Longitudinal Trajectories of HbA1c and Fasting Plasma Glucose Levels During the Development of Type 2 Diabetes
Open accessAbstract
OBJECTIVE: To describe the trajectory of HbA1c and glucose concentrations before the diagnosis of diabetes. RESEARCH DESIGN AND METHODS: The study comprised 1,722 nondiabetic Japanese individuals aged 26–80 years. Fasting plasma glucose (FPG) and HbA1c were measured annually for a mean of 9.5 (SD 1.8) years. RESULTS: Diabetes occurred in 193 individuals (FPG ≥7.0 mmol/L, self-reported clinician-diagnosed diabetes, or HbA1c ≥6.5%). Mean HbA1c values were >5.6% each year before diagnosis in diabetes cases. Mean HbA1c (5.69% [95% CI 5.50–5.88]) was higher in the 21 individuals who developed diabetes 10 years after the baseline examination than in nondiabetic individuals after 10 years (5.27% [5.25–5.28]). From 3 years to 1 year prediagnosis, HbA1c increased 0.09% (SE 0.01)/year, reaching 5.90% (5.84–5.96) 1 year prediagnosis. In the entire group, marked increases in HbA1c of 0.3% (SE 0.05%)/year and FPG of 0.63 (0.07) mmol/L/year predicted diabetes. CONCLUSIONS: HbA1c trajectory increased sharply after gradual long-term increases in diabetic individuals.
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Each 1 kg decrease in excess body weight was associated with a 0.071% decrease in A1c over 56 weeks in the CONQUER trial.
“Over the 56 week period, each 1kg decrease in excess body weight was associated with a 0.071% decrease in A1c [22].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [22]
The Results describe HbA1c changes before a type 2 diabetes diagnosis, not changes associated with weight loss. Searches for the 0.071% per kg estimate and the CONQUER trial found no supporting passage in our copy; it does not address the claimed 56-week association. (LLM, conf=0.77)
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- Authors
- Heianza, Y., Arase, Y., Fujihara, K., Hsieh, S. D., Saito, K., Tsuji, H., Kodama, S., Yahagi, N., Shimano, H., Yamada, N., Hara, S., & Sone, H.
- Affiliations
- University of Tsukuba (JP)
- Toranomon Hospital (JP)
- Corresponding author
- Sone, Hirohito
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2012-04-11
- Volume
- 35
- Issue
- 5
- Pages
- 1050-1052
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3329827
- OpenAlex
- W2154104644
- Cited by
- 56
- References
- 14
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 2 · 2023: 7 · 2022: 5 · 2021: 5 · 2020: 1 · 2019: 1 · 2018: 8 · 2017: 2 · 2016: 6 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (23116006, 24300233, 20300227)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, HbA1c, fasting blood glucose, prediabetes, diabetes risk prediction, longitudinal trajectories, Japanese adults
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 2, Fasting, Female, Glycated Hemoglobin, Humans, Longitudinal Studies, Male, Middle Aged
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