Dataset Information

Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort.

ABSTRACT: BACKGROUND:Glycemic variation has been suggested to be a risk factor for diabetes-related complications. Previous studies did not address confounding of diabetes duration, number of visits and length of follow-up. Here, we characterize glycemic variability over time and whether its relation to diabetes-related complications and mortality is independent from diabetes- and follow-up duration. MATERIALS AND METHODS:Individuals with type 2 diabetes (n?=?6770) from the Hoorn Diabetes Care System cohort were included in this study. The coefficient of variation (CV) was calculated over 5-year sliding intervals. People divided in quintiles based on their CV. Cox proportional hazard models were used to investigate the role of glycemic CV as risk factor in diabetes-related complications and mortality. RESULTS:The coefficient of variation of glucose (FG-CV) increased with time, in contrast to HbA1c (HbA1c-CV). People with a high FG-CV were those with an early age of diabetes onset (?Q5-Q1?=?-?2.39 years), a higher BMI (?Q5-Q1?= +?0.92 kg/m2), an unfavorable lipid profile, i.e. lower levels of HDL-C (?Q5-Q1?=?-?0.06 mmol/mol) and higher triglycerides (?Q5-Q1?=+?1.20 mmol/mol). People with the highest FG-CV in the first 5-year interval showed an increased risk of insulin initiation, retinopathy, macrovascular complications and mortality independent of mean glycemia, classical risk factors and medication use. For HbA1c, the associations were weaker and less consistent. CONCLUSIONS:Individuals with a higher FG-CV have an unfavorable metabolic profile and have an increased risk of developing micro- and macrovascular complications and mortality. The association of HbA1c-CV with metabolic outcomes and complications was less consistent in comparison to FG-CV.

SUBMITTER: Slieker RC

PROVIDER: S-EPMC6909524 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort.

Slieker Roderick C RC van der Heijden Amber A W H AAWH Nijpels Giel G Elders Petra J M PJM 't Hart Leen M LM Beulens Joline W J JWJ

Cardiovascular diabetology 20191212 1

<h4>Background</h4>Glycemic variation has been suggested to be a risk factor for diabetes-related complications. Previous studies did not address confounding of diabetes duration, number of visits and length of follow-up. Here, we characterize glycemic variability over time and whether its relation to diabetes-related complications and mortality is independent from diabetes- and follow-up duration.<h4>Materials and methods</h4>Individuals with type 2 diabetes (n = 6770) from the Hoorn Diabetes C ...[more]

PMID: 31830993

Similar Datasets

Project description:PurposePeople with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort.ParticipantsThe DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands. Enrolment in the cohort started in 1998 and this prospective dynamic cohort currently holds 12 673 persons with T2D.Findings to dateClinical measures are collected annually, with a high internal validity due to the centrally organised standardised examinations. Microvascular complications are assessed by measuring kidney function, and screening feet and eyes. Information on cardiovascular disease is obtained by 1) self-report, 2) electrocardiography and 3) electronic patient records. In subgroups of the cohort, biobanking and additional measurements were performed to obtain information on, for example, lifestyle, depression and genomics. Finally, the DCS cohort is linked to national cancer and all-cause mortality registers. A selection of published findings from the DCS includes identification of subgroups with distinct development of haemoglobin A1c, blood pressure and retinopathy, and their predictors; validation of a prediction model for personalised retinopathy screening; the assessment of the role of genetics in development and treatment of T2D, providing options for personalised medicine.Future plansWe will continue with the inclusion of persons with newly diagnosed T2D, follow-up of persons in the cohort and linkage to morbidity and mortality registries. Currently, we are involved in (inter)national projects on, among others, biomarkers and prediction models for T2D and complications and we are interested in collaborations with external researchers.Trial registrationISRCTN26257579.

Dataset Information

Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort.

Publications

Visit-to-visit variability of glycemia and vascular complications: the Hoorn Diabetes Care System cohort.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure