The relationship between glycated haemoglobin and blood glucose‐lowering treatment trajectories in type 2 diabetes: The Fremantle Diabetes Study Phase II
Aims To examine the relationships between glycaemia and treatment complexity over 6 years in well‐characterized community‐based people with type 2 diabetes. Materials and Methods Fremantle Diabetes Study Phase II participants who had type 2 diabetes with glycated haemoglobin (HbA1c) and blood glucos...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2024-01, Vol.26 (1), p.283-292 |
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| creator | Davis, Timothy M. E. Davis, Wendy |
| description | Aims
To examine the relationships between glycaemia and treatment complexity over 6 years in well‐characterized community‐based people with type 2 diabetes.
Materials and Methods
Fremantle Diabetes Study Phase II participants who had type 2 diabetes with glycated haemoglobin (HbA1c) and blood glucose‐lowering therapy (BGLT) data over 6 years were included. Group‐based multi‐trajectory modelling identified combined HbA1c/BGLT trajectory subgroups for diabetes durations of ≤1.0 year (Group 1; n = 160), >1.0 to 10.0 years (Group 2; n = 382;) and >10.0 years (Group 3; n = 357). Multinomial regression was used to identify baseline associates of subgroup membership.
Results
The optimum numbers of trajectory subgroups were three in Group 1 (low, medium, high) and four in Groups 2 and 3 (low, low/high medium, high). Each low trajectory subgroup maintained a mean HbA1c concentration of |
| doi_str_mv | 10.1111/dom.15314 |
| format | Article |
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To examine the relationships between glycaemia and treatment complexity over 6 years in well‐characterized community‐based people with type 2 diabetes.
Materials and Methods
Fremantle Diabetes Study Phase II participants who had type 2 diabetes with glycated haemoglobin (HbA1c) and blood glucose‐lowering therapy (BGLT) data over 6 years were included. Group‐based multi‐trajectory modelling identified combined HbA1c/BGLT trajectory subgroups for diabetes durations of ≤1.0 year (Group 1; n = 160), >1.0 to 10.0 years (Group 2; n = 382;) and >10.0 years (Group 3; n = 357). Multinomial regression was used to identify baseline associates of subgroup membership.
Results
The optimum numbers of trajectory subgroups were three in Group 1 (low, medium, high) and four in Groups 2 and 3 (low, low/high medium, high). Each low trajectory subgroup maintained a mean HbA1c concentration of <53 mmol/mol (<7.0%) on lifestyle measures, or monotherapy (Group 3). All five medium subgroups had stable HbA1c trajectories at <58 mmol/mol (<7.5%) but required increasing oral BGLT, or insulin (Group 3, high medium). The Group 1 high subgroup showed a falling then increasing HbA1c with steady progression to insulin. The high subgroups in Groups 2 and 3 showed stable HbA1c profiles at means of approximately 64 mmol/mol (8.0%) and 86 mmol/L (10.0%), respectively, on insulin. Non‐Anglo Celt ethnicity, central obesity and hypertriglyceridaemia were strongly associated with Group 1 high subgroup membership. Younger age at diagnosis and central obesity were independent associates of the most adverse HbA1c trajectories in Groups 2 and 3.
Conclusions
These data demonstrate diabetes duration‐dependent heterogeneity in glycaemic and treatment profiles and related clinical and laboratory variables, which have implications for management.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.15314</identifier><identifier>PMID: 37795655</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Blood Glucose ; cohort study ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Glucose - therapeutic use ; glycaemic control ; Glycated Hemoglobin ; Hemoglobin ; Humans ; Hypoglycemic Agents - therapeutic use ; Insulin ; Insulin - therapeutic use ; insulin therapy ; Obesity ; Obesity, Abdominal ; real‐world evidence ; type 2 diabetes</subject><ispartof>Diabetes, obesity & metabolism, 2024-01, Vol.26 (1), p.283-292</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3484-be74c4f4fa51fd255ef9d1a660d64b83cfb7eaf16eaf3fb642ee3226cc736eb03</cites><orcidid>0000-0003-0749-7411</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.15314$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.15314$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37795655$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Davis, Timothy M. E.</creatorcontrib><creatorcontrib>Davis, Wendy</creatorcontrib><title>The relationship between glycated haemoglobin and blood glucose‐lowering treatment trajectories in type 2 diabetes: The Fremantle Diabetes Study Phase II</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aims
To examine the relationships between glycaemia and treatment complexity over 6 years in well‐characterized community‐based people with type 2 diabetes.
Materials and Methods
Fremantle Diabetes Study Phase II participants who had type 2 diabetes with glycated haemoglobin (HbA1c) and blood glucose‐lowering therapy (BGLT) data over 6 years were included. Group‐based multi‐trajectory modelling identified combined HbA1c/BGLT trajectory subgroups for diabetes durations of ≤1.0 year (Group 1; n = 160), >1.0 to 10.0 years (Group 2; n = 382;) and >10.0 years (Group 3; n = 357). Multinomial regression was used to identify baseline associates of subgroup membership.
Results
The optimum numbers of trajectory subgroups were three in Group 1 (low, medium, high) and four in Groups 2 and 3 (low, low/high medium, high). Each low trajectory subgroup maintained a mean HbA1c concentration of <53 mmol/mol (<7.0%) on lifestyle measures, or monotherapy (Group 3). All five medium subgroups had stable HbA1c trajectories at <58 mmol/mol (<7.5%) but required increasing oral BGLT, or insulin (Group 3, high medium). The Group 1 high subgroup showed a falling then increasing HbA1c with steady progression to insulin. The high subgroups in Groups 2 and 3 showed stable HbA1c profiles at means of approximately 64 mmol/mol (8.0%) and 86 mmol/L (10.0%), respectively, on insulin. Non‐Anglo Celt ethnicity, central obesity and hypertriglyceridaemia were strongly associated with Group 1 high subgroup membership. Younger age at diagnosis and central obesity were independent associates of the most adverse HbA1c trajectories in Groups 2 and 3.
