The association between sustained HbA1c control and long-term complications among individuals with type 2 diabetes: a retrospective study
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INTRODUCTION: The prevalence of type 2 diabetes (T2D) represents a rising burden in the US and worldwide, with the condition shown to be associated with relatively large human and economic costs. Part of the reason for such high costs associated with T2D is that the condition is often accompanied by additional health-related complications. The goal of this research is to examine the association between glycemic control and diabetes-related complications for individuals with T2D. METHODS: The Optum Clinformatics® Data Mart (CDM) database from 2007 to 2020 was used to identify adults with T2D. Individuals were classified as having sustained glycemic control (all hemoglobin A1c [HbA1c] < 7%) or poor glycemic control (all HbA1c ≥ 7%) over the 5-year post-period, and diabetes-related complications were identified based upon the Diabetes Complications Severity Index. Multivariable analyses examined the association between sustained glycemic control and diagnosis of a diabetes-related complication in the post-period. RESULTS: Maintaining HbA1c < 7% over the 5-year post-period, compared to maintaining HbA1c ≥ 7%, was associated with reduced odds of the diabetes-related complications of cardiovascular disease (odds ratio [OR] = 0.76, 95% confidence interval [CI] 0.61-0.94), metabolic disease (OR = 0.37, 95% CI 0.22-0.600), neuropathy (OR = 0.62, 95% CI 0.45-0.84), nephropathy (OR = 0.81, 95% CI 0.69-0.94), and peripheral vascular disease (OR = 0.52, 95% CI 0.33-0.83). There was no statistically significant association between sustained glycemic control and cerebrovascular disease. CONCLUSIONS: Sustained glycemic control was found to be associated with significant reductions in the odds of being diagnosed with diabetes-related complications over a 5-year post-period.
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HbA1c levels below the <7% threshold could reduce risk of ischemic stroke, coronary heart disease, and cardiovascular disease for patients with diabetes, metabolic disease, neuropathy, nephropathy, and peripheral vascular disease.
“HbA 1c levels below this threshold could reduce risk of ischemic stroke, coronary heart disease, and cardiovascular disease (30) for patients with diabetes, metabolic disease, neuropathy, nephropathy, and peripheral vascular disease (31).”
From Optimal Dose and Type of Physical Activity to Improve Glycemic Control in People Diagnosed With Type 2 Diabetes: A Systematic Review and Meta-analysis (2024) · cites this paper as [31]
The Results report that, among individuals with type 2 diabetes, sustained HbA1c <7% was associated with lower odds of subsequent cardiovascular disease, metabolic disease, neuropathy, nephropathy, and peripheral vascular disease diagnoses. The citing sentence instead describes these conditions as characteristics of patients for whom risk was reduced; the paper studied them as outcomes, not as patient subgroups. The ischemic-stroke and coronary-heart-disease clause is attached to citation (30), not this source. (LLM, conf=0.86)
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- Authors
- Boye, K. S., Thieu, V. T., Lage, M. J., Miller, H., & Paczkowski, R.
- Affiliations
- Eli Lilly (United States) (US)
- Pennsylvania State University (US)
- Corresponding author
- Lage, Maureen J.
- Venue
- Advances in Therapy
- Published
- 2022-03-22
- Volume
- 39
- Issue
- 5
- Pages
- 2208-2221
- ISSN
- 0741-238X (ISSN-L)
- 1865-8652
- PMC
- PMC9056490
- OpenAlex
- W4221077010
- Cited by
- 99
- References
- 40
- Citations by year
- 2026: 29 · 2025: 36 · 2024: 25 · 2023: 8
- FWCI
- 12.79
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Advances in Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, glycemic control, HbA1c, diabetes complications, cardiovascular disease, diabetic neuropathy, diabetic nephropathy, peripheral vascular disease, cerebrovascular disease, metabolic disorders, Diabetes Complications Severity Index
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Hyperglycemia, Retrospective Studies, Diabetes Complications
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