Achieved levels of HbA1c and likelihood of hospital admission in people with type 1 diabetes in the Scottish population: a study from the Scottish Diabetes Research Network Epidemiology Group

Govan, L. et al. (2011) Achieved levels of HbA1c and likelihood of hospital admission in people with type 1 diabetes in the Scottish population: a study from the Scottish Diabetes Research Network Epidemiology Group. Diabetes Care, 34(9), pp. 1992-1997. (doi:10.2337/dc10-2099)

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Publisher's URL: http://dx.doi.org/10.2337/dc10-2099

Abstract

<p>OBJECTIVE People with type 1 diabetes have increased risk of hospital admission compared with those without diabetes. We hypothesized that HbA1c would be an important indicator of risk of hospital admission.</p> <p>RESEARCH DESIGN AND METHODS The Scottish Care Information–Diabetes Collaboration, a dynamic national register of diagnosed cases of diabetes in Scotland, was linked to national data on admissions. We identified 24,750 people with type 1 diabetes during January 2005 to December 2007. We assessed the relationship between deciles of mean HbA1c and hospital admissions in people with type 1 diabetes adjusting for patient characteristics.</p> <p>RESULTS There were 3,229 hospital admissions. Of the admissions, 8.1% of people had mean HbA1c <7.0% (53 mmol/mol) and 16.3% had HbA1c <7.5% (58 mmol/mol). The lowest odds of admission were associated with HbA1c 7.7–8.7% (61–72 mmol/mol). When compared with this decile, a J-shaped relationship existed between HbA1c and admission. The highest HbA1c decile (10.8–18.4%/95–178 mmol/mol) showed significantly higher odds ratio (95% CI) for any admission (2.80, 2.51–3.12); the lowest HbA1c decile (4.4–7.1%/25–54 mmol/mol) showed an increase in odds of admission of 1.29 (1.10–1.51). The highest HbA1c decile experienced significantly higher odds of diabetes-related (3.31, 2.94–3.72) and diabetes ketoacidosis admissions (10.18, 7.96–13.01).</p> <p>CONCLUSIONS People with type 1 diabetes with highest and lowest mean HbA1c values were associated with increased odds of admission. People with high HbA1c (>10.8%/95 mmol/mol) were at particularly high risk. There is the need to develop effective interventions to reduce this risk.</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lindsay, Dr Robert and Govan, Dr Lindsay and Briggs, Professor Andrew and Wu, Professor Olivia and Sattar, Professor Naveed
Authors: Govan, L., Wu, O., Briggs, A., Colhoun, H.M., Fischbacher, C.M., Leese, G.P., McKnight, J.A., Philip, S., Sattar, N., Wild, S.H., and Lindsay, R.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Centre for Population and Health Sciences
Research Group:Scottish Diabetes Research Network Epidemiology Group
Journal Name:Diabetes Care
Publisher:American Diabetes Association
ISSN:0149-5992
ISSN (Online):1935-5548
Published Online:25 July 2011

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