Higher HbA1c levels and longer duration of Diabetes increase HF risk among Diabetics
New research found that there is an increased risk of heart failure among diabetic patients who have had diabetes for a long duration and increased HbA1c levels. The study results were published in The Journal of Clinical Endocrinology and Metabolism.
Diabetes is a global pandemic and there is an increased risk of cardiorenal problems in patients with diabetes. Diabetes duration and glycemic control have a potential role in the risk of heart failure (HF) in diabetics but there is uncertainty over the same. Hence researchers conducted a study to investigate the association of diabetes duration and glycemic control with the risk of HF.
Nearly 23,754 individuals with diabetes but without HF during the baseline recruitment of UK Biobank were recruited for the study. All the participants self-reported the duration of diabetes, and the status of glycemic control was reflected by glycated hemoglobin A1c (HbA1c) levels. The association of diabetes duration and glycemic control with incident HF was assessed using multivariate Cox models adjusting for traditional risk factors.
Results:
Duration of diabetes and HbA1c levels both were positively associated with the risk of HF.
The hazard ratios (HRs) (95% CI) for diabetes durations (vs < 5 years); and the HRs for HbA1c (vs < 53.0 mmol/mol [7.0%]) are as follows.
| Diabetes Duration | Hazard ratios (95% CI) |
5 -10 years | 1.09 (0.97-1.23) |
| 10-15 years | 1.13 (0.97-1.30) |
| 15 and more years | 1.32 (1.15-1.53) |
| HbA1c | |
| 53-58.5 mmol/mol (7.0% to < 7.5%) | 1.15 (1.02-1.31) |
58.5 - 63.9 mmol/mol (7.5% to < 8.0%) | 1.07 (0.91-1.26) |
63.9 mmol/mol or greater (8.0%) | 1.46 (1.30-1.65) |
A higher risk of HF (P for interaction = .026) was found especially in Individuals with the longest disease duration (≥ 15 years) and poorer glycemic control (HbA1c ≥ 63.9 mmol/mol [8.0%]).
Thus, the study finds that there is an increased risk of heart failure in diabetic patients with an increased duration of diabetes and increased HBA1c levels.
Further reading: Yang HH, Li FR, Chen ZK, et al. Duration of Diabetes, Glycemic Control, and Risk of Heart Failure Among Adults With Diabetes: A Cohort Study [published online ahead of print, 2022 Nov 16]. J Clin Endocrinol Metab. 2022;dgac642. doi: 10.1210/clinem/dgac642
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