The relationship between glycaemic control and heart failure in 83,021 patients with type 2 diabetes
Artikel i vetenskaplig tidskrift, 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.

Riskestimation

survival

Glycaemic control

Type 1 diabetes

Heart failure

association

Incidence

HbA(1c)

risk

management

mortality

blood-glucose control

microvascular complications

position statement

register

Type 2 diabetes

prevention

Författare

Marcus Lind

Göteborgs universitet

Marita Olsson

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

Annika Rosengren

Göteborgs universitet

A. M. Svensson

b Centre of Registers in Region Västra Götaland

I. Bounias

Uddevalla Hospital

Soffia Gudbjörnsdottir

Göteborgs universitet

Diabetologia

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

Vol. 55 2946-2953

Ämneskategorier

Endokrinologi och diabetes

Styrkeområden

Livsvetenskaper och teknik

DOI

10.1007/s00125-012-2681-3

PubMed

22895807