Glycaemic control, disease duration and beta-cell function in patients with Type 2 diabetes in a Swedish community. Skaraborg Hypertension and Diabetes Project.

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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.

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Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Endocrinology and Diabetes

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
Original languageEnglish
Pages (from-to)125-129
JournalDiabetic Medicine
Volume19
Issue number2
Publication statusPublished - 2002
Publication categoryResearch
Peer-reviewedYes

Bibliographic 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)

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