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The relationship between glycaemic control and heart failure in 83,021 patients with type 2 diabetes
Diabetologia - Clinical and Experimental Diabetes and Metabolism, 08/20/2012
Clinical Article
Lind M et al. – Poor glycaemic control (HbA1c >7% [53 mmol/mol]) is associated with an increased risk of hospitalisation for heart failure in patients with type 2 diabetes.
Methods- 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 HbA1c (10 mmol/mol) for heart–failure hospitalisation was 1.12 (95% CI 1.10, 1.14).
- By category of HbA1c the HR for heart failure hospitalisation was: HbA1c 6.0 to <7.0% (42 to <53 mmol/mol), 0.91 (95% CI 0.84, 0.98); HbA1c 7.0 to <8.0% (53 to <64 mmol/mol), 0.99 (95% CI 0.91, 1.07); HbA1c 8.0 to <9.0% (64 to <75 mmol/mol), 1.10 (95% CI 1.01, 1.20); HbA1c 9.0 to <10.0% (75 to <86 mmol/mol), 1.27 (95% CI 1.15, 1.41); HbA1c ≥10.0 % (≥86 mmol/mol), 1.71 (1.51, 1.93) (reference HbA1c <6% [42 mmol/mol]).
- The HR for patients with HbA1c 7.0 to <8.0% (53 to <64 mmol/mol) compared with patients with HbA1c 6.0 to <7.0% (42 to <53 mmol/mol) was 1.09 (95% CI 1.03, 1.14).