Glycemic control and the risk of multiple microvascular diabetic complications. Fam Med 2005 Feb;37(2):125-30
Date
02/04/2005Pubmed ID
15690253Scopus ID
2-s2.0-13444252514 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
BACKGROUND AND OBJECTIVES: Tight glycemic control in type 2 diabetes reduces risk of certain end-organ complications. However, among patients with one complication already, it is unknown whether tight glycemic control reduces the risk of subsequent complications in another organ. We sought to determine if glycemic control is associated with the risk of a second, distinct, end-organ diabetic complication.
METHODS: Subjects were a retrospective cohort of 250 patients with type 2 diabetes, at least one microvascular diabetic complication, and at least one hemoglobin A1c (HbA1c) measurement after that complication. Proportional hazard models estimated the relative hazard of developing another diabetic complication in a second organ system, as predicted by either (1) mean HbA1c level over the study period or (2) first HbA1c after the initial complication.
RESULTS: Thirty-eight patients had a second complication; the average follow-up duration was 3.7 years. The mean HbA1c model showed an adjusted relative hazard of 1.25 (95% confidence interval [CI]=1.04, 1.51) per percentage-point elevation in mean HbA1c. The first HbA1c model showed an adjusted relative hazard of 1.23 (95% CI=1.08, 1.40) per percentage-point elevation in first HbA1c.
CONCLUSIONS: Among these type 2 diabetes patients with an initial complication, tight glycemic control was associated with reduced risk of additional complications in other organs.
Author List
Schellhase KG, Koepsell TD, Weiss NSAuthor
Kenneth G. Schellhase MD, MPH Adjunct Professor in the Family Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Algorithms
Diabetes Mellitus, Type 2
Diabetic Angiopathies
Diabetic Foot
Diabetic Neuropathies
Diabetic Retinopathy
Epidemiologic Methods
Female
Humans
Hyperglycemia
Kidney Failure, Chronic
Male
Middle Aged