In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
Abstract:
Background: Although guidelines recommend regular glycated hemoglobin (HbA1c) testing every 6 months for type 2 diabetes patients, whether adherence to these guidelines leads to improved health outcomes is unclear. We aimed to determine the association of HbA1c testing intervals on stroke and cardiovascular disease (CVD) risk among newly diagnosed type 2 diabetes patients. Methods: The study population consisted of 31,041 newly diagnosed type 2 diabetes patients during 2003-2011 from the Korean National Health Insurance Service. Average HbA1c testing interval was calculated during 3 years after type 2 diabetes diagnosis. Participants were categorized into average HbA1c testing intervals of ≤6, 〉 6 to ≤12, 〉 12 to ≤18, and 〉 18 months, after which they were followed-up for stroke and CVD until 2015. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were determined by Cox proportional hazards regression for the risk of stroke and CVD according to HbA1c testing interval. Results: Compared to patients with HbA1c testing intervals of ≤6 months, patients with 〉 6 to ≤12 (aHR 1.40, 95% CI 1.10-1.78), 〉 12 to ≤18 (aHR 1.43, 95% CI 1.12-1.84), and 〉 18 (aHR 1.64, 95% CI 1.32-2.04) month intervals had elevated risk for stroke ( p trend 〈 0.001). Similarly, patients with 〉 12 to ≤18 (aHR 1.28, 95% CI 1.10-1.50), and 〉 18 (aHR 1.38, 95% CI 1.21-1.58) month intervals had increased risk for CVD ( p trend 〈 0.001) compared to those with intervals of ≤6 months. There was no significant association between HbA1c testing intervals of ≤3 and 〉 3 to ≤6 months on stroke and CVD risk. The risk-increasing effect of stroke and CVD by longer HbA1c testing intervals was preserved among subgroups divided by fasting serum glucose, initial diabetes medication, outpatient department visits, and Charlson comorbidity index. Conclusions: HbA1c testing interval of more than 6 months was associated with increased risk of stroke and CVD among newly diagnosed type 2 diabetes patients. Type 2 diabetes patients who undergo biannual HbA1c testing may benefit from reduced stroke and CVD risk.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.50.suppl_1.WMP59
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
1467823-8
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