Conclusions
These data demonstrate diabetes duration‐dependent heterogeneity in glycaemic and treatment profiles and related clinical and laboratory variables, which have implications for management.</description><subject>Blood Glucose</subject><subject>cohort study</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Glucose - therapeutic use</subject><subject>glycaemic control</subject><subject>Glycated Hemoglobin</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin</subject><subject>Insulin - therapeutic use</subject><subject>insulin therapy</subject><subject>Obesity</subject><subject>Obesity, Abdominal</subject><subject>real‐world evidence</subject><subject>type 2 diabetes</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhiMEohdY8ALIEhu6SOtbnAy7qqUwUlGRKGvLl5MZj5x4sB2NsuMR2PN2PAluZ2CBhBfHR8efP1v6q-oVweekrAsbhnPSMMKfVMeEC1YTRsXTx57W3QLTo-okpQ3GmLOufV4dsbZdNKJpjquf92tAEbzKLoxp7bZIQ94BjGjlZ6MyWLRWMISVD9qNSI0WaR-CLceTCQl-ff_hww6iG1coR1B5gDGXTm3A5BAdJFSu5XkLiCLrVLFDeoceXr2JMKgxe0DXhzn6kic7o89rlQAtly-qZ73yCV4e9tPq6837-6uP9e3dh-XV5W1tGO94raHlhve8Vw3pLW0a6BeWKCGwFVx3zPS6BdUTUQrrteAUgFEqjGmZAI3ZafV2793G8G2ClOXgkgHv1QhhSpJ2LaMNbjtW0Df_oJswxbH8TtIFxoRQxmihzvaUiSGlCL3cRjeoOEuC5UNisiQmHxMr7OuDcdID2L_kn4gKcLEHds7D_H-TvL77tFf-BkDOo6s</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Davis, Timothy M. E.</creator><creator>Davis, Wendy</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0749-7411</orcidid></search><sort><creationdate>202401</creationdate><title>The relationship between glycated haemoglobin and blood glucose‐lowering treatment trajectories in type 2 diabetes: The Fremantle Diabetes Study Phase II</title><author>Davis, Timothy M. E. ; Davis, Wendy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3484-be74c4f4fa51fd255ef9d1a660d64b83cfb7eaf16eaf3fb642ee3226cc736eb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Blood Glucose</topic><topic>cohort study</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Glucose - therapeutic use</topic><topic>glycaemic control</topic><topic>Glycated Hemoglobin</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin</topic><topic>Insulin - therapeutic use</topic><topic>insulin therapy</topic><topic>Obesity</topic><topic>Obesity, Abdominal</topic><topic>real‐world evidence</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Davis, Timothy M. E.</creatorcontrib><creatorcontrib>Davis, Wendy</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Davis, Timothy M. E.</au><au>Davis, Wendy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The relationship between glycated haemoglobin and blood glucose‐lowering treatment trajectories in type 2 diabetes: The Fremantle Diabetes Study Phase II</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2024-01</date><risdate>2024</risdate><volume>26</volume><issue>1</issue><spage>283</spage><epage>292</epage><pages>283-292</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><abstract>Aims
To examine the relationships between glycaemia and treatment complexity over 6 years in well‐characterized community‐based people with type 2 diabetes.
Materials and Methods
Fremantle Diabetes Study Phase II participants who had type 2 diabetes with glycated haemoglobin (HbA1c) and blood glucose‐lowering therapy (BGLT) data over 6 years were included. Group‐based multi‐trajectory modelling identified combined HbA1c/BGLT trajectory subgroups for diabetes durations of ≤1.0 year (Group 1; n = 160), >1.0 to 10.0 years (Group 2; n = 382;) and >10.0 years (Group 3; n = 357). Multinomial regression was used to identify baseline associates of subgroup membership.
Results
The optimum numbers of trajectory subgroups were three in Group 1 (low, medium, high) and four in Groups 2 and 3 (low, low/high medium, high). Each low trajectory subgroup maintained a mean HbA1c concentration of <53 mmol/mol (<7.0%) on lifestyle measures, or monotherapy (Group 3). All five medium subgroups had stable HbA1c trajectories at <58 mmol/mol (<7.5%) but required increasing oral BGLT, or insulin (Group 3, high medium). The Group 1 high subgroup showed a falling then increasing HbA1c with steady progression to insulin. The high subgroups in Groups 2 and 3 showed stable HbA1c profiles at means of approximately 64 mmol/mol (8.0%) and 86 mmol/L (10.0%), respectively, on insulin. Non‐Anglo Celt ethnicity, central obesity and hypertriglyceridaemia were strongly associated with Group 1 high subgroup membership. Younger age at diagnosis and central obesity were independent associates of the most adverse HbA1c trajectories in Groups 2 and 3.
Conclusions
These data demonstrate diabetes duration‐dependent heterogeneity in glycaemic and treatment profiles and related clinical and laboratory variables, which have implications for management.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>37795655</pmid><doi>10.1111/dom.15314</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0749-7411</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Blood Glucose cohort study Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Glucose - therapeutic use glycaemic control Glycated Hemoglobin Hemoglobin Humans Hypoglycemic Agents - therapeutic use Insulin Insulin - therapeutic use insulin therapy Obesity Obesity, Abdominal real‐world evidence type 2 diabetes |
| title | The relationship between glycated haemoglobin and blood glucose‐lowering treatment trajectories in type 2 diabetes: The Fremantle Diabetes Study Phase II |
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