumin-to-creatinine ratio ≥30 mg/g.
- HbA1c variability calculated using the standard deviation (SD) of serially measured HbA1c.
- Cox proportional hazards models analyzed the association between HbA1c SD quartiles and microalbuminuria incidence.
Main Results:
- Higher HbA1c variability (Q4 vs Q1) was associated with a 37% increased likelihood of developing microalbuminuria.
- Incidence of microalbuminuria increased with higher HbA1c SD quartiles (p=0.042).
- Risk prediction using 2-year HbA1c measurements was comparable to longer follow-up periods.
Conclusions:
- HbA1c variability is an independent predictor of microalbuminuria in type 2 diabetes.
- Early assessment of HbA1c variability (within 2 years) can identify patients at higher risk.
- This finding adds to the importance of glycemic control beyond mean HbA1c levels.
Related Concept Videos
01:28Diabetic Nephropathy
Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:26Type I Diabetes II: Pathophysiology
Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:24Type II Diabetes II: Pathophysiology
PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...