239-OR: Association between Hemoglobin A1c and Stroke Risk in Patients with Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 239-OR
Author(s):  
YUN SHEN ◽  
LIZHENG SHI ◽  
ELIZABETH NAUMAN ◽  
PETER KATZMARZYK ◽  
EBONI G. PRICE-HAYWOOD ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hemoglobin A1c ◽  
Stroke Risk

scholarly journals Association between Hemoglobin A1c and Stroke Risk in Patients with Type 2 Diabetes

2020 ◽  
Vol 22 (1) ◽  
pp. 87-98 ◽  
Author(s):  
Yun Shen ◽  
Lizheng Shi ◽  
Elizabeth Nauman ◽  
Peter Katzmarzyk ◽  
Eboni Price-Haywood ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hemorrhagic Stroke ◽  
Hemoglobin A1c ◽  
Stroke Risk ◽  
Diabetes Management ◽  
Reference Group ◽  
Research Network ◽  
Lipid Lowering ◽  
Common Data Model

Background and Purpose The association between hemoglobin A1c (HbA1c) and stroke risk along with its subtypes is rarely reported. We aimed to investigate the association between HbA1c and the risk of incident stroke in patients with type 2 diabetes based on real world data from three healthcare systems.Methods We performed a retrospective cohort study of 27,113 African Americans and 40,431 whites with type 2 diabetes. Demographic, anthropometric, laboratory, and medication information were abstracted from the National Patient-Centered Clinical Research Network common data model. Incident stroke events including both ischemic and hemorrhagic stroke were defined.Results During a mean follow-up period of 3.79±1.68 years, 7,735 patients developed stroke (6,862 ischemic and 873 hemorrhagic). Multivariable-adjusted hazard ratios across levels of HbA1c at baseline (<6.0%, 6.0% to 6.9% [reference group], 7.0% to 7.9%, 8.0% to 8.9%, 9.0% to 9.9%, and ≥10%) were 1.07, 1.00, 1.13, 1.23, 1.27, and 1.37 (<i>P</i><sub>trend</sub> <0.001) for total stroke, 1.02, 1.00, 1.13, 1.20, 1.24, and 1.35 (<i>P</i><sub>trend</sub> <0.001) for ischemic stroke, and 1.40, 1.00, 1.14, 1.47, 1.47, and 1.51 (<i>P</i><sub>trend</sub>=0.002) for hemorrhagic stroke. When we used an updated mean value of HbA1c, the U-shaped association of HbA1c with stroke risk did not change. This U-shaped association was consistent among patients of different subgroups. The U-shaped association was more pronounced among patients taking antidiabetic, lipid-lowering, and antihypertensive medications compared with those without these medications.Conclusions These data suggest that diabetes management may have to be individualized according to the guideline recommendations rather than intensively attempting to lower HbA1c.

909-P: The Related Factors Accounting for the Discrepancy between Estimated Hemoglobin A1c Derived from CGMS and the Measured A1C in Patients with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 909-P
Author(s):  
BEISI LIN ◽  
WEN XU ◽  
ZHIGU LIU ◽  
DAIZHI YANG ◽  
YANNA SU ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Hemoglobin A1c ◽  
Related Factors

scholarly journals Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
First Generation ◽  
Hemoglobin A1c ◽  
Diabetes Remission ◽  
Factors Associated ◽  
Generation Immigrant

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.

scholarly journals The Impact of Aerobic and Resistance Training on Hemoglobin A1c and Fitness Measures in Dynapenic-Obese with Type 2 Diabetes: Results from the HART-D Study

2013 ◽  
Vol 37 ◽  
pp. S227-S228
Author(s):  
Martin Sénéchal ◽  
Neil M. Johanssen ◽  
Damon L. Swift ◽  
Steven N. Blair ◽  
Conrad P. Earnest ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Resistance Training ◽  
Hemoglobin A1c ◽  
Fitness Measures ◽  
The Impact
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