Relation Between Different Measures of Glycemic Exposure and Microvascular and Macrovascular Complications in Patients with Type 2 Diabetes Mellitus: An Observational Cohort Study

• DOI: 10.1007/s13300-017-0301-4
• Publication Date: 2017-09-18T02:49:57Z
• Authors: Rients P. T. van ...; Jetty A. Overbeek; Edith M. Heintjes; Agata Schubert; Joris Diels; Huub Straatman; Ewout W. Steyerberg; Ron M. C. Herings
• Keywords: Macrovascular disease

This retrospective cohort study investigated the relation between different measures of glycemic exposure and micro- macrovascular complications among patients with type 2 diabetes.The analysis included receiving oral antihyperglycemic agents 1 January 2006 31 December 2014 from General Practitioner Database PHARMO Network. All recorded HbA1c levels during follow-up were used to express in four ways: index HbA1c, time-dependent exponential moving average (EMA) burden. Association micro-/macrovascular was analyzed by estimating hazard ratios 95% confidence intervals using an adjusted (time-dependent) Cox proportional hazards model.The 32,725 (median age, 65 years; 47% female). Median 5.4 median number measurements per patient 18.0. From all measures, at showed weakest complications, coronary artery disease (CAD) having highest HR (95% CI): 1.18 (1.04-1.34) for ≥64 mmol/mol (8%). The model a significant association only microvascular retinopathy 1.55 (1.40-1.73) EMA-defined similar findings, although effect more pronounced [HR 1.81 (1.63-2.02) (8%)] also predictive CAD 1.29 (1.10-1.50) (8%)]. A statistically burden found selected (95%): 2.60 (2.19-3.07) years >3.This shows that greater prolonged hyperglycemia increases risk complications.Janssen Pharmaceutica NV.