Abstract
Objectives
Glycated hemoglobin (HbA1c) has proven to be indicative in the development of microvascular complications. In this study, the contribution of HbA1c variability to microvascular complications was evaluated.
Methods
Twenty-one cases with type 1 diabetes mellitus (T1DM) who developed microvascular complications and 39 cases without complications, that were similar in terms of gender, age of diagnosis, insulin treatment, insulin doses (U/kg), and mean HbA1c levels were included.
Results
Mean age of T1DM diagnosis was 5.87 ± 3.93 years in the complication group and 4.63 ± 3.33 years in the control group. Nephropathy was detected in 17 cases, neuropathy in 8 cases, and retinopathy in 1 case. Nephropathy occurred at a mean age of 11.52 ± 4.12 years and neuropathy at 14.13 ± 5.68 years. The mean HbA1c during follow-up was similar in the group with complications and the control group (8.60 ± 0.63 vs. 8.84 ± 1.32). Adjusted HbA1c-standard deviation (SD) and HbA1c-variation coefficient (CV) values were 1.30 ± 0.65 and 14.36 ± 6.23 in the group with complications (p=0.014), and 0.91 ± 0.37 and 10.59 ± 4.01 in the control group (p=0.013). In the Receiver Operating Characteristic (ROC)-analysis for microvascular complications, the limit value HbA1c-CV was 11.99 (sensitivity: 61.9%, specificity: 71.9%). This value for HbA1c-SD was 0.9699 (sensitivity: 71.43%, specificity: 66.67%)
Conclusions
This study has shown that long-term fluctuations in HbA1c are associated with the development of microvascular complications in type 1 diabetes.
Research funding: The authors receive no financial support for the study authorship, and publications of this article.
Author Contributions: Eren Er: Methodology, conceptualization, writing, Aysun Ata: Soft-ware, investigation, Ferda Evin: Investigation, Günay Demir: Investigation, Yasemin Atik Altınok: Investigation, Samim Özen: Methodology, supervision, Şükran Darcan: Project administration, Damla Gökşen: Writing- reviewing, editing.
Ethical statement: The study was conducted in accordance with the guideline of the Declaration of Helsinki. This research was approved by the local ethics committee and written informed consent was obtained from all participants or their parents/guardians.
Conflict of interest: The authors declare no conflict of interest.
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