Haemoglobin A1c and 5-year all-cause mortality in French type 2 diabetic patients aged 70 years and older: The GERODIAB observational cohort
| Autor: | André Scheen, Jean Doucet, C. Verny, Bernard Bauduceau, Beverley Balkau |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Endocrinology Risk Factors Diabetes mellitus Internal medicine Internal Medicine medicine Humans Prospective Studies Aged Aged 80 and over Glycated Hemoglobin Haemoglobin A1c Proportional hazards model business.industry Mean age General Medicine medicine.disease Survival Rate Diabetes Mellitus Type 2 Cohort Female Observational study France business All cause mortality |
| Zdroj: | Diabetes & Metabolism. 44:465-472 |
| ISSN: | 1262-3636 |
| Popis: | The role of glycaemic control in the mortality of elderly diabetic patients remains uncertain. GERODIAB is the first multi-centre, prospective, observational study that aims to describe the link between HbA1c and 5-year mortality in French, type 2 diabetic patients aged ≥70 years.Consecutive patients (n=987; mean age 77 years) were included from 56 diabetes centres and followed for five years. Individual histories, risk factors, standard diabetes parameters and geriatric evaluations were regularly recorded. Survival was studied using the Kaplan-Meier method. Multivariable analyses used Cox regression.Twenty-one percent of the patients died, 13% were lost during follow-up. Patients with a 5-year mean HbA1c in the range [40-50) mmol/mol ([5.8-6.7) %) had the highest survival (84%); those in the range [50-70) mmol/mol ([6.7-8.6) %) or40mmol/mol (5.8%) an intermediary survival rate (79%); patients with HbA1c ≥70mmol/mol (≥8.6%) the worst survival (71%). Patients with mean HbA1c ≥70mmol/mol (≥8.6%) had a significantly higher mortality than those with lower HbA1c (P=0.011), and HbA1c remained a significant predictor of mortality after adjusting for individual, diabetic and geriatric factors (hazards ratio [95%CI]: 1.76 [1.21 to 2.57], P=0.0033). Survival was also significantly associated with both HbA1c variability and with the frequency of HbA1c determinations.In this large sample of elderly French type 2 diabetic patients, an HbA1c level70mmol/mol (8.6%) was associated with lower mortality. The range [40-50) mmol/mol ([5.8-6.7) %) could be an acceptable target provided patients are not exposed to hypoglycaemia. |
| Databáze: | OpenAIRE |
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