Visit-to-visit HbA1c variability tied to poor prognosis in diabetes patients on peritoneal dialysis

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-10-05T20:00:22+05:30 | Updated On 5 Oct 2023 8:00 PM IST

Visit-to-visit HbA1c variability tied to poor prognosis in diabetes patients on peritoneal dialysis suggests a new study published in the BMC Nephrology.

The prognosis of diabetic peritoneal dialysis patients is poor. HbA1c is a crucial indicator for monitoring blood glucose control in patients with diabetes. Nevertheless, the relationship between visit-to-visit HbA1c variability and prognosis in peritoneal dialysis with diabetes remains unclear.

All participants were categorized into 3 groups based on the HbA1c variability score (HVS), which is the frequency of 0.5% (5.5 mmol/mol) alter in visit-to-visit HbA1c values. Then, the hazard ratio to HVS with all-cause mortality was analyzed using the Cox hazard model, followed by the Fine-Gray competing risk model for major adverse cardiovascular events. Subgroup and sensitivity analysis were conducted to ascertain the robustness of the findings.

Results

Eight hundred twenty patients with type 2 diabetes were finally enrolled in this study from 2,855 participants with a mean age of 56.9 ± 14.6 years and a median follow-up time of 44 months [IQR: 27–70], death occurred in 496 (60.2%) individuals. Compared with the lowest category (HVS < 1/3) after being adjusted by potential confounding factors, the hazard ratio for all-cause mortality was 4.59 (3.74–5.64) and the sub-distribution hazard ratio for major adverse cardiovascular events was 1.91 (1.46–2.51) of the highest category (HVS ≥ 2/3). Subgroup interaction and sensitivity analysis, including the adjustment for variables such as time-weighted average HbA1c, HbA1c measurement times and expansion, confirmed the reliability of the results

The HVS is related to the risk of poor prognosis in peritoneal dialysis with type 2 diabetes mellitus, independently of clinical multiple variables, and is a novel indicator with clinical guidance.

Reference:

Zhang, F., Shi, T., Feng, X. et al. Visit-to-visit HbA1c variability is associated with poor prognosis in peritoneal dialysis patients with type 2 diabetes mellitus. BMC Nephrol 24, 288 (2023). https://doi.org/10.1186/s12882-023-03348-2

Keywords:

Zhang, F., Shi, T., Feng, X, BMC Nephrology, Visit-to-visit, HbA1c, variability, associated, poor prognosis, peritoneal, dialysis, patients, type 2 diabetes mellitus

Visit-to-visitHbA1cvariabilitytiedpoorprognosisdiabetespatientsperitonealdialysis

Source : BMC Nephrology

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751