Abstract
AimsTo examine determinants for glycaemic control in primary care patients with Type 2 diabetes.
MethodsIn a community-based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and beta-cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c < 6.5%.
ResultsFollowing adjustment for age and gender, HbA1c>= 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P < 0.001), lower levels of serum insulin (6.3 vs. 8.0 mU/l, P = 0.012), higher serum triglyceride levels (2.0 vs. 1.7 mmol/l, P = 0.002) and impairment of beta-cell function (HOMA index 19.5 vs. 45.8, P < 0.001). The association between HbA1c levels and duration remained with adjustment for age, gender, waist-hip ratio (WHR) and serum triglycerides (odds ratio (OR) for HbA1c>= 6.5% by 5 years diabetes duration = 1.7; 95% confidence interval (CI) 1.4-2.1) but was lost following additional adjustment for beta-cell function (OR for HbA1c>= 6.5% = 1.3; 95% CI 0.96-1.7). In a separate linear regression with beta-cell function as the dependent variable there was a significant association with HbA1c after adjustments for differences in age, gender, WHR, serum triglyceride levels and diabetes duration (P < 0.001).
ConclusionsIncreasing HbA1c by time was associated with declining beta-cell function.
MethodsIn a community-based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and beta-cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c < 6.5%.
ResultsFollowing adjustment for age and gender, HbA1c>= 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P < 0.001), lower levels of serum insulin (6.3 vs. 8.0 mU/l, P = 0.012), higher serum triglyceride levels (2.0 vs. 1.7 mmol/l, P = 0.002) and impairment of beta-cell function (HOMA index 19.5 vs. 45.8, P < 0.001). The association between HbA1c levels and duration remained with adjustment for age, gender, waist-hip ratio (WHR) and serum triglycerides (odds ratio (OR) for HbA1c>= 6.5% by 5 years diabetes duration = 1.7; 95% confidence interval (CI) 1.4-2.1) but was lost following additional adjustment for beta-cell function (OR for HbA1c>= 6.5% = 1.3; 95% CI 0.96-1.7). In a separate linear regression with beta-cell function as the dependent variable there was a significant association with HbA1c after adjustments for differences in age, gender, WHR, serum triglyceride levels and diabetes duration (P < 0.001).
ConclusionsIncreasing HbA1c by time was associated with declining beta-cell function.
| Original language | English |
|---|---|
| Pages (from-to) | 125-129 |
| Journal | Diabetic Medicine |
| Volume | 19 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2002 |
Bibliographical note
The information about affiliations in this record was updated in December 2015.The record was previously connected to the following departments: Psychiatry/Primary Care/Public Health (013240500), Community Medicine (013241810), Department of Orthopaedics (Lund) (013028000)
Subject classification (UKÄ)
- Endocrinology and Diabetes
Free keywords
- Human
- Glycosylated: analysis
- Hemoglobin A
- Female
- Non-Insulin-Dependent: blood
- Aged
- 8 Age of Onset
- Diabetes Mellitus
- Blood Pressure
- Blood Glucose: metabolism
- Cardiovascular Diseases: epidemiology
- Diabetic Angiopathies: epidemiology
- Non-Insulin-Dependent: physiopathology
- Triglycerides: blood
- Sweden
- Support
- Non-U.S. Gov't
- Risk Factors
- Male
- Insulin: secretion
- Insulin: blood
- Islets of Langerhans: secretion
