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. ISSN 0149-5992 (doi:10.2337/dc10-2099)
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Publisher's URL: http://dx.doi.org/10.2337/dc10-2099
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. 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. 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). 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.
|Glasgow Author(s):||Lindsay, Dr Robert and Govan, Dr Lindsay and Briggs, Prof Andrew and Wu, Dr Olivia and Sattar, Prof 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 Cardiovascular and Medical Sciences|
College of Medical Veterinary and Life Sciences > School of Medicine > Centre for Population and Health Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
|Research Group:||Scottish Diabetes Research Network Epidemiology Group|
|Journal Name:||Diabetes Care|
|Publisher:||American Diabetes Association|
|Published Online:||25 July 2011|