Impact of diagnosing diabetic complications on future hemoglobin A1c levels

Abstract

Aim: To assess how hemoglobin A1c (HbA1c) values might change following the diagnosis of the first complication from diabetes mellitus (DM).

Methods: Using a nationwide, longitudinal managed care network claims database (2001-2011), we identified patients with DM who experienced an initial diabetes-related complication. A paired t-test was used to compare average HbA1c levels before the initial complication was first diagnosed to average HbA1c levels following the diagnosis of the complication.

Results: 518 enrollees met study inclusion criteria. Patients with suboptimally controlled DM (defined as HbA1c>7% (53 mmol/mol)) prior to the diagnosis of their first diabetic complication demonstrated a clinically significant reduction in average HbA1c following the diagnosis of their first complication (mean pre-complication HbA1c=8.5 ± 1.5% (69 ± 17 mmol/mol) vs. mean post-complication HbA1c=7.9 ± 1.7% (63 ± 18 mmol/mol) (p<0.0001)).

Conclusion: Enrollees with suboptimally controlled DM may achieve better glycemic control following the diagnosis of a complication from DM. The results from this study, if confirmed in prospective studies, may provide a rationale for the earlier detection of complications from DM to facilitate improved glycemic control among patients with DM.

Keywords: Change in hemoglobin A(1c); Diabetes mellitus; Diabetic retinopathy; First complication; Glycemic control.