HbA1c measurement and relationship to incident stroke

Robson, R., Lacey, A. S., Luzio, S. D., Van Woerden, H., Heaven, M. L., Wani, M., Halcox, J. P. J., Castilla-Guerra, L., Dawson, J. and Hewitt, J. (2016) HbA1c measurement and relationship to incident stroke. Diabetic Medicine, 33(4), pp. 459-462. (doi:10.1111/dme.13057) (PMID:26683404)

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Abstract

Aims: To determine the proportion of people with diabetes who have Hb A1c measured, what proportion achieve an HbA1c level of < 58 mmol/mol (7.5%), the frequency of testing and if there was any change in HbA1c level in the year before and the year after an incident stroke. Methods: This study used the Secure Anonymised Information Linkage (SAIL) databank, which stores hospital data for the whole of Wales and ~65% of Welsh general practice records, to identify cases of stroke in patients with diabetes between 2000 and 2010. These were matched against patients with diabetes but without stroke disease. We assessed the frequency of HbA1c testing and change in HbA1c in the first year after stroke. Estimation was made of the proportion of patients achieving an HbA1c measurement ≤ 58 mmol/mol (7.5%). Results: There were 1741 patients with diabetes and stroke. Of these, 1173 (67.4%) had their HbA1c checked before their stroke and 1137 (65.3%) after their stroke. In the control group of 16 838 patients with diabetes but no stroke, 8413 (49.9%) and 9288 (55.1%) had their HbA1c checked before and after the case-matched stroke date, respectively. In patients with diabetes and stroke, HbA1c fell from 7.7 to 7.3% after their stroke ( P<0.001). Before the study, 55.0% of patients with stroke had an HbA1c ≥58 mmol/mol compared with 65.2% of control patients, these figures were 62.5% and 65.3% after the stroke. Conclusions: The frequency of diabetes testing was higher in patients who had experienced a stroke before and after their incident stroke compared with control patients but did not increase after their stroke. Glucose control improved significantly in the year after a stroke.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dawson, Professor Jesse
Authors: Robson, R., Lacey, A. S., Luzio, S. D., Van Woerden, H., Heaven, M. L., Wani, M., Halcox, J. P. J., Castilla-Guerra, L., Dawson, J., and Hewitt, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetic Medicine
Publisher:John Wiley & Sons, Inc.
ISSN:0742-3071
ISSN (Online):0742-3071
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Diabetic Medicine 33(4):459-462
Publisher Policy:Reproduced under a Creative Commons License

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