The relationship between glycaemic control and heart failure in 83,021 patients with type 2 diabetes
Journal article, 2012

The aim of this study was to examine the relationship between glycaemic control and hospitalisation for heart failure in patients with type 2 diabetes. Patients included in the Swedish National Diabetes Register (NDR) during 1998-2003 were followed until hospitalisation for heart failure, death or 31 December 2009. Unadjusted and adjusted incidence rates for heart failure were estimated by Poisson regression and relative risk was estimated by Cox regression. In 83,021 patients with type 2 diabetes, 10,969 (13.2%) were hospitalised with a primary or secondary diagnosis of heart failure during a mean follow-up of 7.2 years. The incidence increased by male sex (p < 0.001), older age (p < 0.001) and longer diabetes duration (p < 0.001). In Cox regression adjusting for risk factors of heart failure the HR per each percentage unit higher HbA(1c) (10 mmol/mol) for heart-failure hospitalisation was 1.12 (95% CI 1.10, 1.14). By category of HbA(1c) the HR for heart failure hospitalisation was: HbA(1c) 6.0 to < 7.0% (42 to < 53 mmol/mol), 0.91 (95% CI 0.84, 0.98); HbA(1c) 7.0 to < 8.0% (53 to < 64 mmol/mol), 0.99 (95% CI 0.91, 1.07); HbA(1c) 8.0 to < 9.0% (64 to < 75 mmol/mol), 1.10 (95% CI 1.01, 1.20); HbA(1c) 9.0 to < 10.0% (75 to < 86 mmol/mol), 1.27 (95% CI 1.15, 1.41); HbA(1c) a parts per thousand yen10.0 % (a parts per thousand yen86 mmol/mol), 1.71 (1.51, 1.93) (reference HbA(1c) < 6% [42 mmol/mol]). The HR for patients with HbA(1c) 7.0 to < 8.0% (53 to < 64 mmol/mol) compared with patients with HbA(1c) 6.0 to < 7.0% (42 to < 53 mmol/mol) was 1.09 (95% CI 1.03, 1.14). Poor glycaemic control (HbA(1c) > 7% [53 mmol/mol]) is associated with an increased risk of hospitalisation for heart failure in patients with type 2 diabetes.

position statement

HbA(1c)

blood-glucose control

register

Glycaemic control

Heart failure

mortality

Type 1 diabetes

association

microvascular complications

Type 2 diabetes

risk

Incidence

survival

prevention

Riskestimation

management

Author

Marcus Lind

University of Gothenburg

Marita Olsson

University of Gothenburg

Chalmers, Mathematical Sciences, Mathematical Statistics

Annika Rosengren

University of Gothenburg

A. M. Svensson

Region Västra Götaland

I. Bounias

NU Hospital Group

Soffia Gudbjörnsdottir

University of Gothenburg

Diabetologia

0012-186X (ISSN) 1432-0428 (eISSN)

Vol. 55 11 2946-2953

Subject Categories

Endocrinology and Diabetes

Areas of Advance

Life Science Engineering (2010-2018)

DOI

10.1007/s00125-012-2681-3

PubMed

22895807

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Latest update

1/5/2021 1